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.
United Nations
UN Human Rights Council extends LGBTQ rights expert’s mandate
29 countries voted for resolution
The U.N. Human Rights Council on Monday extended the mandate of the United Nations’ independent LGBTQ rights expert for another three years.
The resolution passed with 29 countries (Albania, Belgium, Bolivia, Brazil, Bulgaria, Chile, Colombia, Costa Rica, Cuba, Cyprus, the Czech Republic, the Dominican Republic, France, Georgia, Germany, Iceland, Japan, Kenya, the Marshall Islands, Mexico, the Netherlands, North Macedonia, South Korea, Romania, South Africa, Spain, Switzerland, Thailand, and Vietnam) voting for it and 15 countries (Algeria, Bangladesh, Burundi, China, Cote d’Ivoire, Democratic Republic of Congo, Ethiopia, Gambia, Indonesia, Kuwait, Malawi, Maldives, Morocco, Qatar, and Sudan) voted against it.
Benin, Ghana, and Kyrgyzstan abstained.
The U.S. in February withdrew from the Human Rights Council. The Trump-Pence administration in 2018 pulled the U.S. from it. The U.S. in 2021 regained a seat on the Human Rights Council.
Graeme Reid has been the UN’s independent LGBTQ rights expert since 2023. The South African activist, among other things, previously ran Human Rights Watch’s LGBT Rights Program.
South Africa National Assembly Speaker Thoko Didiza on June 17 swore in lesbian feminist Palomino Jama as a new MP.
Jama joins other LGBTQ legislators — including Public Works and Infrastructure Minister Dean Macpherson; Forestry, Fisheries and the Environment Minister Dion George; and Deputy Women, Youth, and Persons with Disabilities Minister, Steve Letsike.
Jama said she will work hard and excel as MP.
“What a great moment to be alive. Thank you youth of 1976, thank you Simon Nkoli, Phumi Mthetwa, Paddy Nhlaphos, Vanessa Ludwig, and others for what you did for the LGBTI people in the 80s and 90s. Lastly, for the fierce fist of the Jamas to always hit where it matters for the people of this country,” said Letsike.
Embrace Diversity Movement, a local LGBTQ organization, said Jama’s inauguration came at an appropriate time, during Pride month.
“Her swearing-in took place during a month of profound significance in June, which marks both international Pride Month and Youth Month in South Africa,” said the group. “Palomino is a seasoned queer activist and dedicated community builder with a distinguished record of leadership and service.”
“The EDM proudly supports Palomino in her deployment to parliament, her presence meaningfully advances youth and queer representation in public office,” added the Embrace Diversity Movement. “We are confident that she will serve the people of South Africa with integrity, courage, and distinction.”
South Africa is the only African country that constitutionally upholds LGBTQ rights. There are, however, still myriad challenges the LGBTQ community faces on a daily basis that range from physical attacks to online abuse.
Letsike in May faced a barrage of online attacks after she released a scathing statement against popular podcaster Macgyver “MacG” Mukwevho, who during a podcast episode in April insinuated that the reason behind popular socialite Minnie Dlamini’s “unsuccessful” relationships were probably due to the bad odor from her genitals.
Letsike, who viewed MacG’s comments as offensive, called for the podcaster to be summoned before parliament’s Portfolio Committee on Women, Youth, and Persons with Disabilities and criticized the local television station that aired the podcast.
X users and other social media subscribers bombarded Letsike with anti-lesbian comments. She, however, was unphased.
Letsike continues to face anti-lesbian comments, even though MacG apologized and the television station on which his podcast had aired cancelled its contract with him.
Israel
Activist recalls experience in Tel Aviv after Israel-Iran war began
Marty Rouse was part of Jewish Federations of North America Pride mission
A long-time activist who was in Israel last month when its war with Iran began has returned to D.C.
Marty Rouse traveled to Israel on June 6 with the Jewish Federations of North America. The 5-day mission ended the night before the annual Tel Aviv Pride parade was scheduled to take place.
Mission participants met with Israeli President Isaac Herzog and several LGBTQ activists in Tel Aviv and Jerusalem. They visited the Western Wall, the Nova Music Festival site, and Nir Oz, a kibbutz in southern Israel that is less than a mile from the country’s border with the Gaza Strip. Mission participants also visited Sderot, a city that is roughly a mile from the Hamas-controlled enclave, a veterans rehabilitation facility, a new LGBTQ health center and the Aguda: The Association for LGBTQ Equality in Israel in Tel Aviv.
Hamas militants on Oct. 7, 2023, killed upwards of 360 partygoers and kidnapped dozens more at the music festival that was taking place at a campground near Re’im, a kibbutz that is roughly 10 miles southwest of Nir Oz. The militants killed or took hostage nearly a quarter of Nir Oz’s residents. They also took control of Sderot’s police station.
Tel Aviv Deputy Mayor Chen Arieli spoke at the mission’s closing party that took place at the Sheraton Grand, a hotel that overlooks Tel Aviv’s beachfront, on June 12.
Rouse and other mission participants planned to stay in Tel Aviv for the Pride parade, which was scheduled to take place the following day. He and Gordie Nathan, another mission participant who lives in Palm Springs, Calif., had checked into a nearby hotel that was less expensive.
“We said our farewells,” recalled Rouse when he spoke with the Washington Blade in D.C. on June 24. “We went to our hotels, and we get the warning, and then all hell broke loose.”
Israel early on June 13 launched airstrikes against Iran that targeted the country’s nuclear and military facilities.
