This thesis entitled: The decentralization process trends for the treatment of people living with HIV/AIDS in the city of Rio de Janeiro, proposes an analysis of the decentralization process for the treatment of people that live with HIV/AIDS in the city of Rio de Janeiro/RJ, as a way to clarify how the current configuration of the treatment of the person who has HIV/AIDS takes place in this attendance model. Currently, there is the decentralization of HIV/AIDS assistance to basic health attention as a redefinition of its care line. We present the HIV/AIDS trajectory in Brazil, we contextualize the health policy in the country, we debate the decentralization for the treatment of people living with HIV/AIDS in the city of Rio de Janeiro, we discuss about the Basic Health Units as treatment places for the HIV/AIDS and we present data from field research, revealing the trends and the decentralization process limits of HIV/AIDS treatment in the city. We also identified how this process takes place for users, doctors and managers of health units. Campany et al. (2021, p. 376) explain the recent trends presented by the HIV epidemic in Brazil – heterosexualization, feminization, juvenilization, impoverishment and interiorization (in relation to Brazilian regions). These trends are articulated with issues of class, gender and race, connecting with the complexification of the social issue in Brazil. It was a qualitative approach research. We used the semi-structured interview (in loco) to collect data from the professionals, users and managers. We contextualize and situate the HIV/AIDS care policy and how it has been working in a way to attend the demands of its patients. We present a characterization of these users, identifying who are the users of the service and in which conditions they live. As results, we identified that the most part of users, managers and doctors do not find great difficulties in the operationalization and experience of the Service Policy. The big issue revolved around the need for confidentiality of the diagnosis, for the social preservation of the user and the loneliness resulting from it, which makes it difficult to live with HIV/AIDS. The silencing of the diagnosis requires the care team to make arrangements and alternative paths within the service to guarantee access to health, in view of the secrecy of the patient s diagnosis, including for some health professionals within the unit itself. The central hypothesis developed in this thesis consisted of identifying the confidentiality of the diagnosis as a contradictory need, resulting from the persistent prejudice around AIDS, which, despite having evolved in the aspects of prevention and treatment, is still loaded with negativity. The main problem with this is the embarrassment and, in a way, the social imposition by silence that prevents the human being living with HIV/AIDS from being who they are, abdicating this right that should be simple. It is an alienated way of living.