World
Mexicans with HIV/AIDS struggle with treatment access
Government in 2019 created new health care entity
Roberto Navarro has been a dancer since he was 17. Jazz became his passion and he fell in love with classical dancing after he took many classes. And he began to teach four years later.
“I’m so happy when I teach dancing to my girls because they bring me so much joy, I feel like I help my girls to become better women, without noticing I’m some kind of a therapist,” Navarro told the Washington Blade.
He discovered the discipline of dancing in heels in 2014, which made him connect and explore more with his sexuality. He did, however, suffer a lot of bullying because of it.
Navarro — a 33-year-old gay man who is originally from Sahuayo de Morelos in Michoacán state — currently owns a dance salon. Navarro said he started to become an entrepreneur, but it hasn’t been easy because of the pandemic.
He was diagnosed with HIV in 2016. Navarro suffered from depression for several months after he learned his status.
“I woke up very overwhelmed in the morning thinking that I had to go to the hospital to make a long line of patients; to have blood drawn for fast screening tests,” he said. “We arrived at 7 in the morning and left until 1 in the afternoon.”
Navarro has been receiving treatment for almost five years, and he is still dancing.
“Subsequently, I went to my consultations every three or six months depending on my results,” he stated. “By the third month I was undetectable.”
Navarro started with Atripla, an antiretroviral drug he received through Mexico’s Seguro Popular, and he was undetectable a month later.
A shortage of Atripla forced a change to Biktarby after President Andrés Manuel López Obrador in 2019 scrapped Seguro Popular and created the Health Institute for Wellbeing (INSABI). The pharmaceutical company Gilead has said there are many counterfeit versions of the drug on the market.
Seguro Popular in 2018 had almost 52 million beneficiaries. The National Council for the Evaluation of Social Development Policy (CONEVAL) said INSABI at the end of 2020 had more than 34 million beneficiaries.
Antiretroviral drugs have been available in Mexico since 2003, although the Mexican health system is divided into various subsystems based on where one works.
- Institute of Social Security and Services for State Workers (ISSSTE)
- Mexican Institute of Social Security (IMS)
- INSABI (Health Institute for Wellbeing) that was previously known as the Seguro Popular
They vary in the time it takes to receive medication and the time for CD4 viral load tests. The availability of appointments with infectious disease specialists varies in each of the three public health systems.
People with INSABI will take longer to get tests and have access to doctors. It must also be recognized that everyone, in theory, has the possibility of accessing medicines, but it also depends on the states in which they live.

From Seguro Popular to INSABI
The number of people without access to healthcare in Mexico rose from 20 million to almost 36 million between 2018-2020. INSABI, more than a year after its creation, still does not completely cover the same amount as its predecessor.
INSABI is an independent agency through the Ministry of Health that aims to “provide and ensure the free provision of health services, medicines and other inputs associated with people without social security.” The General Health Law says it was to replace Seguro Popular, which was in place from 2004-2019.
“The situation for treatment right now, it’s quite complex, particularly because there have been many changes in the health department of Mexico, and this has to do with the fact that in 2003 when the Seguro Popular was established; there was an increase to comprehensive care for people living with HIV and resources for prevention strategies which are mainly handled through civil society organizations that obtained money from the government.” stated Ricardo Baruch, who has worked at the International Family Planning Federation for almost 15 years.
López,, who took office in 2018, sought to eliminate Seguro Popular, which was the mechanism by which access to antiretroviral drugs were given to most people living with HIV in the states with greater vulnerability. This change was done in theory to expand access for everyone, but the opposite happened.
There is less access due to the modification of purchasing mechanisms and a huge shortage throughout the country. Baruch says this situation has caused a treatment crisis across Mexico.
“The truth is that the Seguro Popular helped me a lot to have my treatments on time, what I do not like is that there is not enough staff to attend all the patients that we are waiting for our consultations,” said Erick Vasquez, a person who learned in February he is living with HIV.
Vasquez, 34, is an artist who works in Guadalajara and Playa del Carmen.
Vasquez did not have health insurance like other people through IMS. He obtained access to Seguro Popular through an organization that supports people with HIV, but he has to wait until October for his first appointment.
