Brazil has been home to new and innovative ways to spread awareness of sexual health issues and to promote safe sex practices, Parker said. In one case, the Brazilian Interdisciplinary AIDS Association produced a pamphlet that contained a series of three erotic stories that put a positive light on condom use – without mentioning HIV or AIDS. The approach was “more shocking than anything produced in the U.S.,” Parker said.

In 2002, Brazil’s Health Ministry recruited sex workers as “partners” in the fight against HIV. A series of posters, leaflets and stickers depicted the cartoon character “Maria Without Shame,” who promoted a positive view of women in the sex industry. The advertisements proclaimed, “You need have no shame, girl. You have a profession.”

According to a 2010 U.N. report, 47 percent of female sex workers in Brazil were receiving assistance from an AIDS prevention program in 2009.

Despite the near-universal access to medication and aggressive approaches to prevention, activists’ fears haven’t abated.

“We have a kind of silence with what is happening with health in Brazil,” Terto said. “We don’t like to admit our mistakes.”

Cabral said that despite these fears, she hadn’t seen any negative impacts on AIDS treatments at her hospital, and that other diseases often saw their public funding fluctuate. From her perspective, the focus should shift toward lessening the stigma associated with AIDS.

“It is essential that there is progress against prejudice,” Cabral said. “I think it will continue to get better.”