Pre-exposure prophylaxis and its implications in Mexico: notions of men who have sex with men

Abstract

Background The aim of this study was to analyse ideas regarding pre-exposure prophylaxis (PrEP) for the prevention of HIV among groups of men who have sex with men in Mexico for future implementation in health services. Methods: During 2015, 54 people participated in four focus groups in three Mexican cities. Issues related to challenges for uses and limitations of PrEP were explored. Results: In contrast with other qualitative studies, which emphasised problems with relationships with other people for PrEP use or access to key populations, Mexican participants focused their concerns around the public health services organisation: PrEP is too expensive and the health services have no resources, which will affect services and result in discrimination. Participants identified possible stigmatisation related to prejudices of medical providers who do not approve the decreased use of condoms. As a potential solution, participants suggested that the Mexican Government could negotiate a lower cost for PrEP and public health services could provide the medication, with periodical review of the arrangements by civil organisations. Conclusion: In the current context of the new Mexican government, it is necessary to propose public politics focused on negotiating with pharmaceutical companies on the costs of the PrEP, coordinating public services with groups within civil society and strengthening policies and actions to reduce stigma and discrimination.