Key Results
Investments
Key Results

The Joint Team made significant contributions in reinforcing Mexico’s effort in providing free antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) strengthening access to HIV prevention services among vulnerable and key populations and improving the health outcomes of people living with HIV. Technical support was provided for implementation of a strong COVID-19 response which enabled the Government and its partners to scale up HIV testing services.

HIV prevention, testing, and treatment

Mexico has a concentrated HIV epidemic among men who have sex with men, transgender women, and women partners of men living with HIV and thus provided technical support to the Government to initiate free PrEP services to all eligible persons at high risk of HIV infections in five selected cities—Chiapas, Jalisco, Mexico City, Nuevo Leon, and Yucatan. Scale up of PrEP service to more states is planned for 2022.

As a result of technical and financial support, the Imprep Project—the first large scale implementation research PrEP project in the country—enrolled 3297 transgender persons and men who have sex with men to study the feasibility and safety of same-day initiation of PrEP. This was a 10% increase from the 3000 people targeted in the initial plan, with a higher proportion of young people compared to similar projects in other countries of the region. With 83.9% early retention rate among participants enrolled on PrEP, the study underscored the feasibility, safety, and effectiveness of same-day initiation of PrEP as part of combination HIV prevention package.

The Government of Mexico, supported by the Joint Team and other development partners implemented a robust COVID-19 response in the context of HIV that led to a 31% increase in HIV testing and counselling (HTC) in 2021 compared to 2020. Personal protective equipment, including face masks, face shields, gloves, and antibacterial gel were provided to healthcare workers to ensure the continuity of HIV prevention and care services during the pandemic.

Contribution to the integrated SDG agenda

The Joint Team provided technical assistance to ensure vulnerable populations and all people who live with HIV in Mexico have access to free ART in line with Sustainable Development Goals (SDGs) 3 and 10, helping them focus their resources to support other areas of their lives, improving their quality of life and thereby granting to pursue opportunities for development which contributes towards SDGs 1 and 2.

Encouraging gains were also made in recognizing the rights of sexual minorities in accessing healthcare services—a contribution towards SDGs 10 and 16.

Challenges and lessons learned

In January 2020, the new government agency National Institute of Health and Wellness (INSABI) was instituted to provide health services for people who are not covered by the Mexican Social Security Institute (IMSS) and other social security programmes. However, INSABI was faced with administrative and logistical challenges that led to shortages of HIV and cancer medicines. In response, the President of Mexico gave an executive order to migrate all state health services for people without public health insurance to IMSS with a subsequent plan to replace INSBI in the next two years. Lessons learned showed the need for adequate structure to support HIV prevention, care, and treatment services in IMSS to accelerate progress in the HIV response.

A directive that came to effect in 2018 banning government funding for non-governmental organizations led to the cancellation of social contracting projects aimed at scaling up HIV prevention and detection programmes led by civil society organizations. Due to the COVID-19 pandemic and closure of community-led HIV prevention programmes, the rate of new HIV infection is expected to further rise in the coming years.

In 2021, the Mexico City Congress rescinded the specific 2012 Law for the Prevention and Comprehensive Care of HIV/AIDS of the Federal District aimed at guiding the HIV response in Mexico City in favour of a general health law. However, the new health law fails to include transgender women and gay men and other men who have sex with men under the articles addressing HIV and gender discrimination. As such, HIV prevention programmes will target the general population contrary to the World Health Organization’s recommendations on provision of focussed HIV prevention services in concentrated epidemics. The national HIV service guidelines have also not been updated since 2010, making most of the directives obsolete.

The Joint Team provided financial support to the National Centre for the Prevention and Control of HIV and AIDS (Censida) to conduct a study that revealed a 60% decrease in HIV case detection due to the COVID-19 pandemic, compared to previous years. The pandemic also took significant number of healthcare professionals and resources away from the HIV response impacting services for vulnerable people, including people living with HIV.

Mexico has complex security challenges that particularly affect key populations. Men who have sex with men and transgender women, especially sex workers from these groups remain at high risk of physical and mental abuse in areas that are affected by criminal activities. Criminal activities further affect access to HIV and violence prevention information and services. Experiences underscore the need to collaborate with community leaders and member to promote uptake of HIV prevention services; keep government officials abreast about ongoing efforts and create opportunities for collaboration; advocate for increased HIV case detection in areas with high HIV prevalence; increase the Joint Team’s support to the Government to address challenges in the HIV response.