amfAR, The Foundation for AIDS Research

GMT Grantee Profile

Vallarta Enfrente el SIDA (Puerto Vallarta, Mexico)

Preventing HIV in a growing MSM population

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Strategies

  • Providing targeted HIV prevention services for gay tourists and hard-to-reach MSM
  • Bridging the gap between local HIV clinics and MSM

Every year, millions of tourists visit the beaches of Puerto Vallarta, Mexico, to escape their everyday lives. The visitors are Mexican and foreign alike, and thousands of them choose to settle permanently, leaving behind the past in favor of a more open, tolerant community.

Mexico 1

VES members participated in a march and rally marking the International Day Against Homophobia on May 17, 2010. (Photo: Vallarta Enfrenta el SIDA A.C.) 

The welcoming culture of Puerto Vallarta has made it a hotspot for a growing gay population. Gay men and other MSM from all over Mexico, indeed the world, go there looking for fun and new sexual encounters. It is in this setting that Vallarta Enfrente el SIDA (VES) works to combat HIV and build links between the MSM population and the city’s health services.

Julio Madrid, the executive director of VES, explains why Puerto Vallarta is unique, and the challenges that creates: “The closed nature of other parts of the country means more people flock here. But out of that population, a lot do not identify as gay or bisexual. They still want to portray an image of being straight, but have sex just with men. It’s a cultural thing here. People want to come here and be part of the gay community but still do not identify as gay. It’s hard to reach those people—and they have taboos in mind, that they do not wear a condom because they associate it with ‘gay’ identity.” Those taboos have contributed to an HIV prevalence rate of approximately 25 percent among Mexican MSM.*

VES has learned that one of the keys to engaging MSM in its community is to maintain a nonjudgmental attitude in all its programs. Many of the MSM in Puerto Vallarta have left other places to escape judgment and mistreatment. Thus, it is essential that these men be approached in a way that shows respect and genuine caring.

VES leads a range of outreach and prevention activities with MSM, getting educational information and prevention tools (such as condoms and lubricant) into the hands of the men who are at risk of infection. Among its strategies is a peer “celebrity” education effort that relies on the popularity of local figures to convey important prevention messages. The local celebrity advocates are identified by VES staff and volunteers, trained on basic aspects of HIV prevention and access to services, and then encouraged to speak out about the topic. In Puerto Vallarta, this has proven to be a useful activity to raise basic awareness of the disease and get more men engaged with VES’s other programs.

VES also conducts extensive street outreach at popular gay nightclubs and more hidden cruising spots in and around the city. Making progress at the cruising sites has been challenging, but with persistence VES has seen real change. According to Mr. Madrid, “We went right to the men [at the cruising sites]. We didn’t interfere with what they were up to, just said, ‘We’re here, we have condoms and lube and info.’ At first, they rejected us, but we stayed there and as weeks went by they opened up more. We now have some volunteers at those cruising sites who were originally sex workers.” Where they were once ignored, VES staff and volunteers are now busy providing condoms and educating men on how to prevent infection.

Beyond HIV prevention, VES serves as a vital link between MSM and the greater healthcare infrastructure in the city. In particular, it works with a large community clinic that has ample resources but little means to spread the word about its services. VES bridges the gap between the clinic and the community, helping clients gain quick access to the clinic’s services, especially clients who test positive for HIV.

 

In their own words

“Alejandro” is a client and volunteer of VES  

“In Puerto Vallarta there are many gay clubs. One night VES was providing condoms at a club and the packaging had their information on it. That was my first contact with them. I went straight to their office the next day to take an HIV test. After counseling me and giving me the result of the test, they told me they had a volunteer program. They saw that I was very interested because I asked many questions! Soon I helped to prepare brochures and went to health fairs as a promoter, passing information to people, inviting them to ask questions and take an HIV test. 

Puerto Vallarta is a port where people are in and out. There is much promiscuity and I had had some behaviors that I see now were quite risky. But since starting my involvement with VES, I have become a more responsible person, especially with my sexual behavior. I know the transmission routes. Now I can say “no” when I have to say “no.” 

I see myself as a permanent member of VES, supporting them in any way I can, trying to recruit more volunteers among my friends. In a few months I will be able to give HIV tests because I’m getting training to do so. There is plenty to do, so I want to get more volunteers and people to support us.” drugstore.” 

 

Footnotes

* Baral S, Sifakis F, Cleghorn F, Beyrer C. Elevated risk for HIV infection among men who have sex with men in low- and middle-income countries 2000-2006: A systematic review. PLoS Med. 2007;4(12):e339. . Accessed on May 5, 2010.