Challenges to the HIV Care Continuum During the COVID-19 Pandemic in Mexico: A Mixed Methods Study.

The COVID-19 pandemic has been reported to disrupt the access to care of people who live with HIV (PWH). The impact of the pandemic on the longitudinal HIV care continuum, however, has not been properly evaluated. We performed a mixed-methods study using data from the Mexican System of Distribution, Logistics, and ART Surveillance on PWH that are cared for in the state of Oaxaca. We evaluated the number of HIV diagnoses performed in the state before and during the pandemic with an interrupted time series. We used the longitudinal HIV care continuum framework to describe the stages of HIV care before and during the pandemic. Finally, we performed a qualitative analysis to determine which were the challenges faced by staff and users regarding HIV care during the pandemic. New HIV diagnoses were lower during the first year of the pandemic compared with the year immediately before. Among 2682 PWH with enough information to determine their status of care, 728 started receiving care during the COVID-19 pandemic and 1954 before the pandemic. PWH engaged before the pandemic spent 42825 months (58.2% of follow-up) in optimal HIV control compared with 3061 months (56.1% of follow-up) for those engaged in care during the pandemic. Staff and users reported decreases in the frequency of appointments, prioritisation of unhealthy users, larger disbursements of ART medication, and novel communication strategies with PWH. Despite challenges due to government cutbacks, changes implemented by staff helped maintain HIV care due to higher flexibility in ART delivery and individualised attention.

Limits, excesses and pleasures: practices and discourses of sex work in a Mexican rural community.

In Tomatlán, a small city on the Mexican Pacific Coast there is a tolerance zone in which a group of sex workers, separated from the rest of the city by a garbage dump, offer their services to local men. The women present themselves materially and symbolically as agents of regulation with respect to male sexuality, itself constructed as overwhelming and insatiable, which, were it not for services provided by the sex workers, would threaten the family-based social order. Through in-depth interviews with 19 sex workers and 5 municipal officials, this paper discusses how the sex gender system results in a series of borders that are both geographical and subjective. Such borders have to do with periphery and control, body and intimacy, and the boundaries of animality.

Límites, excedentes y placeres: prácticas y discursos en torno al trabajo sexual en una zona rural de México / Limits, excesses and pleasures: practices and discourses on sexual work in a Mexican rural community / Limites, excessos e prazeres: práticas e discursos em torno do trabalho sexual em uma zona rural do México

En una pequena ciudad de la costa mexicana del Pacífico se encuentra una zona de tolerancia donde un grupo de trabajadoras sexuales, separadas del resto de la ciudad por contenedores de basura, ofrece sus servicios a los hombres de la localidad. Las mujeres se presentan, material y simbólicamente, como agentes regulatorias de una sexualidad masculina que se construye desbordante e insaciable y que, de no ser por ellas, amenazaría el orden social fundado en la familia. A partir de entrevistas realizadas con trabajadoras y con autoridades municipales, en este artículo se analizan las maneras en que un sistema de sexo-género produce localmente una serie de limites cuyos ejes son, al tiempo, geográficos y subjetivos: la periferia y el control, cuerpo e intimidad, y la frontera de la animalidad.

In a small city in the Pacific coast of Mexico there is a red-light district where a group of sex workers, separated from the rest of the town by trash containers, offer their services to local men. The women present themselves both materially and symbolically as regulatory agents of a male sexuality understood as overflowing and insatiable and which, were it not for them, would threaten a social order founded in the family. Drawing from interviews with sex workers and municipal authorities, this article discusses the ways in which a sexgender system produces local borders which are both geographical and subjective: periphery and control, body and intimacy, and the boundaries of humanity and heterosexuality.

Em uma pequena cidade da costa mexicana do Pacífico se encontra uma zona de tolerância onde um grupo de trabalhadoras sexuais, separadas do resto da cidade por contêineres de lixo, oferece seus serviços aos homens da localidade. As mulheres se apresentam material e simbolicamente como agentes reguladoras de uma sexualidade masculina que se constrói de forma transbordante e insaciável e que, se não fosse por elas, ameaçaria a ordem social baseada na família. A partir de entrevistas realizadas com trabalhadoras e com autoridades municipais, neste artigo se analisam as maneiras com que um sistema de sexo-gênero produz localmente uma série de limites cujos eixos são, ao mesmo tempo, geográficos e subjetivos: a periferia e o controle, corpo e intimidade e a fronteira da animalidade.

Politics, religion and gender equality in contemporary Mexico: women's sexuality and reproductive rights in a contested secular state.

This article explores the complexities of the interaction between politics, religion and gender equality in contemporary Mexico, by analysing recent developments in public debate, legal changes and implementation of government policies in two areas: 1) the inclusion of emergency contraception in public health services in 2004; and 2) the decriminalisation of abortion in Mexico City in 2008, which was followed by a massive campaign to re-criminalise abortion in the federal states. Three main findings emerge from our analysis: first, that women's sexual and reproductive autonomy has become an issue of intense public debate that is being addressed by both state-public policy and society; second, that the gradual democratisation of the Mexican political system and society is forcing the Catholic Church to play by the rules of democracy; and third, that the character and nature of the Mexican (secular) state has become an arena of intense struggle within which traditional political boundaries and ideologies are being reconfigured.