Vasquez, who has a very low viral load, in March began a job through which he obtained IMS. He had access to his treatments through it.
He received three months worth of Biktarvy at the end of June; one prescription for each month. He said the drug is not difficult to obtain.
“I have not had any problem with the medication, it is not difficult to get it when you are on the insurance, but there is still a long time left until October,” said Vasquez.
The cost of the antiretroviral treatment in Mexico is approximately $650 per month, and one bottle has only 30 pills.
“I have not had side effects, I have not had nausea, I don’t vomit, I take a pill daily, it is one every 24 hours,” Vasquez said. “I feel very well and I hope very soon to be undetectable.”

Infrastructure over health
Prevention resources were eliminated, and health resources today are used to finance the Felipe Ángeles International Airport at the Santa Lucía military base in Zumpango in Mexico state, a new refinery, the Mayan train and other major infrastructure projects. And this causes many people who want to access treatment not to receive them. It takes much
The cost of the work, including the land connected with the Mexico City International Airport and various military facilities, is set at 82,136,100,000 Mexican pesos and there are provisions to serve 19.5 million passengers the first year of operations, according to a report from the Secretariat of National Defense (SEDENA).
There are, on the other hand, far fewer HIV tests and this shortage has led to a much higher arrival of late-stage HIV cases and even AIDS in hospitals. This trend is particularly serious among transgender women and men who have sex with men.
“Here in Mexico we concentrate the HIV pandemic, and that we are at a time when this issue of shortages has not stabilized, that there is already more clarity in purchases, but it is well known that all these changes in health systems continue for a year over the years they cause the situation to be increasingly fragile and in the matter of migrants that previously there was certainty so that they could access medicines through the Seguro Popular, now there is a legal limbo for which in some states it depends: on the states, the clinic or social worker; whether or not they give you medications,” said Baruch.
“If you are not a resident or a national here in Mexico, this is a matter won for people in transit seeking political asylum or who had stayed in Mexico,” he added.
Migrants lack access to HIV treatment
Mexico is located between the three regions with the world’s highest rates of HIV: the Caribbean, Central America, and the U.S. This has been used as a foundation for a culture of hatred against migrants, according to Siobhan McManus, a biologist, philosopher, and researcher at the Center for Interdisciplinary Research in Sciences and Humanities of the National Autonomous University of Mexico.
The lack of opportunities, violence and climate change that forces people whose livelihoods depend on agriculture to abandon their homes prompts migration from Central America.
Most migrants — LGBTQ or otherwise — experience violence once they arrive in Mexico.

Chiapas and other states have created an extensive network of clinics known by the Spanish acronym CAPASITS (Centro Ambulatorio para la Prevención y Atención en SIDA e Infecciones de Transmisión Sexual) that are specific HIV and STD units in major towns. They are often within close proximity to most people’s homes.
Sonora and Chihuahua states, which border the U.S., often have such clinics in only one or two cities. This lack of access means people will have to travel up to six hours to access these treatments.
People who have already been receiving treatment for a long time were previously given up to three months of treatment. They now must travel every month to receive their medications because of the shortages.
PrEP available in Mexico
The shortage of medical drugs for people who already live with HIV is a current issue for the Mexican government, but they have made free PrEP available for those who want to prevent themselves from the virus.
Ivan Plascencia, a 24-years old, who lives in Guadalajara, the capital of Jalisco state , has been using PrEP for several years since he became sexually active and he never had any complaints about the medication. Plascencia instead recommends his close friends to take advantage of this prevention drug that is available in one of the CAPASITS where he lives.
Post-pandemic screening tests
There are an estimated 260,000 people in Mexico who are living with HIV. Upwards of 80 percent of them knew their status before the COVID-19 pandemic.
The number of new cases that were detected in 2020 were 60 percent less than the previous year, but this figure does not mean HIV rates have decreased.
In Jalisco, which is one of Mexico’s most populous states with upwards of 8 million people, there was a 40 percent increase in positive cases in 2020 compared to 2019. This increase has put a strain on service providers.
Japan
Japanese Supreme Court to consider marriage equality
Japan only G7 country that does not legally recognize same-sex couples
The Japanese Supreme Court on Wednesday said it will consider six marriage equality lawsuits.
