Challenging stigma and discrimination in Mexico
16 January 2006
A participatory community assessment led by the Alliance, linking organisation Colectivo Sol and Positive Action/GlaxoSmithKline, has drawn on the testimonies of people from key populations in Mexico to provide a richly documented account of the interaction between HIV/AIDS and stigma and discrimination. It has also looked at how HIV/AIDS-related stigma and discrimination link to wider social processes of stigmatisation, such as sexuality, gender, race and poverty.
The research builds on project work already underway on reducing HIV/AIDS-related stigma and discrimination among key populations in the cities of Aguascalientes, León, Irapuato, Querétaro and San Luis Potosí. It has involved nearly 700 participants from key populations – 309 men who have sex with men, 220 sex workers, 129 people living with HIV/AIDS and 36 injecting drug users. Sixty one per cent were male, 19 per cent female and 20 per cent transgender.
Men who have sex with men
Research among men who have sex with men has suggested vast socioeconomic divisions between them, with differences of class and level of education, as well as sexual preferences and practices. These differences are creating a foundation for discriminatory and stigmatising behaviour among the men themselves.
Men who have sex with men are frequently discriminated against in the family, with male family members often finding them more difficult to accept. So these men are often supported emotionally by friends rather than family. This points to the relevance of working on family and social networks linked to these populations.
Men who have sex with men are also frequently engaging in risky sexual practices, with drug and/or alcohol consumption often determining whether a condom is used. Many fear being left without a partner as a result of their sexual orientation. The difficulty in establishing longer-term relationships leads many to have casual sex without protection.
People living with HIV/AIDS
People living with HIV/AIDS are generally fearful of rejection when disclosing their HIV status, with gender differences emerging from their experience of discrimination. Both men and women can be discriminated against in the family, being separated from normal family life and with physical contact restricted. Women usually give up sex as soon as they know they are HIV positive and dedicate themselves to their children. They are judged and rejected more readily than men.
Many people living with HIV/AIDS testify to violations of their human rights in terms of unfair dismissal from work and mistreatment by health service providers. Most lose their jobs when employers learn of their status. And public hospitals offer an appalling level of service, partly out of ignorance but also because of a lack of specialised medical personnel. It is also common for health workers to violate clients’ confidentiality.
Sex workers
Sex workers also confirm the human rights violations they experience from civil servants and other public service workers. They all testify to exploitation by civil servants, police, health workers, employers and clients. Almost all of the transgender participants were sex workers. They highlight how they are rejected by family and the wider community because of their appearance and sexual preferences. Consequently, they have limited access to credit, employment, housing and so on. There is also a high level of alcohol and drug consumption among them.
Injecting drug users
The research has widely documented where and how people inject drugs. This has provided important information on practices, risks and how HIV is spread. For example, there is good evidence of risky practices, such as the use of old needles, and also of drug users exchanging sex for drugs or money to buy drugs, which puts this population at high risk of infection. The research has also documented injecting drug users’ experiences of stigma and discrimination, showing cases of family and social rejection as well as ill-treatment in health centres.
Action
Testimonies from the key population groups point to a number of areas needing immediate attention:
- better information on human rights
- addressing how vulnerable groups stigmatise themselves
- the poor quality of health services
- tackling violence and aggression in the family.
