In Mexico, sex work is considered a public health problem because it is associated with the spread of sexually transmitted infections (STIs). Due to this, health regulation is based on reducing or eliminating the effects of sex work on the general population, through mandatory health checks and sanitary control. This comes at a high economic cost for sex workers and violates their human rights.
Joseph is a 28-year-old trans person, known in the LGBTI community as "La Yuli.” Ze is a sex worker and member of “Jóvenes Diversos VIHDA.” In an interview with NSWP’s Latin America Regional Correspondent, ze told NSWP how ze faced this situation:
In order to practice sex work, we are obliged to check in the registry of Comprehensive Care Centers for the Review of Sexual Risk (Centros de Atención Integral para la Revisión de Riesgos Sexuales, CAIRRS). We are expected to provide personal data that will enable our identification, location and control, and be subjected to a medical examination, so we can be provided with a health-check card that comes with a weekly payment of $150.00 pesos (less than $8.00 USD).
We have no choice but to be checked for HIV every 6 months, with a cost of $180.00 (approx. $10.00 USD). In cases of finding out that we have a sexually transmitted infection we are channeled to the health center, that is if you are entitled to Seguro Popular (a Public Health care program). If you are not entitled, we have to buy the medicines on our own. The blood check, and any additional exams we also have to pay for. Everything has a cost. If we dare to work having a sexually transmitted infection, we get a fine of $2,000.00 (approx. $200 USD). If we are diagnosed with HIV we get red flagged in all the workplaces, as well as in the clubs, and all of us who come out as positive get monitored.
In my case, I got the health card withdrawn and I was forbidden to work. I wasn’t channeled to the HIV & Ambulatory Care and Prevention Centre (CAPASITS) so I could receive my medicine promptly, thus violating my sexual and reproductive rights, because I could have continued working if I were given antiretroviral medicine on time and so get undetectable."
In December 2015, “Jóvenes Diversos VIHDA” filed a complaint with the National Commission on Human Rights (Comisión Nacional de Derechos Humanos CNDH). Immediate injunction was issued for care, clinical analysis and administration of medicines by CAPASITS.
Today, “La Yuli” is dedicated to supporting partners and conducts advocacy work to combat the high costs associated with health care in Mexico. These costs include the costs of obtaining a health check card.
Ze argues that mandatory testing and the requirement that sex workers have a health card violates the rights of sex workers as outlined in the Mexican Official Standard (Norma Oficial Mexicana) NOM-010-SSA2-1993.
The Mexican Official Standard establishes that prevention efforts related to HIV/AIDS and the promotion of health should be based on scientific evidence, respect for dignity and human rights and not on prejudice, moral or religious beliefs.
It puts emphasis on respect for the protection of health, and the right to equality, ensuring that health services provided respect every person’s right to privacy. It also determines that HIV tests should be offered for free. The tests should be voluntary and confidential, and shall not be required as a condition for access to goods and services of any kind, marriage, getting a job, joining educational institutions or to receive medical care, and should not be used in any other case to prevent or defeat the exercise of the rights of the individual.