NHK, the country’s public broadcaster, noted all 15 of the court’s justices will consider the case.
Japan is the only G7 country that does not legally recognize same-sex couples, despite several court rulings in recent years that found the denial of marriage benefits to gays and lesbians unconstitutional.
Tokyo High Court Judge Ayumi Higashi last November upheld Japan’s legal definition of a family as a man and a woman and their children.
Prime Minister Sanae Takaichi, who became the country’s first female head of government last October, opposes marriage rights for same-sex couples. She has also reiterated the constitution’s assertion that the family is an institution based around “the equal rights of husband and wife.”
Same-sex couples can legally marry in Taiwan, Nepal, and Thailand.
NHK reported the Supreme Court is expected to issue its ruling in early 2027.
Botswana
Lorato ke Lorato: marriage equality, democracy, and the unfinished work of justice in Botswana
High Court considering marriage equality case
As Botswana prepares for the resumption of a landmark marriage equality case before the High Court on July 14–15, the country finds itself at a critical constitutional crossroads.
At first glance, the matter may appear to be about whether two women, Bonolo Selelelo and Tsholofelo Kumile, can have their love legally recognized. At its core however, this case is about something far more profound: the dismantling of patriarchy, the decolonization of law, and the integrity of Botswana’s constitutional democracy.
Beyond marriage: a question of power
Marriage, as a legal institution, has never been neutral. It has historically functioned as a mechanism for regulating women’s bodies, sexuality, and social roles within a patriarchal order. To deny LBQ (lesbian, bisexual, and queer) women access to marriage is not merely to exclude them from a legal benefit, it is to reinforce a hierarchy of relationships, where heterosexual unions are deemed legitimate and all others invisible. This case therefore challenges the very foundations of who gets to love, who gets to belong, and who gets to be protected under the law.
As feminist scholars have long argued, patriarchy is sustained through institutions that appear ordinary but are deeply political. The law is one such institution. And it is precisely here that this case intervenes: by asking whether Botswana’s legal system will continue to uphold exclusion, or evolve to reflect the constitutional promise of equality.
A constitutional journey: Botswana’s courts and human dignity
This is not the first time Botswana’s courts have been called upon to affirm the dignity of LGBTQI+ persons. Over the past decade, the judiciary has built a progressive body of jurisprudence grounded in equality, nondiscrimination, and human dignity.
In Attorney General v. Rammoge and Others (Court of Appeal Civil Appeal No. CACGB 128-14, 2016), the Court of Appeal upheld the right of LEGABIBO to register as an organization. The court affirmed that:
“The refusal to register the appellant society was not only unlawful, but a violation of the respondents’ fundamental rights to freedom of association.”
This was followed by the ND v. Attorney General of Botswana (MAHGB-000449-15, 2017) case, where the High Court recognized the right of a transgender man to change his gender marker. The court held:
“Gender identity is an integral part of a person’s identity … and any interference with that identity is a violation of dignity.”
In Letsweletse Motshidiemang v. Attorney General (MAHGB-000591-16, 2019), the High Court decriminalized same-sex activity, declaring sections of the Penal Code unconstitutional. Justice Leburu powerfully stated:
“Human dignity is harmed when minority groups are marginalized.”
This decision was affirmed by the Court of Appeal in Attorney General v. Motshidiemang (CACGB-157-19, 2021), where the court emphasized:
“The Constitution is a dynamic instrument … it must be interpreted in a manner that gives effect to the values of dignity, liberty, and equality.”
These cases collectively establish a clear principle: the Constitution of Botswana protects all persons, not just the majority.
The marriage equality case now asks a logical next question: If LGBTQI+ persons are entitled to dignity, identity, and freedom from criminalization, why are their relationships still denied recognition?
Decolonizing the law: What is truly ‘UnAfrican’?
Opponents of marriage equality often argue that homosexuality is “unAfrican.” This claim, while politically powerful, is historically inaccurate. Same-sex relationships and diverse gender identities have existed across African societies long before colonial rule. What is foreign, however, are the laws that criminalize these identities.
