BACKGROUND:
Tuberculosis is strongly shaped by social determinants of health, and social protection measures play a critical role in supporting treatment adherence and successful outcomes.(1) Despite the availability of free diagnosis and treatment in Brazil, socially vulnerable populations may experience barriers to accessing social benefits and public assistance.(2) Understanding these gaps is essential to inform intersectoral responses to TB.

METHODS:
This descriptive, cross-sectional and exploratory study included 26 individuals undergoing tuberculosis treatment in São Paulo State, Brazil. Data were collected using a structured electronic form (REDCap)(3) and covered sociodemographic characteristics, employment status, income, and access to social protection programs, including Bolsa Família, Continuous Cash Benefit (BPC), and registration in Social Assistance Reference Centers (CRAS).

RESULTS:
Participants exhibited high levels of social vulnerability. Most had low educational attainment, with 61.5% completing no more than primary education. Unemployment affected 38.5% of participants, while 15.4% were engaged in informal work. Approximately one-third reported a family income below one minimum wage, and 30% had no regular source of income. Access to social protection was limited: only 42.3% reported receiving social assistance benefits, and 53.8% were registered with CRAS.

CONCLUSIONS:
The study highlights significant gaps in social protection among people undergoing tuberculosis treatment, even within a setting with established health services. These vulnerabilities may compromise treatment adherence and outcomes. Strengthening coordination between health and social assistance sectors is crucial to ensure comprehensive support for socially vulnerable populations affected by tuberculosis.