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Mexicans with HIV/AIDS struggle with treatment access

Government in 2019 created new health care entity

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Roberto Navarro (Photo courtesy of Roberto Navarro)

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. 

There are three health care systems in Mexico. (Washington Blade photo by Michael K. Lavers)

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.”

Members of the Gay Men’s Chorus of Mexico City who are living with HIV perform at Clínica Condesa, a public health clinic in Mexico City, on July 21, 2019. The clinic’s 20th anniversary coincided with the International AIDS Society’s Conference on HIV Science that took place in the Mexican capital. (Washington Blade photo by Michael K. Lavers)

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.

Migrants wait for humanitarian visas at the Ciudad Hidalgo port of entry in Ciudad Hidalgo, Mexico, on Jan. 30, 2019. (Washington Blade photo by Michael K. Lavers)

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.

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United Kingdom

British prime minister panned as ‘disgrace’ in response to Pride message

Government cancelled conference after rights groups announced boycott

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British Prime Minister Boris Johnson (Screenshot from YouTube/Twitter)

British Prime Minister Boris Johnson released a video message on his official Twitter and YouTube platforms celebrating Pride Month in the U.K. Tuesday under the social hashtag of #WhyPridematters.

The prime minister said that he was “proud” at how many LGBTQ and intersex people have sought asylum in the U.K. from Afghanistan after the Taliban regained control of the country. However, within literal minutes he was promptly criticized and in the Twitter pushback was told by one user: “You’re an absolute disgrace.”

Another chimed in saying his remarks were hollow.

Johnson’s Tory-led government seemingly has been more indifferent to Britain’s LGBTQ and intersex community — transgender people in particular — according to activists and the largest LGBTQ and intersex advocacy group, Stonewall UK.

Last Spring, in early April, Bloomberg reported more than 80 organizations pulled out of the British government’s international LGBTQ and intersex conference due to be held in June after Johnson dropped a plan to ban so-called conversion therapy for trans people.

One of Johnson’s top ministers, Liz Truss, was accused of using LGBTQ and intersex rights to ‘rile up her right-wing support base’ PinkNewsUK reported.

As minister for women and equalities, Truss scrapped much-needed reform to the Gender Recognition Act (GRA) despite reams of evidence showing there was strong public support for changes that would make accessing legal gender recognition easier for the trans community.

She has also been criticized for her appointments to the Equalities and Human Rights Commission, and her defenses of “gender critical” views.

There has also been outcry by LGBTQ and intersex advocacy groups and activists over the government’s willingness to deport LGBTQ and intersex and other asylum seekers on one-way flights to Rwanda. That decision has been criticized by queer and trans advocates as “hugely concerning” and “potentially life-threatening.”

Canadian LGBTQ and intersex news outlet Xtra reported that queer and trans asylum seekers in the U.K. already face inhospitable conditions. Sebastian Rocca, founder of charity Micro Rainbow, which provides safe housing to LGBTQ and intersex asylum seekers and refugees in the U.K., tells Xtra in a statement: “One of the most common reasons for the Home Office to refuse asylum to LGBTQI+ people in the U.K. is because they do not believe they are LGBTQI+,” adding that the policy has “potentially life-threatening consequences.” 

The “single young men” framing of the policy means any gay or bisexual men, transmasculine people or transfeminine people — including those seeking asylum in the U.K. for their sexual orientation or gender identity — could potentially be deported to a country with a long history of human rights violations.

In Tuesday’s message the prime minister referred specifically to Afghan LGBTQ and intersex people fleeing the notoriously intolerant Taliban which regained control of the country after the Biden administration pulled the remaining armed forces out of the war-torn country last summer after nearly 21 years of conflict.

“LGBT Afghans coming to this country because we’re a place that is welcoming and understands that type of intolerance is simply unacceptable in this country,” Johnson said.

Johnson added: “I’m proud above all that the U.K. is a country where you can be however you want to be and you can love whomever you choose to love no matter who you are or where you come from or what your background is.

“So it’s great to see Afghans coming to this country with that knowledge and seeing our country as a beacon of hope.

“That’s why Pride Month matters so much. And I hope you have a great Pride.”

Twitter was less than impressed:

Why Pride matters | Prime Minister Boris Johnson:

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Europe

Istanbul once again bans Pride march

Organizers sharply criticized authorities’ decision

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LGBTQ people gather in Istanbul and face-off against police defying ban (Screenshot/YouTube EURONEWS)

The Beyoğlu and Kadıköy District governors’ offices which oversee the mega metropolitan area of this ancient city located on both banks of the Bosporus connecting the Black Sea to the Sea of Marmara have once again banned the city’s Pride march.

The governors’ offices announced a ban on all gatherings in both districts, where Pride week events have traditionally been held, on Monday, the Diken news site reported, citing the Turkish Law on Demonstrations and Public Meetings.

“We have obtained information that between 21 June 2022 (Tuesday) and 23 June 2022 (Thursday) gatherings, press releases, marches, distribution of leaflets, etc are planned to be held within the scope of the 30th ‘Istanbul LGBTI+ Pride Week,’” the governor’s statement said.

“All events are banned in all open and closed areas for seven days.”