Botswana’s anti-sodomy laws were inherited from British colonial legal systems, not from indigenous Tswana culture. As scholars of African history have demonstrated, colonial administrations imposed rigid Victorian moral codes that erased and suppressed existing sexual diversity. To claim that homosexuality is unAfrican, while defending colonial-era laws, is therefore a contradiction.
A truly decolonial approach to the law requires us to ask: Whose morality are we upholding? And whose history are we erasing?
Marriage equality, in this sense, is not a Western imposition: it is part of a broader project of reclaiming African dignity, plurality, and humanity.
Democracy on trial: the question of separation of powers
This case also raises important questions about the health of Botswana’s democracy.
Following the 2021 Court of Appeal decision affirming the decriminalization of same-sex relations, Botswana witnessed public demonstrations, including marches led by groups such as the Evangelical Fellowship of Botswana (EFB), opposing the judgment and calling for the retention of discriminatory laws.
While public participation is a cornerstone of democracy, these events raise deeper concerns about the separation of powers. Courts are constitutionally mandated to interpret the law and protect fundamental rights, even when such decisions are unpopular. When judicial decisions grounded in constitutional principles are publicly resisted on moral or religious grounds, it risks undermining the authority of the courts and the rule of law itself.
Democracy is not simply about majority opinion: it is about the protection of minority rights within a constitutional framework.
Botswana is not a theocracy
It is also important to clarify a recurring misconception: Botswana is not a Christian nation.
Botswana is a secular constitutional democracy and more accurately, a pluralistic society that recognizes and respects diversity of belief, culture, and identity. The Constitution does not elevate one religion above others, nor does it permit religious doctrine to dictate legal rights. The law must serve all citizens equally, regardless of faith.
To frame marriage equality as a threat to Christianity is therefore misplaced. The question before the courts is not theological, but constitutional: Does the exclusion of same-sex couples from marriage violate the rights to equality and nondiscrimination?
Love, equality, and the future of justice
At its heart, this case is about love, but it is also about power, history, and justice. It asks whether Botswana is prepared to move beyond colonial legal frameworks and patriarchal norms, and to embrace a future grounded in equality, dignity, and inclusion.
It asks whether the Constitution will continue to be interpreted as a living document, one that evolves with society, or remain constrained by outdated moral assumptions. Ultimately, it asks whether Botswana’s democracy can hold true to its founding promise: that all persons are equal before the law.
As the High Court prepares to hear this case in July 2026, the nation has an opportunity to affirm not only the rights of two individuals, but the broader principle that love, in all its diversity, deserves recognition, and protection.
Lorato ke lorato.
Love is love.
Justice, if it is to mean anything at all, must make space for it.
Nozizwe is the CEO of LEGABIBO (Lesbians, Gays and Bisexuals of Botswana)
India
Menaka Guruswamy celebrated as India’s first openly LGBTQ MP
Constitutional lawyer elected to Rajya Sabha on March 9
India’s LGBTQ community has found renewed hope in the election of Menaka Guruswamy, a lawyer who has argued before the Supreme Court, as the country’s first openly LGBTQ MP.
Guruswamy was declared elected unopposed to the Rajya Sabha, the upper house of Parliament, on March 9, representing West Bengal. The All India Trinamool Congress, the regional party that governs the state, nominated her.
Guruswamy is a constitutional lawyer who studied at Oxford University, Harvard Law School, and the National Law School of India University. She has argued several significant cases before the Supreme Court and is widely known for her work on constitutional law, civil liberties, and LGBTQ rights.
Guruswamy was part of the legal team that successfully challenged Section 377 of the Indian Penal Code, a colonial-era law that criminalized consensual same-sex sexual relations, which the Supreme Court struck down in 2018. She has also written and spoken extensively on issues of democracy, rights and institutional accountability.
Ankit Bhupatani, a global diversity, equity and inclusion leader and LGBTQ activist, welcomed Guruswamy’s election.
“This is significant not because Parliament needed a queer person, but because a queer person needed Parliament,” Bhupatani told the Washington Blade.
India has seen LGBTQ representation in elected office at the state and local levels, though it has remained limited.
