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.
Eswatini
The emperor has no clothes: how rhetoric fuels repression in Eswatini
King Mswati III’s anti-LGBTQ comments can have deadly consequences
In an absolute monarchy, the words spoken by the sovereign can swiftly become a baton striking a citizen. When King Mswati III speaks, his words do not simply drift into the air as political “opinion”; they often quickly turn into, sometimes violently, state policy. This reflects the reality of Eswatini, where the right to freedom of expression, including the right to hold dissenting political views, is increasingly being systematically eroded by the very voice that claims to uphold “traditional values.”
To understand the current crisis facing the LGBTIQ+ community in Eswatini, one must view it through the lens of a broader strategy: the weaponization of culture to justify the erosion of democratic institutions, the rule of law, and human rights protections. As observed across Africa, from the streets of Harare and Dar es Salaam to the parliamentary courtrooms of Dakar and Kampala, African leaders are increasingly using the marginalised as an entry point to dismantle civil society. In Eswatini, this strategy has manifest its most brutal expression in the king’s recent harmful rhetoric concerning sexual orientation and gender identity.
The danger of the king’s words lies in how the state apparatus interprets them as a divine mandate for persecution. Recently, we have seen this “Rhetoric-to-Policy Pipeline” operate with chilling efficiency. Shortly after the Minister of Education made public vitriol against the existence of LGBTIQ+ students, reports emerged of children being expelled from schools. In a country where the king is culturally and traditionally called the “ingwenyama” (the lion), the bureaucracy acts as his pride; when leadership suggests that a particular group is “un-African” or “deviant,” the machinery of the state, along with the emboldened segments of the public, moves to purge that group from society.
For an openly gay man who has dedicated most of his adulthood to advancing equality and dignity for all, especially marginalized communities, these are not merely policy changes; they pose existential threats. When a powerful leader speaks, they offer a moral shield for the dogmatist and a legal roadmap for the policeman. In Eswatini, where political parties are banned, and the “tinkhundla” system (constituency-based system) — a system that systematically silences dissent and favors those aligned with the sovereign — is celebrated as the sole “authentic” form of governance, any identity that falls outside the narrow, state-defined “tradition” is seen as treason. By branding LGBTIQ+ rights as “ungodly” and essentially unwelcome in Eswatini, the monarchy effectively views the mere existence of queer Swazis as a subversive act against the crown.
The most harrowing example of this pattern is the assassination of human rights lawyer Thulani Maseko in January 2023. Maseko’s murder did not happen in isolation. It followed a period of heated rhetoric directed at those calling for democratic reforms. The king had publicly warned those demanding change that they would face consequences. On the evening after the king had said, “[t]hese people started the violence first, but when the state institutes a crackdown on them for their actions, they make a lot of noise blaming King Mswati for bringing in mercenaries,” Maseko was shot dead at his home in front of his family.
The parallel here is unmistakable. When the king targets the LGBTIQ+ community with his words, he is aiming at the most vulnerable. If a world-renowned human rights lawyer can be silenced following royal condemnation, what chance does a queer youth in a rural area stand when the king’s words reach the local chief or school head? This is what I call “Chaos as Governance”: a state where the law is replaced by the monarch’s whims, leaving the population in a constant cycle of managed chaos that renders collective opposition nearly impossible. Despite strong condemnation from the organization I founded, Eswatini Sexual and Gender Minorities (ESGM), recent reports already suggest growing support for the rhetoric shared by the king, indicating treacherous weeks and months ahead for ordinary queer people in Eswatini.
The monarchy’s defense of these actions is almost always based on “African tradition.” As Mswati has shown, the ban on political parties and the suppression of minority rights are framed as a return to indigenous governance, the “tinkhundla” system. But we must ask: whose culture is being defended? Is it a culture that historically valued communal care and diverse social roles, or is it a modern, imported authoritarianism cloaked in the robes of the ancestors?
When he uses his platform at the “sibaya” (traditional gathering) to alienate a segment of his own people, he is not engaging in dialogue; he is delivering a monologue of exclusion. This weaponized version of culture serves a dual purpose. First, it offers a “neocolonial” defense against international criticism, portraying human rights as a foreign threat. Second, it creates an internal enemy, the “terrorist” political dissident or the “immoral” LGBTIQ+ person, to distract from the fact that nearly two-thirds of the population live below the poverty line. In contrast, the royal family resides in obscene luxury, acquiring fleets of expensive vehicles.
