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.
Amid heatwaves in the Indian capital of New Delhi, the world’s biggest election is raising the temperature even higher.
The temperature in the Indian capital on the morning of April 18 reached 107 degrees, and the sun blazed like a furnace. In the political corridors, however, the sweat wasn’t just from the heat, but from the fervent preparation for and in anticipation of the election results.
The Bharatiya Janata Party, the current ruling party, aggressively prepared for the 2024 general election months ago but the other regional and national parties still seem to be preparing while the election has started in the country.
The Washington Blade traveled to New Delhi and witnessed the political party’s campaign and preparations.
Home Minister Amit Shah, representing the BJP, was aggressively campaigning in Ahmedabad and Gandhinagar in Gujarat state. BJP National President Jagat Prakash Nadda was campaigning in Assam state.
The Blade interviewed Barkha Trehan, a political activist in New Delhi. She said that while various political parties in India address transgender and women’s issues in their campaign rhetoric, the Indian National Congress fails to translate its promises into action at the grassroots level.
“Political parties, especially the Congress party in the country, have talked and written enough in their election manifesto, but in last many years they have done nothing,” Barkha told the Blade. “In the last 10 years, we have seen that whatever Bharatiya Janata Party (BJP) says or has written in their election manifesto, we have seen that work done on the ground level. Let’s say it is a women’s issue or transgender community issue, or any other issues like infrastructure issues, everything is visible.”
Barkha said that discussing an issue and taking tangible action on it are distinct endeavors.
She emphasized the BJP’s efforts at the grassroots level, whether concerning trans issues or other matters, deserve recognition. The BJP, according to her, has undertaken numerous initiatives for the trans community that skill development programs and providing loans for startups.
“BJP wants to work for all without any discrimination,” Barkha told the Blade. “They want to create a good image of our country in the world, but the Congress party always pulls down the fame. They always go abroad and discredit the country by talking negative all the time. They think this is the only way to win election in India, but this won’t work out for them.”
Talking about trans issues, Barkha said Prime Minister Narendra Modi has met people from the trans community. She told the Blade that he is trying to motivate the trans community to take advantage of employment opportunities.
“Before Modi, nobody used to look at the transgender community,” said Barkha. “No one used to talk about them. When the prime minister’s video went viral on the internet and television while he had a conversation with the transgender community, other people started and felt inspired to work for the transgender community and talk to them.”
Barkha told the Blade these things send a message to the trans community that there are people who are listening and who will always stand by it.
She noted the trans community has always faced discrimination, neglect, and abuse in India. This political outreach, according to Barkha, sends a strong message that the trans community is as important as anyone else, they have the same value as any other citizens in the country, and they deserve a better life. She told the Blade trans people can make money when they can learn new skills, and they will have self-confidence and self-respect when they can earn a living.
Discrimination based on gender identity remains commonplace in India
India’s trans community has suffered discrimination for many years.
An openDemocracy report notes 80 percent of trans Indians are either engaged in sex work or begging. India in 2019 passed a law, Transgender Persons (Protection of Rights) Act, with aims to protect the rights of trans people, their welfare, and matters connected therewith and incidental thereto.
The Indian government and BJP in 2022 came up with a socialist scheme for trans people. Support for Marginalized Individuals for Livelihood and Enterprise is a program to support trans people who are engaged in begging. It provides them access to medical facilities, counseling, education, skill development, and economic linkages with the support of state governments and local urban bodies along with volunteer and community-based organizations.
The Congress in Telangana state was recently accused of disrespecting the trans community when Revanth Reddy, the Congress party’s sitting chief minister, sent anti-trans slurs that targeted the state’s opposition party.
The Blade reached out to the Congress party’s office in New Delhi, but it denied the interview request.
BJP’s position on LGBTQ issues questioned
The Blade while in New Delhi also visited the Aam Aadmi Party’s headquarters.
Despite the scorching sun overhead, Delhi residents sought refuge from the sweltering temperatures. The Blade, amid the election fervor and campaign hustle, interviewed Aam Aadmi Party spokesperson Preeti Sharma Menon. She said the BJP is regressive and seeks to intrude into a person’s bedroom, dietary choices, and other aspects of their personal lives.
