“Sexual and Gender Minorities” (SGM) comprise the social group whose sexual orientation, gender identity, and/or reproductive development diverge from hegemonic social norms. This group faces disproportionate levels of psychological distress, often worsened by historical exclusion from public health policies. Pre-Exposure Prophylaxis (PrEP) has been established as an effective strategy for preventing Human Immunodeficiency Virus (HIV) infection, offered through the Brazilian Unified Health System (SUS) since 2017, initially prioritizing SGM as a key population. However, its subjective impact remains insufficiently studied. This study aims to evaluate variations in self-reported feelings of guilt before and after initiating Oral PrEP in a capital city of Northeastern Brazil.

This is an observational cross-sectional study based on a proprietary questionnaire administered to users of a Specialized Care Service (SAE-HIV/AIDS). The sample included 41 participants aged 18 years or older, belonging to SGM and registered as active PrEP users. Incorrectly or incompletely answered questionnaires were excluded. Data were organized in Excel, and McNemar’s Test (Python – v3.13.3) was applied to assess significant changes in self-reported feelings of guilt before and after PrEP initiation. The study was approved by the Research Ethics Committee (CAAE 83245924.0.0000.5641).

The prevalence of guilt related to sexual experiences among participants was 51% (21 individuals) prior to the use of the prophylactic strategy, decreasing significantly to 15% (6 individuals) after medication initiation. Statistically, there was a highly significant reduction in self-reported guilt in the population studied, with p = 0.0003.

Therefore, we conclude that the statistically significant reduction in self-reported guilt associated with PrEP use among SGM indicates a positive subjective impact of the medication on the psychosocial well-being of this population.