The silence of Eswatini’s neighbors worsens its situation. The Southern African Development Community (SADC), a regional organization ostensibly committed to democracy and human rights, has repeatedly allowed Mswati to evade accountability. By agreeing to remove Eswatini from the Organ Troika agenda at the king’s request in 2024, SADC sent a message to every authoritarian in the region. If you conceal your repression behind the guise of tradition, we will not intervene.
The call for freedom of expression, including LGBTIQ+ rights, is a fundamental human right vital for safety and dignity. It demands that a child should not be expelled from school because of who they are. It insists that a lawyer should not be murdered for expressing their beliefs. It states that a king’s word should not be a death sentence. We must resist the “politics of distraction” that portrays the fight for minority rights as separate from the fight for democratic reform. The dissolution of political parties in Burkina Faso, the attack on lawyers in Zimbabwe, and the criminalization of advocacy in Senegal, Tanzania, and Uganda are all parts of the same pattern. They reflect a leadership class that fears its own people.
It is time for the African Union and SADC to decide whether to uphold the ideals of their lofty charters or to prioritize political convenience across Africa. For the people of Eswatini, improving livelihoods and human development can only occur when the king’s words are limited by a constitution that protects every citizen, regardless of whom they love or how they pray. Until then, the chaos is not a failure; it is the purpose. The monarch’s word may be law today, but the universal right to dignity is the only law that will endure. We must demand an Eswatini, and by extension, an Africa that seeks to improve the lives of its people, and where the “lion” protects all his people, rather than hunting those he deems “unworthy” of the shade.
Melusi Simelane is the founder and board chair of Eswatini Sexual and Gender Minorities. He is also the Civic Rights Program Manager for the Southern Africa Litigation Center.
Cuba
Cuba bajo presión y sin respuestas
Cubanos no hablan en términos geopolíticos. Hablan de sobrevivir
Las tensiones entre Estados Unidos y Cuba han vuelto a subir de tono. No es algo nuevo, pero este momento se siente distinto. Las medidas más recientes desde Washington buscan cerrar aún más los espacios financieros del gobierno cubano, limitar sus fuentes de ingreso y presionar sectores clave de la economía. No es simbólico. Es una política directa.
Desde Estados Unidos, el mensaje es claro. Se busca provocar cambios que no han ocurrido en más de seis décadas. También hay un componente interno, una presión política que responde a sectores del exilio que llevan años exigiendo una postura más dura. Todo eso forma parte del escenario.
Pero esa es solo una parte.
Del lado cubano, la respuesta sigue un patrón conocido. El gobierno habla de agresión externa, de guerra económica, de un embargo que se endurece. Cada medida se convierte en argumento para reforzar su narrativa y cerrar filas. No hay espacio para reconocer errores propios. Todo apunta hacia afuera.
Mientras tanto, la vida en la isla va por otro camino.
La crisis energética que hoy vive Cuba no empezó con estas medidas. Lleva años acumulándose. El sistema eléctrico está deteriorado, sin mantenimiento suficiente, con fallas constantes. Los apagones no son nuevos. Lo que ha cambiado es la frecuencia y la duración.
Durante años entró petróleo a Cuba, especialmente desde Venezuela. Hubo acuerdos. Hubo suministro. Y aun así, la vida del cubano no mejoró. La electricidad seguía fallando, el combustible seguía racionado, el transporte seguía siendo un problema diario.
Entonces la pregunta sigue siendo la misma.
Si el petróleo estaba entrando, ¿por qué nada cambiaba?
¿Dónde fue a parar ese recurso?
¿Dónde está el dinero que generó?
Hoy se habla de restricciones al petróleo como si fueran la causa principal de la crisis. No lo son. Empeoran una situación ya frágil, pero no la explican completamente.
Hay una historia más larga que no se puede ignorar.
Lo mismo ocurre con las brigadas médicas.
Durante años se presentaron como un gesto de solidaridad internacional. Y en muchos casos lo fueron. Médicos cubanos trabajaron en condiciones difíciles, salvaron vidas, sostuvieron sistemas de salud en otros países. Eso es real.
Pero también funcionaron como una de las principales fuentes de ingreso del Estado cubano.
Muchos de esos profesionales no recibían el salario completo por su trabajo. Una parte significativa quedaba en manos del gobierno. En algunos casos, ni siquiera tenían control sobre el dinero que generaban.
Y hay algo más duro.
Si uno de esos médicos decidía no regresar a Cuba, ese dinero no llegaba a su familia. Se quedaba retenido.
Hoy varios países están revisando o cancelando esos acuerdos. Y otra vez, la respuesta oficial es señalar hacia afuera. Pero la pregunta sigue siendo inevitable.
¿Se está perdiendo un modelo de cooperación o un sistema que dependía del control sobre sus propios profesionales?