“If BJP comes back to power, the party will keep doing what it is doing now, not supporting LGBTQ rights,” said Menon. “I think, there is no doubt in the LGBTQ community that one cannot have BJP in power and live safely. If we want to give equal rights to every citizen of this country, then only the Indian National Developmental Inclusive Alliance is the only chance.”
She said the Aam Aadmi Party always tries to give LGBTQ people a chance, but the party in this general election has few seats (in parliament) for which to fight because it is part of the opposition alliance.
“We always think if you want the change, the LGBTQ community must have a representation in the parliament,” said Menon. “So, we always try to make LGBTQ community in the country politically active.”
Ankush Kumar is a reporter who has covered many stories for Washington and Los Angeles Blades from Iran, India and Singapore. He recently reported for the Daily Beast. He can be reached at [email protected]. He is on Twitter at @mohitkopinion.
Africa
Senegalese NGO claims new president discussed LGBTQ rights with top EU official
Jamra Ong Islamique demands government expedite anti-LGBTQ law
A Senegalese NGO has called on the government to expedite the process of enacting an anti-LGBTQ law after the country’s new president met with a top EU official.
Jamra Ong Islamique made the call during a press conference last Wednesday after newly elected Senegalese President Bassirou Diomaye Faye met with European Council President Charles Michel.
Mamae Makhtar Gueye of Jamra Ong Islamique claimed the meeting between the two dignitaries involved an acknowledgment of LGBTQ rights in Senegal. Gueye said Michel is an LGBTQ ally who wants to change Senegal’s cultural customs that do not condone LGBTQ rights.
“His ardent proselytism for the expansion of LGBT ideology could not leave Jamra indifferent,” said Gueye. “Countries including Gabon, Central African Republic, and Mauritius, amongst others, that underestimated the nuisance of these propagandists of homosexuality paid dearly for it because these global lobbyists ended up legalizing this abomination, so beware.”
Gueye, however, has received a lot of backlash and has been accused of not raising the same sentiments during the tenure of former President Macky Sall, who also met with Michel.
“Did he come as a defender of the LGBT cause or as a European official? Did he come to talk about LGBT rights or partnership agreement between the European Union and Senegal?,” asked Ahmadou Diaw, a Senegalese academic. “Mr. Gueye should know when to alert and when to shut up.”
Cheikh Maï Niang, a social commentator, described Jamra as a “useless organization” that is focused on restricting the freedom of the Senegalese people.
“They are absolutely good for nothing apart from eating the taxpayer’s money,” said Niang. “Where is the democracy we cry about everyday? Seems like they are here to restrict the freedom of the Senegalese people.”
“Not everyone is interested in religion,” added Niang. “We wasted too much time with these useless things. Let’s talk about developing the country. People should live their lives in the manner they want.”
Jamra has previously made proclamations against the LGBTQ community.
The organization in February — before Senegal’s presidential election that took place on March 24 — accused the EU Electoral Observation Mission to Senegal of wanting to indoctrinate Senegalese people with their pro-LGBTQ narrative.
Senegal does not have a law that specifically criminalizes those who identify as LGBTQ or advocate for them. Article 319 of the country’s penal code criminalizes consensual same-sex sexual relations with a fine and between one and five years in prison.
Some Senegalese lawmakers have sought to increase the prison sentence to 10 years for anyone convicted of engaging in homosexuality. These efforts thus far have not been successful.
Samm Jikko Yi (Together for the Safeguarding of Values), an Islamic lobby group that includes many organizations, in 2022 organized an anti-LGBTQ demonstration in Dakar, the country’s capital. Protesters called for harsher penalties for Senegalese who identify as LGBTQ and/or advocate for LGBTQ rights.
The Washington Blade in 2022 noted LGBTQ people have suffered physical and sexual abuse while in prison.
Senegal’s deep religious roots, which are largely Islamic, have contributed to the lack of tolerance of LGBTQ people in the country. This reality has prompted LGBTQ Senegalese to either flee the country or remain in the closet.
Media reports indicate there are fewer bars, clubs and other places where LGBTQ people can freely socialize.
The queer community in Kenya can breathe a sigh of relief after a Mombasa court on Monday ruled clerics, politicians, and anti-LGBTQ groups cannot hold homophobic protests or engage in incitement.
