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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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Brazil

2026 International AIDS Conference to take place in Rio

US funding cuts have significantly impacted global HIV/AIDS fight

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The 2026 International AIDS Conference will take place next week in Rio de Janeiro. (Washington Blade photo by Michael K. Lavers)

The 2026 International AIDS Conference will take place next week in Rio de Janeiro.

Francisco Ruiz, the former director of the White House Office of National AIDS Policy, and UNAIDS Executive Director Winnie Byanyima are among those scheduled to speak at the conference that will take place in the Brazilian city from July 26-31. Other scheduled speakers include Spanish Health Secretary Javier Padilla, World Health Organization Director-General Tedros Adhanom Ghebreyesus, South African Deputy Health Minister Mathume Joseph “Joe” Phaahla, and Alexus D’Marco of the United Caribbean Trans Network.

The International AIDS Society-organized AIDS 2026’s theme is “Rethink. Rebuild. Rise.”

AIDS 2026 will take place against the backdrop of U.S. funding cuts that have significantly impacted the global HIV/AIDS fight.

Secretary of State Marco Rubio shortly after the Trump-Vance administration took office issued a waiver that allowed PEPFAR and other “life-saving humanitarian assistance” programs to continue to operate during a freeze on nearly all U.S. foreign aid spending. HIV/AIDS service providers around the world with whom the Washington Blade has spoken say PEPFAR cuts and the loss of funding from the U.S. Agency for International Development, which officially closed on July 1, 2025, has severely impacted their work.

The International AIDS Society in a press release it issued on Tuesday noted PEPFAR “has saved more than 26 million lives” since President George W. Bush implemented it in 2003, “and changed the trajectory of the HIV pandemic.”

“PEPFAR was a success under the first Trump administration, with major progress toward the 95-95-95 goals,” it said.

The UNAIDS’s 95-95-95 goals are 95 percent of people with HIV knowing their status, 95 percent of people with HIV having access to antiretroviral therapy, and 95 percent of those receiving ART having suppressed viral loads by 2030.

“Since the start of the second Trump administration, however, it has undergone major disruptions,” added the International AIDS Society.

Eswatini is among the African countries that have received doses of lenacapavir, a groundbreaking HIV prevention drug that users inject twice a year, through PEPFAR since the Trump-Vance administration took office.

The White House last month announced it will end PEPFAR funding for South Africa.

President Ronald Reagan in 1985 implemented the global gag rule, also known as the “Mexico City” policy, that banned U.S. foreign aid for groups that support abortion and/or offer abortion-related services. The Trump-Vance administration earlier this year expanded the prohibition to include groups that promote “gender ideology” and support gender-affirming care and diversity, equity, and inclusion programs.

The International AIDS Society in its press release notes 52 percent of “all implementing partners had at least once terminated award,” while 77 percent of them “had been asked to restrict their work to comply with an additional U.S. policy.” The International AIDS Society notes 1,010 public health facilities, 325 “access points” and 126 “drop-in centers” around the world have closed because of U.S. funding cuts.

“Science is moving fast, giving us more powerful HIV prevention and treatment tools. But these advances cannot save lives if they never reach the people who need them,” said International AIDS Society President Beatriz Grinsztejn, who co-chairs AIDS 2026 and is the director of Rio de Janeiro’s Evandro Chagas National Institute of Infection Diseases’ HIV/AIDS Clinical Research Unit. “That requires robust, stable financing and steadfast political commitment.”

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Poland

Polish president vetoes same-sex relationship recognition bills

Karol Nawrocki: measures would ‘lead to the loss of the special status of marriage’

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Polish President Karol Nawrocki (Screen capture via Karol Nawrocki/YouTube)

Polish President Karol Nawrocki on July 17 vetoed bills that would have extended rights to same-sex couples.

Reuters reported Nawrocki rejected two measures that would have allowed same-sex couples who live together to enter into “cohabitation contracts.” Reuters noted the bills would have allowed same-sex couples to make decisions on issues that include access to medical information, property rights, and burial.

The country’s coalition government backed the bills that MPs approved. Nawrocki, a socially conservative Catholic, in a statement said they “create a new, formalized institution of family law, ​equipped with a broad catalogue of rights similar to those of marriage.”

“As the guardian of the Constitution, I cannot accept a solution that would lead to the loss of the ‌special ⁠status of marriage, defined in Article 18 of the Constitution as a union of a man and a woman under the protection and care of the Republic of Poland,” said Nawrocki, as Reuters noted.

Prime Minister Donald Tusk sharply criticized Nawrocki.

Miko Czerwiński of the Campaign Against Homophobia, a Polish LGBTQ advocacy group, in a statement noted nearly 80 percent of Poles “believe that the status of same-sex couples should be protected.”

“Once again, the voice of society has proven irrelevant to those in power,” said Czerwiński. “We are not willing to accept this. We will continue working towards full marriage equality.”

