tin-roofed brothel for the day, the 42-year-old Dominican
prostitute journeys to the capital for an injection that
might save not only her life but possibly millions
more around the world.
Adams Fernandez, a mother of three, is one of 175 Dominican
prostitutes lending their bodies to a trial of what New
Jersey-based Merck & Co. hopes will prove
to be a vaccine against the virus that causes AIDS.
Since turning to
prostitution after a divorce 13 years ago, Adams has
seen friends and coworkers die from the disease.
Prostitution is illegal but widespread here, largely
ignored by the authorities.
''It's rare for
anyone who lives here not to know AIDS and what it can
do,'' said Adams, a heavyset woman dressed for work in a
tight-fitting yellow dress and bright red lipstick.
AIDS is the
leading killer of people aged 15 to 44 in the Caribbean,
claiming 24,000 lives in 2005, a rate second only to that of
sub-Saharan Africa. And according to the United
Nations, nearly three quarters of those infected live
on the island of Hispaniola, which the Dominican
Republic shares with Haiti.
At least 70,000
of the Dominican Republic's 9 million people are
HIV-positive, and discrimination discourages many from
seeking testing or treatment. Among prostitutes, about
3.6% are infected, although researchers report rates
as high as 12% in some areas.
who will spend much of the next four years traveling to
Santo Domingo for injections and checkups, were recruited
from brothels across the country. They are among some
3,000 people in eight countries testing the
experimental vaccine--a combination of deactivated
cold viruses and synthetically produced HIV genes
meant to train the body to destroy infected cells.
risks will take years to discover, but once doctors
explained there was no way to contract the disease from the
vaccine, they found plenty of volunteers at Adams's
brothel in Las Guaranas, a town of dirt streets and
low-slung houses surrounded by rice fields about 75
miles north of Santo Domingo.
Many were turned
away because of pregnancy, conditions like high blood
pressure, or because they are already infected.
don't know whether they are getting the drug or a placebo.
Even if the results are promising, a vaccine would be
several years away from reaching the market.
The program pays
the women's meals, transportation, and $30 for a lost
day's work. A handful have dropped out, and the clinic
provides health training and occasional gifts like
bags of cosmetics to keep others from losing interest.
three injections over their first seven months in the
study and then must keep reporting back for four years of
For many, the
greatest reward is pride.
''We are doing it
for the world,'' said 38-year-old Lucila Mendoza
The other test
sites--Haiti, United States, Australia, Brazil,
Canada, Jamaica, and Peru--all have the same
strain of HIV, said Merck spokeswoman Janet Skidmore.
The strain is also found in Europe, meaning a formula
that works in the Dominican Republic could find a
lucrative global market. A trial was launched Thursday
in South Africa to see if the vaccine would have any
effect on African strains.
The Merck trial,
currently in the second of three testing phases--each
of which is to last several years--is one of 17
sponsored by the HIV Vaccine Trials Network, a
Seattle-based group supported by the U.S. government.
The trial is ''is
an extremely important step, but not the only one,''
said Jorge Flores, chief of vaccine research for the AIDS
division at the U.S. National Institute of Allergy and
Infectious Diseases. He stressed the importance of
education and research into other strategies, like
microbicides in vaginal gels.
Even a vaccine
that reduces the level of HIV in future infections would
be a victory.
''A 90%, 80%
reduction is going to be acceptable for the time being,''
said Ellen Koenig, who heads one of two Santo Domingo
clinics testing the formula.
de los Santos, 24, said she volunteered after her
brother and sister-in-law died of AIDS complications.
''I am worried
about my health,'' she said.
Adams's brothel insists on more familiar
methods--condoms and frequent testing for HIV.
And if a client
refuses to use protection? ''We kick him out,'' Adams
says with a laugh. (AP)
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