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.
Belarus
Belarusian lawmakers approve bill to crackdown on LGBTQ rights
Country’s president known as ‘Europe’s last dictator’
Lawmakers in Belarus on Thursday approved a bill that would allow the government to crack down on LGBTQ advocacy.
The Associated Press notes the bill would punish anyone found guilty of “propaganda of homosexual relations, gender change, refusal to have children, and pedophilia” with fines, community labor, and 15 days in jail.
The House of Representatives, the lower house of the Belarusian National Assembly, last month approved the bill. The Council of the Republic, which is the parliament’s upper chamber, passed it on Thursday.
President Alexander Lukashenko is expected to sign it.
Belarus borders Poland, Ukraine, Russia, Latvia, and Lithuania. Lukashenko — known as “Europe’s last dictator” is a close ally of Russian President Vladimir Putin.
Kazakhstan is among the countries that have enacted Russian-style anti-LGBTQ propaganda laws in recent years.
Vika Biran, a Belarusian LGBTQ activist, is among those arrested during anti-Lukashenko protests that took place in 2020 after he declared victory in the country’s presidential election.
Kenya
Kenyan advocacy groups launch LGBTQ voter mobilization campaign
As Kenya prepares for next year’s August general election, local queer rights groups have joined Gen Zers in also mobilizing their members to register as voters.
The groups’ drive began ahead of the electoral commission’s official launch of a one-month nationwide mass voter registration on March 30, targeting 6.5 million new voters to bring the total to more than 28 million.
The groups — led by the Initiative for Equality and Non-Discrimination (INEND) and Galck+ — note that politics is not optional, but rather it is “our responsibility” to use the ballot to put an end to bad leadership and discriminatory laws against them.
“Voting is one of the most powerful ways we exercise our autonomy and remind the State that our human rights are not ‘Western imports’; our struggles for housing, employment, safety, and dignity are fundamentally Kenyan issues,” INEND states.
It reminds queer individuals that the nation entrusts them with an identity card at age 18 as a recognition of their ability to make decisions, follow laws, and take responsibility for the country’s future.
INEND also notes that despite this honor, LGBTQ people get kicked out of their homes due to homophobia, are discriminated against at work, and face violence in public places due to the punitive laws that the same State legislates.
“As queer Kenyans, our vote matters,” INEND states. “Our voice belongs in the democratic and governance conversations, and true democracy includes everyone.”
Some voter mobilization initiatives the queer lobby groups have been using include ‘Queering the Ballot’ Podcasts on civic participation, dubbed ‘Your Vote is Your Future’. The topics explored include how laws shape their lives, the relationship between lived experiences of common citizens, discrimination fatigue, distrust in government systems, and voter apathy.
The groups through the mobilization drive hope to create a queer voting bloc to actively participate in restructuring and reconstructing the existing governance system they argue has been a problem for them. They maintain the queer community navigates a system that was not built for them from its questioning of their right to exist, yet the Kenyan Constitution clearly states that no citizen should be discriminated against based on sexual orientation or gender identity.
The Court of Appeal next month will hear a case challenging the constitutionality of provisions in Kenya’s Penal Code that criminalize consensual same-sex relationships among adults. The appeals court postponed the case after adjourning on Feb. 4, its first substantive hearing since the High Court judgement in 2019.
“Change requires more than pointing fingers. It requires reflection, action, and showing up, especially at the ballot box as LGBTQ Kenyan citizens and declaring that this is our country, our business, and we can no longer watch from the sidelines,” INEND states.
The group notes that they want a governance system that embraces queer people as they go about their daily lives without any form of homophobic discrimination, harassment, or arrests. Queer people are therefore urged to pick the right leaders who listen to them in Kenya’s six elective positions, from the president down to the local government representatives, as their decisions while in power affect them.
“It is very irresponsible for any human being, even around the world, to assume that they don’t have political responsibility. It is easy and sounds fancy to say ‘I don’t like politics,’ but it does not make one good as it makes one abandon their political responsibility as a citizen,” INEND states.
The groups are also concerned with the existing homophobia among Kenyans, especially whenever they join them in street protests against the government’s punitive measures or advocating for change. However, they maintain that the LGBTQ community won’t be left behind despite being marginalized in society, yet they are the most affected group when the government raids people’s pockets for taxes.
“Now we are moving from the margins to the centre of this political conversation early enough to ensure that our community sees the sense because if we live in a country that doesn’t work, we will be the most affected,” INEND states.
INEND, with the National Gay and Lesbian Human Rights Commission and Galck+, last November launched the second Queering the Ballot Campaign and the 2024 Situation Report on queer participation in Kenya’s democracy.
The report surveyed 14 of the country’s 47 local governments, whose key findings affirm that queer Kenyans are not outsiders to democracy but its heartbeat.
“The title ‘Our Vote, Our Future: LGBTQ+ Inclusion in Democratic and Governance Processes’ in Kenya is an ode to the spirit of the queer movement in Kenya; unshaken in the face of adversity, determined in its pursuit of justice, and unrelenting in demand to be seen, heard and counted in democratic and political processes,” reads the report forwarded by former Chief Justice Willy Mutunga.
The report calls on Parliament, the Independent Electoral and Boundaries Commission, the County Assemblies, and every Kenyan to make inclusion not symbolic but systemic.
Vice President JD Vance and his wife, second lady Usha Vance, will visit Hungary next week.
An announcement the White House released on Thursday said the Vances will be in Budapest, the Hungarian capital, from April 7-8.
JD Vance “will hold bilateral meetings with” Hungarian Prime Minister Viktor Orbán. The announcement further indicates the vice president “will also deliver remarks on the rich partnership between the United States and Hungary.”
The Vances will travel to Hungary less than a week before the country’s parliamentary elections take place on April 12.
Orbán, who has been in office since 2010, and his Fidesz-KDNP coalition government have faced widespread criticism over its anti-LGBTQ crackdown.
The Associated Press notes polls indicate Orbán is trailing Péter Magyar and his center-right Tisza party.
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