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By Milena Pafundi, from Mexico City

2019 was a challenging year for HIV/AIDS prevention, care, and control in Mexico, according to organizations. In addition to newly diagnosed cases, there were delays and confusion surrounding the publication of the call for proposals for subsidies to Civil Society Organizations (CSOs) dedicated to HIV/AIDS prevention and diagnosis. Throughout 2019, several people indicated that the Mexican government's new bidding process for purchasing medications led to shortages of antiretroviral treatments.

Although care and medications are free in some of the federal Ministry of Health's facilities, these changes are affecting the actions that CSOs offered in terms of prevention and field care in a way that complements the health agencies, as noted by the Mexican Network of People Living with HIV.

READ MORE: Society owes a great debt to people living with HIV.

The Mexican Network is one of approximately one hundred civil society organizations that had received funding from the previous call for proposals to implement targeted prevention strategies for HIV and other sexually transmitted infections (STIs). However, in the current situation, the Network is feeling the effects of President Andrés Manuel López Obrador's mandate, who announced that resources would not be transferred to social organizations but directly to beneficiaries as a strategy to eradicate the mismanagement of funds by some organizations. This means that the 110 million pesos that the legislators allocated to this area will not be distributed among CSOs but will instead be used to strengthen the public health institutions of the current government, says Javier Martínez, adding, "They don't trust CSOs."

What problems does this shift in resources create? For CSOs, it disadvantages the most vulnerable populations living with HIV/AIDS: trans women, sex workers, people who inject drugs, and incarcerated individuals . This is because the work of CSOs is complementary to that of public health agencies.

READ MORE: Let's talk about HIV: What is HIV?

Andrea Luna is a promoter, defender, and advocate for the human rights of trans men, trans women, and people living with HIV. She is a representative of the Trans Collective for the Freedom to Be and Decide. This group has been dedicated to HIV and AIDS prevention in Mexico City and some other states for the past nine years. “We are trans women, the same ones who work at the brothels, the same ones who do sex work, the same ones who work in beauty salons. Sometimes we have funding, and other times we do it as a community service. We don't receive any payment; we only ask government agencies for brochures, and the Condesa Clinic for condoms, dual tests for HIV and syphilis, and rapid tests because we conduct outreach visits where we test the trans community who work in sex work and in beauty salons,” Andrea told Presentes.

Although they believe addressing this issue is a government priority, they continue with all possible actions. “We continue to hold prevention campaigns, outreach events, and workshops. And thanks to our excellent relationship with the Condesa Clinic, where they provide us with condoms, lubricants, and informational brochures, we also have support from other organizations and foundations. However, we haven't received any government support to continue our work.”

One of this group's projects in the city is in the Iztapalapa borough, which has the highest rate of people living with HIV. "In all the centers in Iztapalapa, people are already being trained and information is being promoted about HIV, gender identities, the sexual and reproductive rights of young people and adolescents, and early HIV detection."

READ MORE: Gay couple adopted baby girl suspected of having HIV: she had been rejected by ten families

More than 8,700 new cases diagnosed in Mexico

Mexico reached World AIDS Day 2019 with a total of 8,757 newly diagnosed HIV cases and 5,119 reported AIDS cases . This brings the total number of new cases for the year to 13,876, according to the HIV/AIDS Epidemiological Surveillance System as of November 2019. These figures are part of the total of 210,104 cases reported throughout the country over the past 36 years. The 2019 figures are lower (although data collection only began on November 11) than those of 2018, when 10,787 new HIV diagnoses and 6,396 reported AIDS cases were recorded.

Data from the Ministry of Health indicates that in Mexico, HIV infection has an estimated prevalence of 0.23% in the population aged 15 to 49. This figure is considered stable and concentrated, although it increases in population subgroups such as transgender women, men who have sex with men, sex workers, people who inject drugs, and incarcerated individuals .

The difficulties in reaching these populations are related to stigma, discrimination, and lack of access to health services, as Javier Martínez Vadillo of the Mexican Network of People Living with HIV in Mexico City points out. 

One of the problems these vulnerable groups face in accessing the public health system is stigma and discrimination, something the Mexican Network has been working on for 23 years. The network regrets the shift the current government has made in its strategy for HIV/AIDS prevention, care, and control. 

Discrimination behind the white coat

“Here in Mexico, it was Civil Society Organizations that began teaching health institutions how to work, how to ensure respect for the human rights of doctors, nurses, and other healthcare professionals. They lacked information on how to care for a cisgender lesbian woman, a trans woman, or a gay or bisexual man, or a trans man. We then observed that stigma and discrimination also exist behind the white coats and caps of lab technicians,” says Javier Martinez Vadillo, a community health technician with the Mexican Network of People Living with HIV in Mexico City. For 27 years, Javier, as an LGBTTTI+ activist and healthcare professional, has worked in the fight against AIDS. 

Martínez Vadillo states: “We can’t go out on the street because they aren’t giving us as many condoms anymore. And the volunteers don’t even have enough for a subway fare.” This affects Mexico’s commitment to meeting the “ 90-90-90: Treatment to End the AIDS Epidemic” , one of UNAIDS’ goals for HIV treatment. This means the commitment that 90% of the population living with HIV should be diagnosed, 90% of those diagnosed should receive treatment, and 90% of those on treatment should achieve undetectable viral loads.

SEE MORE: Let's talk about HIV: Undetectable = untransmittable

“I see it as a failure, and we in the civil society also have to acknowledge it. We rested on our laurels, we felt very comfortable, we didn't move. This is waking us up, and we've decided to work hard, even if it's just a little. To go as far as we can. Some organizations will probably disappear. Because they only survived thanks to this coordinated work with CONASIDA, which is the official agency of the Mexican Republic. And today it's a weak agency, one that isn't providing answers,” the expert pointed out.