Rouse said mission organizers told him and other participants who remained in Tel Aviv to meet at the Sheraton Grand for breakfast and dinner — Israel’s airspace was closed in anticipation of an Iranian counterattack, and authorities cancelled the Pride parade.
He said he went to bomb shelters at least twice a night for three nights.
Israel’s Home Front Command during the war typically issued warnings about 10 minutes ahead of an anticipated Iranian missile attack. Sirens then sounded 90 seconds before an expected strike.
Rouse and Nathan walked to the Sheraton Grand on June 13 when the Home Front Command issued a 10-minute warning. They reached the hotel in a couple of minutes, and staff directed them to the bomb shelter.
“You know to walk slowly, everything’s fine,” recalled Rouse. “You get 10 minutes, so everything was fine when the alarm goes off.”
Rouse described the Sheraton Grand shelter as “well lit” with WiFi, a television, and air conditioning. He was watching an Israeli television station’s live coverage of the Iranian missile attack when he saw one hit an apartment building in the Tel Aviv suburb of Ramat Gan.
A 74-year-old woman died and her boyfriend was seriously injured.
“I go over to look at the TV, just to watch,” recalled Rouse. “All of a sudden, you watch, and you see one bomb go and land and explode in Tel Aviv on TV. It landed and blew up.”
“I was like, okay, this is real, and so that was scary,” he added.
Rouse said the bomb shelter in the hotel where he and Nathan were staying after the mission ended was far less comfortable.
“It was dark. It was humid. It was hot. It was very uncomfortable,” said Rouse. “You really felt alone.”
Rouse and nearly everyone else on the mission who were in Tel Aviv when the war began left Israel on June 15. They boarded buses that took them to the Jordanian capital of Amman, which is a roughly 2 1/2-hour drive from Tel Aviv through the West Bank.
Rouse described the trip as “like a field trip” until they drove across the Jordan River and arrived at the Jordanian border crossing.
“You walk into this room, and instead of being in a well air-conditioned airport, you’re in this hot, humid, small place in the middle of the desert, packed with people, and those big, large, loud fans and pictures of military people on the walls,” he said. “It was almost like a Casablanca kind of feeling.”
Rouse said Jordanian authorities brought mission participants through customs in groups of 10. A Jewish Federations of North America liaison from Amman who previously worked as a tour guide for A Wider Bridge — a group that “advocates for justice, counters LGBTQphobia, and fights antisemitism and other forms of hatred” — went “behind closed doors” to ensure everyone was able to enter the country.
“It took a really long time,” Rouse told the Blade.
Mission participants arrived in Amman a short time later. They checked into their hotel and then had dinner at a restaurant.
“Now we feel like we’re safe and we’re in Amman,” recalled Rouse. “We’re sitting outside having a beautiful dinner.”
Iranian missiles passed over Amman shortly after Rouse and the other mission participants had begun to eat their dessert. They went inside the restaurant, and waited a few minutes before they boarded busses that brought them back to their hotel.
“No one was openly freaking out, which I was surprised by,” said Rouse.
The group was scheduled to fly from Amman to Cairo at 11 p.m. local time (4 p.m. ET) on June 16. They visited Jerash, an ancient city north of Amman, before their flight left Jordan.
“[The Jerash trip] actually took our minds off of everything,” said Rouse.
A Jewish Federations of North America contact met Rouse and the other mission participants at Cairo’s airport once their flight landed. Rouse arrived at JFK Airport in New York on June 17.
Trump-announced ceasefire ended 12-day war
President Donald Trump on June 23 announced a ceasefire that ended the 12-day war.
The U.S. three days earlier launched airstrikes that struck three Iranian nuclear sites. The ceasefire took effect hours after Iran launched missiles at a U.S. military base in Qatar.
Iran said the war killed more than 900 people in the country.
The Associated Press notes Iranian missiles killed 28 people in Israel. One of them destroyed Tel Aviv’s last gay bar on June 16.
The war took place less than two years after Oct. 7.
The Israeli government says Hamas militants on Oct. 7, 2023, killed roughly 1,200 people on that day when it launched its surprise attack on the country. The militants also kidnapped more than 200 people.
The Hamas-controlled Gaza Health Ministry says Israeli forces have killed nearly 55,000 people in the enclave since Oct. 7. Karim Khan, the International Criminal Court’s chief prosecutor, has said Israeli Prime Minister Benjamin Netanyahu and former Hamas leader Yahya Sinwar, who the IDF killed last October, are among those who have committed war crimes and crimes against humanity in Gaza and Israel.
Rouse upon his return to the U.S. said he “was never as aware of the comfort of another human being than I was during that time.” Rouse affectionately called Nathan his “bomb shelter boyfriend” and even questioned the way he reacted to the missile alerts.
“He’s sitting on the edge of the bed and he goes, okay, I’m going to put on my socks and my shoes, and I say, really? You’re going to put on your socks,” Rouse told the Blade. “The fact that I was nervous, that putting on socks might have changed the direction of our lives, to me was like I can’t believe I said that to him.”
Rouse quickly added Nathan helped him remain calm.
“If I was by myself, those nights would have been long enough,” said Rouse. “It’s a totally different feeling to be with another human that you know than to be by yourself.”
Rouse also praised the Jewish Federations of North America.
“JFNA really sprung into action and started to figure out all options to get us all safely home,” said Rouse. “It was all about logistics. Staff worked around the clock identifying and then mobilizing to get us back to the states. It was a great team effort and I know I speak for everyone in expressing our deep appreciation for their dedication to getting us safely home.”
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