PrEP.App

The prevention of sexually transmitted diseases in the world has a gap in information and assistance. This is even greater in the context of LatAm and theirs LGBT+ communities, we aim to solve this issue by starting with a more specific problem within STI prevention: the HIV prevention and the use of PrEP in Brazil.

In Brazil, the use of PrEP has been possible through the public health system since its implementation in 2017, however, only with the accentuate growth in demand for this prevention and with the great dissatisfaction of customers with the public system, it was made more flexible laws to be prescribed and sold in the private sector. 

Among the main problems in the public system, it is possible to highlight in the client perspective:

• Struggle to find a doctor with the expertise to prescribe PrEP.

• Wait for approximately 9 months in the public health system queue (waiting list) for the first PrEP appointment.

• Visit an HIV treatment center and wait for hours (it varies, but usually 4-6 hours) to get your pills every month.

• Feel they are exposing their sexual intimacy and preferences every time they go to the HIV center and, many times, not having adequate treatment due to prejudice and lack of professionalism of doctors in the public sector.

The main affected population is the gays, bissexuals, transgender groups in Brazil, totaling 7 million people.

If we consider the CDC guidelines for PrEP (here), the number of people recommended to take PrEP is around 127.5 million people in Brazil.

Our solution is a mobile application capable of bringing together and facilitating the entire PrEP (HIV prophylaxis) treatment process.

In the app it is possible to ask question about HIV and STIs for specialists; schedule and carry out medical teleconsultations; get indications and prescriptions for necessary tests to be realized; order and receive medications and self-tests at home.

The demo of our solution (first version) can be seen here.

The idea is to further expand the features included in the app, providing more support to customers and further automating PrEP treatment process. In a short term, as an example, it is possible to cite: Computer vision for reading and inserting patient information; automatic document generation (mainly for prescriptions and reports); AI chatbot to help users with their medical queries; emergency care with specialized doctors.

In a medium term, we want to incorporate other STI prevention methods of other infections in a more structured way; develop partnerships with other organizations to further encourage and facilitate the prevention of STIs; and create our own physical exam centers.

Our main goal is to be able to deliver a good quality prevention against STI to anyone who wants/needs it. 

The solution serves for anyone who is within the recommendations for using PrEP (CDC Guidelines), but it essentially impacts 2 disadvantaged groups: the LGBT+ community and the economically disadvantaged classes.

The LGBT+ community is the largest group of users and they are the main  interested/recommended class in preventing form HIV. Therefore, this minority will directly be positively impacted by implementing our program.

The economically disadvantaged class (in this context also composed of the transsexual and transvestite group in Brazil) currently suffers from the lack of free resources in the public sector and they also cannot afford the high costs for specialized service. Our goal is to work together with the government, offering a much lower cost to the service be affordable for a medium class and, mainly, reducing the number of current users of the public service that is able to pay for this service and increasing the possibility of people who have no condition to pay for the service can enter the PrEP program in the country.*

* As in the past (until 2021), it was only possible to make the PrEP through the public sector, currently in Brazil, 90% of PrEP users in the public sector have private health insurance and are from the upper class of the country (class A). That is, the public system is overwhelmed, because people who could pay for the service are using and those who really need the service 100% free does not have the conditions to start the PrEP treatment. 

Andre and Matheus are from the LGBT+ community and they have experienced the problems that users have suffered and suffer to achieve PrEP treatment in Brazil. In addition to listening to the same problems in the social cycles in which they live, Matheus is a doctor and he has always tried to support his friends in the treatment of PrEP. Therefore, he became even more involved in the legislation and the context that Brazil went to release PrEP privately in the country.

Since MVP's launch, Matheus and Andre have worked prioritizing users' feedback in order to improve the product and serve customers. We don't just create formulants to receive feedbacks, as we try to contact via WhatsApp to ask for the opinion of our customers.

Due to the context of our problem and the complaints that were heard about privacy, delay in the process and lack of professionalism. The design of our solution tries to optimize the time spent by our users in order to give the best medical service quality safely and confidentially.

At the moment, our solution currently serves 104 recurrent users.

In addition to financial resources, the Solve team's technical know-how for our company's scalability would be extremely relevant. Unfortunately our current profit is almost nil and it is being very difficult to grow the company without traction and a solid strategy.

Furthermore, join Solve's network of contacts could help to find partnerships/mentorships/connections in order to reduce the cost of our products and services offered, in addition to decrease the barrier to internationalization of our solution, given cultural and legislative differences.

In Brazil, due to legislations, the context of PrEP was not possible to be done in a private way. Gradually some laws were changing, allowing some private doctors to perform consultations and prescribe the medications privately, however, no one still tried to listen to the costumers needs and claims, bringing the whole process efficiently and in an online version.

The attempt to break the social taboo to talk about sex and prevent the diseases that it may be related is the problems we are impacting. We want to bring to the market a well-known brand where people can talk openly about sex and relate it to prevention, health and information.

Currently, the two full-time members of the company are from the LGBT+ community, however cisgender. Although the MSM community is disadvantaged in the context in which we created this solution, we believe in the urgent need to include transgender people within the creation of our product and in the Brazilian job market in general.

We aim to have more people in our team (when it is financially possible) and that they empathize and represent even more with the problems of the minorities that are our clients. 

We plan to open vacancies exclusively for transgender people in our company (in sectors such as marketing, sales, finance and medicine), unfortunately we do not have them yet because we have not hired any individual for a vacancy, only outsourced services.

We are a company made by minorities and for minorities, where diversity, equity and inclusion are fundamental principles of our company.

Our business model is to prescribe and deliver PrEP medicines. We are a telehealth platform where our doctor can follow-up eligible patients who want to take PrEP. Our recurring revenue comes from providing telehealth appointments, STD's self tests and PrEP refill monthly. In Brazil, the mainly social impacts of prep.app are:

• Support LGBTQIA+ and sexual workers to have easy access to PrEP.

• Decrease the waiting list time to start PrEP in the public system in Brazil by offering a solution in the private system and convincing patients who currently take prep and have health insurance (almost 90% from the current patients take prep) to migrate from a public to our private service. 

• Serve on an online basis the current youth population among ones the numbers of HIV incidence keep increasing.

Currently our key customers are MSM (men who have sex with men) who want an easy and affordable way to start and do their follow-ups on PrEP. A safe and privacy way to talk about sex.

Our business is slightly profitable, so external investment would allow us to scale-up and, consequently, increase our margin. So far we have generated R$ 12.620,00 (U$2400.00) revenue. We are currently fundraising our seed and we plan to give 15% equity for R$8mi (around U$1.5mi). According to our business model we may break-even in two years, when we plan to raise our series A funding round in order to offer another STD`s solutions for our patients.

In Brazil, most people who take PrEP in the public system have health insurance. It happens because until 2021 it was not allowed for the private system to prescribe and work with PrEP. The currently waiting list to start prep at the public system is 9 months. We measure 2 indicators around health equality (goal 10): 

1- Timing for the waiting list for PrEP in the public system.

2- Number of new clients who changed from the public to the private system.

Our goal is to allow the public system to achieve the most vulnerable communities while we concentrate those with health insurance at PrEP.