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By Solana Pyne
Fernanda Lorrane stands on a dark corner in Lapa, a neighborhood of Rio de Janeiro known for its nightlife. Lorrane wears skin-tight pink pants, stilettos, and a sheer white shirt that leaves cleavage and midriff bare.
“I work as a sex professional,” said Lorrane, who is biologically male but identifies herself as female. She explained she’s been coming to Lapa every night for fifteen months, since she left home after clashing with her father.
“He didn’t accept me the way I was, so the only option I had was this,” she said.
Sex work puts Lorrane on the front lines of Brazil’s battle with HIV. Transvestite sex workers have one of the highest rates of infection in the country. But a study released last week suggests there’s a drug that could make them safer.
The study—conducted in six countries, including Brazil — found that a drug currently used to treat HIV can help prevent HIV in men who have sex with men.
The drug goes by the brand name Truvada. Men in the study who took Truvada daily saw more than a 90-percent reduction in their risk of catching the virus.
“The more the volunteers stuck with taking the medicine, the more effective it was,” said Dr. Valdilea Veloso, director of the Evandro Chagas Institute of Clinical Research in Rio. She helped conduct the study.
Some scientists have called the new research a “breakthrough” discovery because it provides gay men — and perhaps others — with a new way to protect themselves from HIV.
But Brazilian sex workers won’t have the option of taking Truvada anytime soon.
“It’s still too early,” Veloso said.
For one thing, Truvada isn’t for sale in Brazil, even as a treatment for HIV. The drug is awaiting government approval.
If and when the drug is approved, doctors say they will want to be cautious before putting uninfected people on it. They say more studies are needed to see if long-term use causes serious side effects or might cause the AIDS virus to become drug resistant.
And even if the drug clears these hurdles, Truvada will likely only be recommended for prevention in a small group of people.
“Probably there’s going to be a niche for people that are [at] greater risk, like people who cannot negotiate the use of condoms,” said Dirceu Greco, director of the department of sexually transmitted diseases at Brazil’s Ministry of Health.
Greco fears that some people might use the drug as an excuse to stop using condoms. That, he says, could put individuals at greater risk of diseases like gonorrhea, hepatitis, and syphilis.
But Greco says if Truvada is shown to be safe and effective for HIV prevention, the government will consider providing it for free.
Meanwhile, on the streets of Rio, some of the people who might benefit most seem confused about what the new study means for them.
A transvestite prostitute named Carol said she’s heard of the study but doesn’t believe it — any more than she believes other things she hears on the street.
“There are a lot of people saying that there’s already a cure for AIDS,” she said. “I doubt it.”
But if a pill that could prevent HIV ever hit the streets, Carol said there’s no question what she would do.
“I would take it. Absolutely, without a doubt, I would take it.”
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