“It’s a drug you take every day and it helps prevent HIV infection. Well done, pretty little. ” It is thus, in a relaxed way, that artificial intelligence Amanda Selfie explains to the Facebook user about HIV Pre-exposure Prophylaxis, the so-called PrEP. The first transvestite robot in Brazil, as it likes to introduce itself, is a communication strategy used by the project team PrEP 15-19, which aims to prevent HIV virus among gay adolescents, men who have sex with men ( MSM), transvestites and transsexual women between the ages of 15 and 19, in the cities of Salvador, Belo Horizonte and São Paulo.
In the state of Bahia, the project was named PrEPara Salvador and operates in the “Casarão da Diversidade”, located in Pelourinho, the historical center of the city. The study is funded by Unitaid, an international organization that invests in innovations to prevent, diagnose and treat HIV / AIDS, as well as other health actions. It is the first study in Latin America that seeks to demonstrate the effectiveness of PrEP among adolescents and young people.
Since 2018, prophylaxis is available free of charge by SUS for those over 18 years of age. “We already know PrEP is effective for adults. Their protection for HIV, according to research, reaches 98% if used properly, that is, if there is adherence to the daily intake of the tablet, “says Inês Dourado, a professor at the Institute of Collective Health of UFBA, which leads the project here in Salvador, in addition to being the representative of the three cities before the funding agency Unitaid and the World Health Organization (WHO). The study is also coordinated in the city by Professors Laio Magno, from the State University of Bahia (Uneb), Luís Augusto da Silva, from the Institute of Humanities, Arts and Sciences Professor Milton Santos (IHAC / UFBA), and Marcelo Castellanos, also from the ISC / UFBA.
HIV in numbers
In recent years, the HIV virus epidemic has put obstacles in the way of AIDS control in Brazil, and challenges researchers to design studies that seek increasingly effective prevention strategies. According to the Secretariat of Health of the State of Bahia (Sesab), 2,714 cases of HIV were diagnosed in Bahia in 2018. Of these, about 41% in Salvador alone (404 cases).
And while on the one hand there is a considerable drop in the number of AIDS deaths in the country, achieved through increasingly effective treatments, there is a growing nationwide HIV infection among the young. Data from the Ministry of Health show that the number of people living with HIV has jumped more than 700% in 10 years (2007-2017) among individuals aged 15 and 24.
The risk is also higher in certain key populations for the epidemic, such as men who have sex with men (MSM), transvestites and transgender women, as well as sex workers and people who use drugs because of vulnerability contexts. It is based on this scenario that the project intends to act. “Our challenge is to reach and recruit young people who represent the city of Salvador in all its diversity, not only sexual but also socioeconomic,” explains Inês Dourado.
One tablet only
Since April this year, when it began to work in Salvador, the project has already achieved the adhesion of 40 young people. The goal of the study is to reach 400 participants in the city in two years. To ensure prevention, they need to take one tablet consisting of two antiretrovirals: tenofovir + emtricitabine daily. This combination of drugs, approved in the United States in 2004, was already used in the treatment of HIV virus for infected individuals. In 2012, the US Food and Drug Administration (FDA) announced that it has also been approved as a preventive pill for people who are not infected, that is, as Pre-exposure Prophylaxis (PrEP).
But before starting to use the drug, project participants need to meet a number of criteria. First, young people aged 15 to 19 should be among one of the key populations: gays, men who have sex with men (MSM), transvestites and transsexual women. In addition, you must have a history of unprotected intercourse (without a condom) in the last six months, have had repeated use of PEP (Prophylaxis after Exposure to HIV) due to sexual exposure or have been diagnosed with any sexually transmitted infection ), other than HIV, also in the last six months. “To use PrEP, one has to be HIV negative,” says the coordinator.
A psychosocial questionnaire, nursing consultation, physical and laboratory tests, HIV testing and medical evaluation are available to learn, for example, if they suffer from any type of renal, hepatic, or spontaneous fracture. “These two antiretrovirals, in a single pill, have very few side effects. The most common are abdominal discomforts and, more rarely, renal and bone involvement. When this happens, we stop using the drug and the person returns to normal. ”
Despite the focus on controlling the HIV epidemic with PrEP, the project has obtained important results for the diagnosis and treatment of other infections, such as syphilis and bacterial infections, among participants. Coordinator Inês Dourado highlights the incentive to use the road as part of this activity. “The strategy is to increase forms of protection from sexually transmitted infections, showing that there are possibilities beyond the condom, which can be combined in different ways and in different contexts,” he adds.
The first interviewee of this report would never agree to participate if there was not an exclusive block just for her. It was created by researchers from USP, UFBA, UFMG and Uneb to interact with Facebook netizens, who seek to clarify doubts about the project and also on various issues related to sexual behavior.
“This initiative is a lusho, neah?!”, says Amanda Selfie in our first contact before the story. In addition to being irreverent, the language used is essentially pajuba, a dialect made up of words and expressions from Western African languages widely used by the LGBT community. At the same time as the conversation, artificial intelligence feeds the study with the data collected, if the Internet user authorizes.
In addition to Amanda, the project makes use of various communication tools to reach the target audience of the study. The disclosure happens at city parties, dating applications and, of course, on social networks. “We know that young people today are constantly using these social media. So all the work is done in this sense, “explains Professor Inês Dourado.
And if you want to know more about the study, or even participate in the recruitment, just go to the profile of Instagram (@preparasalvador) or by phone / WhatsApp (71) 99640-9030. You can also chat with the project host on Facebook or the Messenger application on the phone. Simply put “Amanda Selfie” in the search that profile appears on time. It’s virtual, but the information it shares makes all the difference to who’s on the other side of the screen.