Had the Pride week march and accompanying festivities been allowed to take place, it would have marked the 30th anniversary of Pride in the megacity. Istanbul’s Pride Parades, which attracted up to 100,000 people from across the region, have been banned since 2014, with officials citing security reasons for the ban.

In the past years since the ban first was enacted, Turkish police and LGBTQ activists had clashed with police units firing tear-gas pellets at the crowd along with physically violent arrests.

Turkish police confront LGBTQ+ Pride participants at a café in 2019 (Screenshot/YouTube EURONEWS)

Ahval, an independent Turkish media outlet, reported Monday that Turkey’s LGBTQ groups accused the government of President Recep Tayyip Erdoğan of waging a “hate campaign” against them, encouraging violence against a vulnerable community.

Turkey has ranked second worst country in the EU for LGBTQ people, scoring only above Azerbaijan, according the 2022 “Rainbow Europe” ranking compiled by Brussels-based ILGA-Europe.

Less than a week ago in Ankara, Turkish police officers carrying clear-plastic riot shields, wielding batons and deploying pepper powder balls as well as tear gas violently broke up a Pride Parade organized by Middle East Technical University students on their campus.

LGBTQ+ participants of a forbidden gathering in 2019 reacting to tear gas fired by Turkish Police. (Screenshot/YouTube AP)

PinkNewsUK reported the Istanbul LGBTQ+ Pride Week Committee issued a statement shortly after the announcement, saying that the decision was “illegal” and that they would use “our rights [to] make the necessary objections”.

“Today, with the start of Istanbul 30th LGBTI+ Pride Week, police inspected the venues where the events would take place, under the guise of ‘general control,’” the group said. “The law enforcement officers tried to put pressure on the venues by asking for documents such as tax plates.”

“We would like to thank our entire network of lawyers and venues that have supported us. We won’t give up, we are not afraid!”

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Russia

‘Logistical error’ prevented Brittney Griner from speaking with wife on anniversary

Calls to embassy phone in Moscow went unanswered on Saturday

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Brittney Griner (Photo courtesy of Lorie Shaull, CC BY-SA 4.0, via Wikimedia Commons)

A State Department spokesperson on Tuesday admitted a “logistical error” prevented detained WNBA star Brittney Griner from speaking with her wife over the weekend.

Cherelle Griner told the Associated Press that her wife’s lawyers said she tried to call her 11 times “over a period of several hours” on Saturday, which was the couple’s fourth anniversary.

The AP reported the Russian government approved the call.

The U.S. Embassy in Moscow, according to the AP, had given Brittney Griner a number that was to have allowed her to connect to her wife in Phoenix once an embassy staffer received the call. The AP reported each of the calls that Brittney Griner made went unanswered because nobody was at the desk where the phone was located. 

“I was distraught. I was hurt. I was done, fed up,” Cherelle Griner told the AP. “I’m pretty sure I texted BG’s agent and was like: ‘I don’t want to talk to anybody. It’s going to take me a minute to get my emotions together, and just tell everybody I’m unavailable right now.’ Because it just knocked me out. I wasn’t well, I’m still not well.”

Cherelle Griner said the call had been on her schedule for two weeks. She told the AP that she is “very pissed” about what happened.

“We deeply regret that Brittney Griner was unable to speak with her wife because of a logistical error,” the State Department spokesperson told the Washington Blade on Tuesday in a statement.

Officials at Moscow’s Sheremetyevo Airport in February detained Brittney Griner — a center for the Phoenix Mercury — after customs inspectors allegedly found hashish oil in her luggage. The State Department has determined that Russia “wrongfully detained” her.

“We cannot call her a hostage,” Kremlin spokesperson Dmitry Peskov told NBC News’ Keir Simmons on Monday. “She violated Russian law and now she is being prosecuted.”

Secretary of State Antony Blinken on May 14 spoke with Cherelle Griner. 

Officials with the State Department’s Office of the Special Presidential Envoy for Hostage Affairs and Bureau of Educational and Cultural Affairs on June 13 met with Brittney Griner’s teammates to discuss her detention and efforts to secure her release. A Russian court the following day extended Brittney Griner’s detention through at least July 2.

“We are determined to bring her home along with Paul (Whelan, an American citizen who is serving a 16-year prison sentence in Russia after a court convicted him of spying) and for that matter, any and every American who is being unjustly detained anywhere in the world,” said Blinken on June 15 during a roundtable with this reporter and five other LGBTQ and intersex journalists. ” “It’s something that I am personally focused on, and I want to leave it at that because it is obviously an ongoing issue. But just know that this is a matter of intense focus for us.”

The State Department spokesperson reiterated this point.

“We have no higher priority than the safety and security of U.S. citizens overseas,” said the spokesperson. “We remain in regular contact with the families of those held hostage or wrongfully detained; we are grateful for their partnership and feedback; and we continue to work to ensure we are communicating and sharing information in a way useful to our families.”

Cherelle Griner told the AP that she no longer trusts the U.S. government.

“I find it unacceptable and I have zero trust in our government right now,” she said. “If I can’t trust you to catch a Saturday call outside of business hours, how can I trust you to actually be negotiating on my wife’s behalf to come home? Because that’s a much bigger ask than to catch a Saturday call.”

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