Dentro de Cuba, la conversación suena diferente.
La gente no habla en términos geopolíticos. Habla de sobrevivir. De cómo llegar al final del día. De los apagones, de la comida que no alcanza, del transporte que no aparece, de una vida que cada vez se hace más difícil.
Hay quienes miran las medidas de Estados Unidos con cierta expectativa. No porque quieran más escasez, sino porque sienten que el sistema no cambia por sí solo. Hay una sensación de estancamiento que pesa.
Pero esa expectativa convive con una realidad concreta.
Las sanciones no golpean primero a quienes toman decisiones. Golpean al ciudadano común. Al que hace la fila. Al que pierde la comida por falta de electricidad. Al que no tiene cómo moverse.
Esa es la contradicción.
El gobierno cubano pide solidaridad internacional. Y la recibe. Países que envían ayuda, organizaciones que se movilizan, voces que defienden a la isla.
Pero hay otra pregunta que también está ahí.
¿Esa ayuda llega realmente al pueblo?
La falta de transparencia en la distribución de recursos es parte del problema. Porque no se trata solo de lo que entra, sino de lo que realmente llega a quienes lo necesitan.
Reducir lo que pasa en Cuba a un conflicto entre dos gobiernos es no querer ver el cuadro completo.
Aquí hay responsabilidades compartidas, pero no iguales.
Estados Unidos ejerce presión con efectos reales sobre la economía cubana. Eso no se puede negar. Pero dentro de la isla hay un sistema que ha tenido décadas para corregir, para abrir, para responder a su gente, y no lo ha hecho.
Esa parte no se puede seguir esquivando.
Yo escribo esto como cubano. Desde lo que vi, desde lo que viví y desde la gente que sigue allá tratando de resolver el día.
Porque al final, más allá de lo que se diga entre gobiernos, la realidad es otra.
Cuba hoy está más apretada, sí. Pero también lleva años arrastrando problemas que nadie ha querido enfrentar de verdad.
Y mientras eso siga así, da igual lo que venga de afuera. El problema sigue estando adentro.
Iran
LGBTQ groups condemn Trump’s threat to destroy Iranian civilization
Ceasefire announced less than two hours before Tuesday deadline
The Council for Global Equality is among the groups that condemned President Donald Trump on Tuesday over his latest threats against Iran.
Trump in a Truth Social post said “a whole civilization will die tonight” if Tehran did not reach an agreement with the U.S. by 8 p.m. ET on Tuesday.
Iran is among the handful of countries in which consensual same-sex sexual relations remain punishable by death.
Israel and the U.S. on Feb. 28 launched airstrikes against Iran.
One of them killed Supreme Leader Ayatollah Ali Khamenei. Iran in response launched missiles and drones against Israel and other countries that include Kuwait, Bahrain, Qatar, the United Arab Emirates, Jordan, Saudi Arabia, Azerbaijan, and Cyprus.
Gas prices in the U.S. and around the world continue to increase because the war has essentially closed the Strait of Hormuz, a strategic waterway that connects the Persian Gulf and the Gulf of Oman through which roughly 20 percent of the world’s crude oil passes.
Trump less than 90 minutes before his deadline announced a two-week ceasefire with Iran that Pakistan helped broker.
“We the undersigned human rights, humanitarian, civil liberties, faith-based and environmental organizations, think tanks and experts are deeply alarmed by President Trump’s threat regarding Iran that ‘a whole civilization will die tonight’ if his demands are not met. Such language describes a grave atrocity if carried out,” reads the statement that the Council for Global Equality more than 200 other organizations and human rights experts signed. “A threat to wipe out ‘a whole civilization’ may amount to a threat of genocide. Genocide is a crime defined by the Genocide Convention and by the Rome Statute of the International Criminal Court as committing one or more of several acts ‘with intent to destroy in whole or in part a national, racial or religious groups as such.'”
The statement states “the law is clear that civilians must not be targeted, and they must also be protected from indiscriminate or disproportionate attacks.”
“Strikes on civilian infrastructure — such as the recent attack on a bridge and the attacks President Trump is repeatedly threatening to carry out to destroy power plants — have devastating consequences for the civilian population and environment,” it reads.
“We urge all parties to respect international law,” adds the statement. “Those responsible for atrocities, including crimes against humanity and war crimes, can and must be held accountable.”
The Alliance for Diplomacy and Justice, Amnesty International USA, Human Rights Watch, the American Civil Liberties Union, the NAACP, MADRE, and the Robert and Ethel Kennedy Human Rights Center are among the other groups that signed the letter.
Calendar: April 10-16
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Police mental health struggles gain growing attention
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