Suchergebnisse

Se establece una relación entre la inmigración interna e internacional y el Sida en los municipios conurbados del área metropolitana de la ciudad de México, a través de la descripción de las características de los inmigrantes que se cuentan entre los casos de Sida, en comparación con las características de los inmigrantes de la región en general y con las de los casos de Sida (no migrantes); y la presentación de un indicador de migración diferencial de la población con Sida. Los resultados muestran que los lugares de residencia anterior no concuerdan con el patrón conocido de inmigración de la región, con un sobre-representación de migración internacional y de Jalisco y Baja California; y el indicador de migración diferencial muestra que la migración ha sido mayor en la población con Sida que en la población total de la región.

Objective. Qualitative study to identify and understand the barriers to using HIV/AIDS surveillance data experienced at the state level in Mexico. Materials and methods. Eighteen individuals were interviewed in Michoacán, Morelos and Mexico City, including representatives from government and non-government organizations. Transcripts were analyzed thematically based on expected barriers to data utilization drawn from the literature. Results. Four categories of barriers were identified: knowledge and accessibility to existing data, limits on using data, decision-making barriers, and resource barriers. Discussion. This study highlights the factors that influence how local programs use surveillance data to improve their programmatic activities. Two specific areas are identified for potential improvements: awareness and accessibility of surveillance data available, and improving local capacity of officials to use them. ; Objetivo. Estudio cualitativo para identificar y entender las barreras que afectan el uso de datos de vigilancia epidemiológica del VIH/sida en el ámbito estatal en México. Material y métodos. Dieciocho individuos fueron entrevistados en Michoacán, Morelos y México DF, incluyendo representantes gubernamentales y no gubernamentales. Las entrevistas fueron analizadas con códigos temáticos basados en textos especializados sobre las barreras para la utilización de datos. Resultados. Cuatro categorías de barreras fueron identificadas: conocimiento y accesibilidad de datos existentes, límites en la utilización de datos, toma de decisiones, y recursos limitados. Discusión. Este estudio resalta los factores que influyen sobre la manera en que los programas locales usan datos de vigilancia epidemiológica para mejorar actividades programáticas. Se identifican dos áreas específicas para intervenir: conciencia y accesibilidad de los datos de vigilancia disponibles, y capacitar a las autoridades locales para usarlos.

AbstractBackgroundEfforts to increase HIV testing, diagnosis and care are critical to curbing HIV epidemics among cisgender men who have sex with men (MSM) and transgender women (TW) in low‐ and middle‐income countries (LMIC). We compared the effectiveness of respondent‐driven sampling (RDS) and venue‐based sampling (VBS) for identifying previously undiagnosed HIV infection among MSM and TW in Tijuana, Mexico.MethodsBetween March 2015 and December 2018, we conducted RDS within the social networks of MSM and TW and VBS at venues frequented by MSM and TW to socialize and meet sexual partners. Those reached by RDS/VBS who reported at least 18 years of age, anal sex with MSM or TW, and no previous HIV diagnosis were eligible for HIV testing.ResultsOf those screened following recruitment via RDS (N = 1232; 98.6% MSM; 1.3% TW), 60.8% (749/1232) were eligible for HIV testing and 97.5% (730/749) were tested for HIV infection, which led to the identification of 36 newly diagnosed HIV infections (4.9%). Of those screened following recruitment via VBS (N = 2560; 95.2% MSM; 4.6% TW), 56.5% (1446/2560) were eligible for HIV testing and 92.8% (1342/1446) were tested for HIV infection, which led to the identification of 82 newly diagnosed HIV infections (6.1%). The proportion of new HIV diagnoses did not differ by recruitment method (ratio = 0.81, 95% confidence interval: 0.55 to 1.18). Compared to those recruited via RDS, those tested following recruitment via VBS were younger, more likely to identify as gay, and more likely to identify as TW. Compared to those recruited via VBS, those newly diagnosed with HIV infection following recruitment via RDS reported higher levels of internalized stigma and were more likely to report injection drug use and a history of deportation from the United States.ConclusionsDespite RDS and VBS being equally effective for identifying undiagnosed HIV infection, each recruitment method reached different subgroups of MSM and TW in Tijuana. Our findings suggest that there may be benefits to using both RDS and VBS to increase the identification of previously undiagnosed HIV infection and ultimately support HIV care engagement among MSM and TW in Mexico and other similar LMIC.

Objective. This study examines the antiretroviral (ARV) market characteristics for drugs procured and prescribed to Mexico's Social Protection System in Health beneficiaries between 2008 and 2013, and compares them with international data. Materials and methods. Procurement information from the National Center for the Prevention and the Control of HIV/AIDS was analyzed to estimate volumes and prices of key ARV. Annual costs were compared with data from the World Health Organization's Global Price Reporting Mechanism for similar countries. Finally, regimens reported in the ARV Drug Management, Logistics and Surveillance System database were reviewed to identify prescription trends and model ARV expenditures until 2018. Results. Results show that the first-line ARV market is concentrated among a small number of patented treatments, in which prescription is clinically adequate, but which prices are higher than those paid by similar countries. The current set of legal and structural options available to policy makers to bring prices down is extremely limited. Conclusions. Different negotiation policies were not successful to decrease ARV high prices in the public health market. The closed list approach had a good impact on prescription quality but was ineffective in reducing prices. The Coordinating Commission for Negotiating the Price of Medicines and other Health Supplies also failed to obtain adequate prices. To maximize purchase efficiency, policy makers should focus on finding long-term legal and political safeguards to counter the high prices imposed by pharmaceutical companies.