In 1998, Shabnam Mausi was elected to the Madhya Pradesh Legislative Assembly from the Sohagpur constituency, becoming one of the first openly transgender people to hold public office in India. Mausi’s election marked a rare moment of visibility for trans people in the country’s political system, where representation has historically been sparse. Since then, a small number of openly trans candidates have contested and, in some cases, won local and state elections, but no openly LGBTQ person had been elected to Parliament before Guruswamy.
Guruswamy and her partner, Arundhati Katju, who is also a lawyer, were part of the legal team that played a central role in the Section 377 decision.
Representing one of the plaintiffs, the two lawyers helped frame the case around constitutional guarantees of equality, dignity, and privacy. The Navtej Singh Johar v. Union of India ruling marked a watershed moment for LGBTQ rights in India.
“For too long, we have fought our battles only in courtrooms and on streets. Now, there is a seat at the table where laws are written,” said Bhupatani. “Whether that seat produces change depends entirely on how it is used. Representation without substance is decoration. But as a beginning, yes. This matters.”
Guruswamy later represented the plaintiffs in the Supreme Court’s 2023 marriage equality case, Supriyo v. Union of India, which a 5-judge panel heard in the spring of 2023.
Along with other lawyers representing same-sex couples, she advanced arguments rooted in constitutional guarantees of equality, dignity, and personal liberty. The Supreme Court in a 3-2 decision on Oct. 17, 2023, declined to recognize same-sex marriage — holding that such a change falls within Parliament’s domain — but did acknowledge LGBTQ people face discrimination. The Blade previously reported the ruling underscored the court’s view that it could interpret the law, but could not create a new legal framework for marriage rights.
Bhupatani said Guruswamy’s election should not be seen as an immediate shift toward legislative action on LGBTQ rights, cautioning that such expectations may not align with political realities. He said her presence in Parliament could help sustain the issue in a way it has not been before, even as broader legal change is likely to take time.
“What she can do is keep the question alive inside Parliament in a way that it hasn’t been before,” Bhupatani said. “Legislative change in India on social questions usually takes longer than advocates want and shorter than skeptics predict. The 377 decriminalization seemed impossible until it wasn’t. Partnership rights will follow the same pattern eventually.”
Bhupatani added that while Guruswamy’s election may influence the pace of change, it does not, on its own, constitute a broader political movement.
“One person in Parliament, however extraordinary, is not a movement. She is an opening,” he said. “The 2023 ruling created a responsibility. Guruswamy’s election creates an opportunity to fulfill it from inside. Whether opportunity becomes outcome is entirely a question of human will.”
Guruswamy has served as a visiting faculty member at leading American institutions that include Yale Law School, Columbia Law School, and New York University School of Law. She has also worked with international organizations, advising the U.N. Development Fund for Women in New York and the U.N. Children’s Fund in both New York and South Sudan.
According to her professional profile, Guruswamy has been involved in a range of significant cases before the Indian Supreme Court that include matters related to bureaucratic reform and accountability.
One case is connected to the AgustaWestland helicopter deal, an investigation into alleged bribery in a multimillion-dollar defense procurement contract; litigation arising from the Salwa Judum case, in which the court examined the state-backed use of civilian militias in counterinsurgency operations in central India; and cases involving the implementation of the Right to Education Act, a law guaranteeing free and compulsory education for children between the ages of six and 14.
More recently, Guruswamy represented the All India Trinamool Congress in legal proceedings challenging searches conducted by India’s Enforcement Directorate, a federal agency responsible for investigating financial crimes, including money laundering and violations of foreign exchange laws. The searches were carried out at the offices of the Indian Political Action Committee, or I-PAC, a political consulting firm that provides data-driven campaign strategy and election management services to political parties. The case raised questions about the scope of investigative powers and the use of federal agencies in politically sensitive matters.
Guruswamy’s engagement with LGBTQ rights has extended beyond courtroom advocacy into public constitutional discourse.
On July 11, 2018, during hearings in the Section 377 case, she argued the criminalization law could not be justified on the basis of “social morality,” describing it as subjective and incompatible with constitutional guarantees, and framing the case as one fundamentally about “our humanity.” The Thomas Jefferson Foundation Medal in Law at the University of Virginia in February 2023 recognized Guruswamy and Katju for their work on LGBTQ rights.
Guruswamy has not responded to the Blade’s multiple requests for comment about her election.
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