The EU Court of Justice in Luxembourg last November ruled in favor of a same-sex couple who challenged Poland’s refusal to recognize their German marriage. Poland’s Supreme Administrative Court in March reaffirmed the decision.

The couple, who lives in Poland, brought their case to Polish courts in 2019. The Supreme Administrative Court referred it to the EU Court of Justice.

The Polish government in May announced it will recognize same-sex marriages legally performed in other EU countries. Tusk, for his part, apologized to same-sex couples for the “years of rejection and humiliation” they suffered because Poland did not recognize their relationships.

“We will continue working towards full marriage equality,” said Czerwiński in response to Nawrocki’s vetoes. “We will not allow years of work by non-governmental organizations, activists, and our entire community to be wasted.”

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India

Expected India Supreme Court ruling could shape future LGBTQ rights cases

Decision to determine whether courts can use constitutional morality doctrine

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The Indian Supreme Court (Photo by TK Kurikawa via Bigstock)

India’s Supreme Court is expected to issue a closely watched constitutional ruling that could shape the future of LGBTQ rights litigation. 

The decision will determine whether courts can continue to rely on the doctrine of constitutional morality, a principle that has underpinned several landmark rights decisions. During hearings in April, the Indian government urged the Supreme Court to reject the doctrine, arguing that it has no basis in the Constitution and should not guide judicial decision-making.

For years, the Supreme Court has relied on the constitutional morality doctrine to treat the Constitution as a living document: one whose enduring promises of justice, liberty, equality, and fraternity must be applied to the realities of a changing society rather than remain frozen in the era in which it was written.

The Indian government in April asked the Supreme Court to revisit the constitutional reasoning behind two landmark judgments: one that struck down the country’s adultery law and another that decriminalized consensual same-sex relations, arguing that both relied on a subjective invocation of constitutional morality and should no longer be treated as good law.

Arguing before a 9-judge bench considering constitutional questions referred from the Supreme Court’s 2018 Sabarimala temple case, which allowed women of menstruating age to enter one of Hinduism’s holiest shrines after a centuries-old ban, Solicitor General Tushar Mehta, India’s second-highest law officer, argued that “constitutional morality” has no textual basis in the Constitution and is instead a judicially evolved concept that is vague and indeterminate.

Mehta said the government did not oppose the Supreme Court’s decision to strike down Section 497 of the Indian penal code, which criminalized adultery, if it was based on Article 14 of the Constitution, which guarantees equality before the law and equal protection of the laws. Instead, he argued that the court should not have relied on what he described as the “vague and subjective” doctrine of constitutional morality to reach its conclusion.

Mehta told the Supreme Court that its 2018 Navtej Singh Johar v. Union of India ruling that decriminalized consensual same-sex relations wrongly equated “morality” with majoritarian or mob morality while relying on constitutional morality as the basis for its reasoning.

To support his argument against relying on constitutional morality, Mehta quoted extensively from then-Justice Antonin Scalia’s dissent in the U.S. Supreme Court’s 2003 decision in Lawrence v. Texas

Scalia argued that courts should not import foreign legal trends or allow evolving social values to drive constitutional interpretation, contending that judges must remain neutral arbiters rather than participants in broader cultural debates.

Referring to the Supreme Court’s landmark decisions in Navtej Singh Johar and Joseph Shine, Mehta questioned whether the judgments reflected the constitutional vision of India’s founding generation

“If these judgments, Navtej Johar, Joseph Shine, etc., were to be read by Dr. Ambedkar or Kanhaiyalal Munshi or Alladi Krishnaswamy Iyer, I do not know whether they would be surprised, shocked or they would say that this is what we wanted. I believe, they did not want this to happen,” he told the bench.

“A new trend starts, which is Naz Foundation v. Government of NCT of Delhi,” Mehta said. “This is the judgment of Delhi High Court which was ultimately affirmed in Navtej Johar, sodomy … ‘In our scheme of things, constitutional morality must outweigh the argument of public morality, even if it be the majoritarian view.’ In case of a country governed by democratic principles, the view which is always majoritarian will prevail. When it is question of testing a law, it is always the majority which passes the law. How can you define morality based on this?”

The Naz Foundation case marked the beginning of a landmark constitutional challenge to Section 377 of the Indian penal code, a colonial-era provision that criminalized consensual same-sex relations between adults as “against the order of nature.” The public interest litigation, filed in 2001 by the Naz Foundation, an NGO working on HIV/AIDS and sexual health, argued that the law violated fundamental rights guaranteed under the Constitution. 

In 2009, the Delhi High Court ruled in the organization’s favor, holding that Section 377 violated the rights to equality under Article 14, protection against discrimination under Article 15, and life and personal liberty under Article 21 of the Constitution.

The Delhi High Court’s ruling was short-lived. 

In 2013, the Supreme Court, in Suresh Kumar Koushal v. Naz Foundation overturned the decision, recriminalizing homosexuality under Section 377. 