The Mombasa High Court’s ruling, however, is temporary until July 24 when the court in Kenya’s second-largest city determines a petition on the issue.
Two petitioners — Mr. JM and the Center for Minority Rights and Strategic Litigation — last October sued Police Inspector General Japhet Koome for allowing religious leaders and lobby groups to hold homophobic protests whenever a court rules in favor of the LGBTQ community.
The petitioners’ effort to demand a ban on anti-LGBTQ protests in Kenya was in response to a series of homophobic demonstrations, particularly in Mombasa, after the Supreme Court last September affirmed an earlier decision that allowed the National Gay and Lesbian Rights Commission to register as an NGO.
Mombasa High Court Judge Olga Sewe in her Monday ruling also directed the petitioners and the respondents, who include Koome, two anti-LGBTQ activists and a national lobby group dubbed the “Anti-LGBTQ Movement” that organized protests, to file their witness lists and counter statements within 14 days of the July hearing.
“Pending the hearing and determination of this petition, this Honorable Court (does) hereby issue a conservatory order restraining the 2nd and 5th Respondents from calling on or inciting members of the public to carry out extra-judicial killing, lynching, punishing, stoning, forcible conversion, or any other means of harming LGBTQ+ identifying persons and their homes,” Sewe stated.
She also stopped the “Anti-LGBTQ movement,” Koome and any state agency from any attempted “expulsion from Kenya or any party of Kenya of LGBTQ+ identifying persons or closure of organizations serving LGBTQ+ identifying persons.”
The court’s directives come after the Center for Minority Rights and Strategic Litigation led a protest on April 11 against the “anti-LGBTQ Movement”‘s invasion of Mvita Clinic in Mombasa that “hateful misinformation” reportedly sparked because the facility also serves queer people.
“Mvita Clinic, like all healthcare providers, serves the entire community,” CMRSL stated. “Targeting them for LGBTQ+ inclusion is discriminatory and an attack on the basic right to health. Everyone deserves access to healthcare, and we urge an end to the spread of lies. Let’s promote inclusivity and ensure Mvita Clinic remains a safe space for all.”
CMRSL in response to Osewe’s ruling said it was a “major win for safety and equality in Kenya” because it allows the LGBTQ people to live with “greater peace of mind.”
The Initiative for Equality and Non-Discrimination, an LGBTQ rights group, meanwhile lauded the court’s decision as a reprieve to homophobic attacks on the queer community.
“There is some reprieve given the security incidents we witnessed during the protests on Sept. 15 last year,” INEND Communications Officer Melody Njuki told the Washington Blade.
“We had rescued LGBTQ+ folks in Mombasa, Kilifi, and Lamu, due to security incidents caused by the hatred the anti-LGBTQ movement mongered and the calling of violence towards people associated with the queer group and those identifying as members,” she added.
PEMA Kenya, a Mombasa-based gender and sexual minority organization, also applauded the court’s temporary injunction, describing them as timely in protecting the LGBTQ community against all forms of homophobic attacks.
“We welcome the ruling and we believe it will impact our members who for some time felt robbed of the freedom to express themselves,” PEMA Kenya director Ishmael Baraka told the Blade.
The Nature Network, a rights organization for refugees living in Kenya, also welcomed the Monday ruling which it termed “a positive step showing the courts’ commitment to upholding human rights for all.”
“Anti-LGBTQ Movement” Chair Salim Karama, however, declined to respond to the Blade’s questions about the ruling until determination of the petition’s status. He noted the organization is waiting for their lawyer to speak with them about the decision and the filing of counter statements that Sewe ordered.
As LGBTQ rights groups seek the queer community’s protection in Kenyan courts, parliament, on the other hand in is set to consider a petition that notes what it describes as the proliferation of homosexuality in the country.
National Assembly Speaker Moses Wetang’ula on Feb. 27 referred the petition to the relevant parliamentary committee for inquiry after MP Ali Mohamed, a member of the ruling party and a vocal LGBTQ rights opponent, presented it in the National Assembly, the lower house of the Kenyan parliament, on behalf of a group of more than 70 Kenyans and religious organizations opposed to homosexuality.
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