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The purpose of this paper is to describe six recovery-oriented peer support experiences and strategies implemented in different regions of Brazil in the past 12 years, and explore challenges to their development and potential for empowerment and citizenship.

In this paper, a group of stakeholders in mental health services involving people with lived experience of severe mental illness describe their experiences with services of peer support. These were all conducted in Brazil and in partnership with the International Recovery and Citizenship Collective (IRCC) and The Yale Program for Recovery and Community Health. The authors met monthly to exchange experiences, studies and practices, and six experiences were selected, described, analyzed and compared. A discussion of these experiences, their challenges, impact and potential followed.

The explored experiences emphasize that peer support, lived experience leadership and advocacy are feasible in the Brazilian mental health system and can help advance the Brazilian Psychiatric Reform.

This paper is limited to the experience of researchers already engaged in peer support work in six cities in Brazil. Although they represent several different regions in Brazil, there are areas it has not reached. Further research should address and provide a broader view of peer support and recovery strategies spreading in the country.

These experiences demonstrate the feasibility and acceptability of the recovering citizenship approach to reduce stigma, promote empowerment, autonomy, activism and advocacy, and increase a sense of belonging for those in recovery and marginalized by society. The Brazilian psychiatric reform can benefit from including peer supporters as mental health treatment providers.

This paper provides a novel view of the state of the art of peer support initiatives in Brazil and can inspire individuals, government and communities as they see and understand the breadth, depth and meanings of these peer support experiences.

This study aims to estimate the overall SARS-CoV-2 seroprevalence and evaluate the accuracy of an antibody rapid test compared to a reference serological assay during a COVID-19 outbreak in a prison complex housing over 13,000 prisoners in Brasília.

The authors obtained a randomized, stratified representative sample of each prison unit and conducted a repeated serosurvey among prisoners between June and July 2020, using a lateral-flow immunochromatographic assay (LFIA). Samples were also retested using a chemiluminescence enzyme immunoassay (CLIA) to compare SARS-CoV-2 seroprevalence and 21-days incidence, as well as to estimate the overall infection fatality rate (IFR) and determine the diagnostic accuracy of the LFIA test.

This study identified 485 eligible individuals and enrolled 460 participants. Baseline and 21-days follow-up seroprevalence were estimated at 52.0% (95% CI 44.9–59.0) and 56.7% (95% CI 48.2–65.3) with LFIA; and 80.7% (95% CI 74.1–87.3) and 81.1% (95% CI 74.4–87.8) with CLIA, with an overall IFR of 0.02%. There were 78.2% (95% CI 66.7–89.7) symptomatic individuals among the positive cases. Sensitivity and specificity of LFIA were estimated at 43.4% and 83.3% for IgM; 46.5% and 91.5% for IgG; and 59.1% and 77.3% for combined tests.

The authors found high seroprevalence of anti-SARS-CoV-2 antibodies within the prison complex. The occurrence of asymptomatic infection highlights the importance of periodic mass testing in addition to case-finding of symptomatic individuals; however, the field performance of LFIA tests should be validated. This study recommends that vaccination strategies consider the inclusion of prisoners and prison staff in priority groups.