Sexual health through Brazil's SUS: STI tests, PEP and PrEP for lifestyle couples

Couples in the swinging lifestyle often talk a lot about limits and house rules, but not always about the most practical part: how to look after sexual health regularly and without embarrassment. In Brazil, much of that care is available free through the Unified Health System (SUS). This guide summarises what the Ministry of Health says on its official pages (consulted on 7 November 2026) and suggests a simple routine for couples. It is general information and does not replace a consultation with a health professional, who should assess your own case. If you live in Portugal or are travelling there, consult the Serviço Nacional de Saúde, which has its own rules.

1. Talking about sexual health is part of the agreement

Just as you agree what is allowed and what is not, it helps to agree on care: how often each of you gets tested, what you tell your partner after a night out of the routine, and what to do if a condom breaks or was not used. That conversation is lighter when it happens beforehand and calmly than in the middle of a scare. If you are still learning to talk about limits, our guides on consent and on talking after a lifestyle night are a good starting point.

2. Condoms: free and simple

The Ministry of Health says condoms are distributed free of charge at any public health service. The page's basic guidance is direct: do not reuse a condom and do not use two at the same time. To find where to pick them up, it points to Disque Saúde on 136. Condoms remain the foundation of combination prevention, together with regular testing and, when indicated, the prophylaxis described below.

3. Free, rapid tests

According to the Ministry of Health, the SUS offers free tests for HIV, syphilis and hepatitis B and C, and rapid tests give results in 30 minutes at most. In material on post-exposure prophylaxis, the ministry states that these tests are done at public units and at Testing and Counselling Centres (CTA). The clinical protocol recommends investigating syphilis in everyone with risky sexual exposure, preferably starting with a rapid treponemal test, and assessing possible acute hepatitis A, B and C infection after risky exposure to HIV and other STIs.

In practice, that suggests a possible routine: agree a frequency with a health professional (for example, every few months or after risk situations), go together or separately, and keep results somewhere private. The ideal interval and which tests to repeat depend on your case and are for the professional to decide; there is no calendar that fits everyone.

4. PEP: prophylaxis after a risk situation

PEP (post-exposure prophylaxis against HIV) is the use of antiretroviral medicines after a risk situation, such as sex without a condom or with a broken condom. The Ministry highlights three points:

• Time is decisive: it must start as soon as possible, at most within 72 hours of exposure. After that, the national protocol does not recommend it.
• It lasts 28 days and requires follow-up by the health team and tests, including after that period.
• It is offered free of charge by the SUS.

For hepatitis B, the page says the vaccine is available at Basic Health Units with a vaccination room and that anti-hepatitis B immunoglobulin is obtained at a CRIE, with a referral. The practical rule is simple: if there was a risk situation, go to a health service at once, without waiting to "see if a symptom appears" and without blaming yourselves. Note the nearest emergency service to your home and, when travelling, to your hotel.

5. PrEP: prevention before exposure

The Ministry of Health describes PrEP (pre-exposure prophylaxis) as the use of antiretrovirals before exposure to reduce the risk of HIV infection. The PEP protocol notes that people with an indication for PEP may be future candidates for PrEP. Eligibility rules and access are set by the SUS and may change, so the right step is to ask at a health unit or CTA whether PrEP is indicated for you. PrEP protects against HIV, not against other infections, so it does not replace condoms or testing.

6. Vaccines

On vaccines, what the pages consulted confirm is the hepatitis B vaccine at Basic Health Units. The availability of other vaccines, such as HPV, and who is entitled to them changes with the official schedule; ask your health unit which vaccines are recommended for you and which you already have up to date.

7. A simple routine for the couple

1. Talk about testing before you start going to parties or clubs, and periodically afterwards.
2. Carry condoms, including when travelling, and neither reuse them nor use two at once.
3. Decide the plan for the unexpected: who goes to the health service, which one is nearest, and that PEP must start within 72 hours at most.
4. Protect privacy: results are health data, and sharing them with third parties requires consent.
5. Go back to a health professional whenever there are symptoms, doubts or changes in the couple's routine.

Sources consulted on 7 November 2026

• Brazil's Ministry of Health (gov.br): Prevenção, aids e HIV
• Brazil's Ministry of Health (gov.br): PEP, Profilaxia Pós-Exposição ao HIV
• Brazil's Ministry of Health (gov.br): Profilaxia Pós-Exposição