The court held that the law affected only a “minuscule fraction” of the population and said it was for Parliament — not the judiciary — to decide whether the provision should remain on the statute books. Five years later, the Supreme Court’s Constitutional Bench in Navtej Singh Johar, unanimously overruled its 2013 judgment, holding that Section 377 was unconstitutional. The decision marked the culmination of the Naz Foundation’s long legal challenge to the colonial-era provision.

Anish Gawande, the first openly gay person to serve as a national spokesperson for a major political party in India, the Nationalist Congress Party (Sharadchandra Pawar), told the Washington Blade that the doctrine of constitutional morality, which he said underpinned not only Navtej Singh Johar but also forms one of the foundational principles of India’s constitutional jurisprudence, is “an incredibly important concept.”

“It provides a moral backbone to the document in a way that prevents any amendments to the Constitution from being out into place that would violate the very ethos upon which the Constitution was framed,” Gawande said. “Constitutional morality is an incredibly important antidote to societal morality. It’s been what has allowed us to clamp down on things like dowry. It’s been something that has allowed us to bar even regressive religious practices that might go against human dignity. It’s also been an incredibly important framework that has allowed for the advancement of LGBTQ rights in opposition to arguments made by practitioners and leaders of various religious denominations about the societal immorality of queerness.” 

“The most critical part of constitutional morality, which is a doctrine that has been put in place by the courts, is that it is a very effective bulwark against majoritarianism and the unilateral diktat of the executive over the judiciary and, in some ways, also the legislature,” he added.

Gawande said those factors make constitutional morality “an incredibly important concept” in Indian constitutional jurisprudence. 

If the Supreme Court were ultimately to narrow or reject the doctrine, he said, judgments that have relied on constitutional morality, including the landmark Navtej Singh Johar ruling could come under renewed scrutiny. He added, however, that he did not believe the Supreme Court would take that step because it would run contrary to its own institutional interests.

Gawande said the government has advanced several reasons for challenging the doctrine of constitutional morality. One of them, he said, is that the solicitor general has opposed the doctrine in cases involving religious issues, arguing that courts should not rely on it in constitutional adjudication. 

“The downward repercussions of this, however, could extend to LGBTQ rights and to the rights of all sorts of persecuted minorities in the future,” he said.

“The second thing is that, in principle, the section 377 judgment, of course, rests upon constitutional morality, but it is also resting upon so many other fundamental rights, including the right to privacy that Puttuswamy upheld before the Navtej Singh Johar verdict,” Gawande added. “In Navtej, the right to privacy was also cited as an incredibly important condition upon which the decriminalization of ‘carnal intercourse against the order of nature’ could be permitted. In many ways, the fact that Section 377 does not exist on the statute books at all in the present updated penal codes, Bharatiya Nyaya Sanhita and Bharatiya Nagarik Suraksha Sanhita, provides some respite. The entry of Section 377, at least immediately after a reading down of constitutional morality, is not imminent yet. However, it opens the door for a new Section 377 to be introduced and the judicial mechanism available to counter that new section 377, if it were to be introduced, to be reduced significantly.”

Ankit Bhupatani, an LGBTQ activist, said he does not believe the Supreme Court’s reconsideration of constitutional morality would lead to the recriminalization of consensual same-sex sexual relations. 

He argued the 2018 Navtej Singh Johar decision rests on multiple constitutional principles beyond constitutional morality, but warned that weakening the doctrine could make it more difficult to secure future LGBTQ rights through the courts.

“If we have to take an informed guess on why the government does not like the concept of constitutional morality, it is because it wants a narrower field of judicial review and an elected legislature restored as the primary author of social policy,” Bhupatani said. “But we have already seen parliament’s ability to make laws related to LGBT rights, and it does not give optimism.” 

“The only practical way forward for LGBT rights in India is the judiciary,” he added. “But if the government’s argument is accepted by the Supreme Court, it means the next gay Indian who walks into a court for marriage, for adoption, for inheritance, or for a job they were fired from, finds it more difficult to secure these rights from the only institution from which we could hope for a positive outcome.”

Bhupatani said the decriminalization of consensual same-sex sexual relations would probably survive because the Navtej Singh Johar judgment also rests on the constitutional principles of privacy and equality. However, he warned that weakening the doctrine of constitutional morality could stall broader progress for LGBTQ rights. 

“The community keeps the floor and loses the staircase,” he said. “Nobody is criminalized, but nobody moves up.”

“The clever thing about this is that it lets the government have it both ways. To its so-called base, who think that making the law, especially on social issues, is the work of elected parliamentarians and not judges,” said Bhupatani. “It signals that the 2018 verdict was a judicial overreach that ought never to have happened. To everyone else, truthfully, that it never asked to recriminalize anyone. Both messages, one filing.”

Bhupatani said the implications of the government’s position extend beyond LGBTQ rights, arguing that asking the Supreme Court to treat the reasoning in Navtej Singh Johar as “not good law” raises broader questions about India’s commitment to constitutional rights. He said such a move could also affect how India’s constitutional democracy is perceived internationally.

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