Highlights of key initiatives 2017-2018

This document highlights the major achievement of the Ministry of Health for the period 2017-2018. Contains information about compassionate care, the strengthening of the health system , treatment of non-communicable, combating communicable diseases, protecting the health of mothers and children and rehabilitation and new investment in critical health infrastructure.

A Pilot, Web-Based HIV/STI Prevention Intervention Targeting At-Risk Mexican American Adolescents: Feasibility, Acceptability, and Lessons Learned.

Information technology provides new avenues to increase opportunities to deliver HIV/STI prevention interventions in a confidential, sensitive, and engaging manner for youth. While technology-based HIV/STI interventions show promise in preventing HIV/STI among different populations, few have targeted young Latinas. This pilot study examined the feasibility and acceptability of a bilingual, web-based HIV/STI prevention intervention among Latino females aged 15-19. We used a mix-method approach, including a prospective 2-group design with 3 repeated measures, and a post-intervention focus group discussion. We recruited 14 participants from an alternative high school and randomized into each study condition. Participants took 5 structurally equivalent modules focusing on either HIV/STI prevention (intervention) or nutrition/exercise (comparison) and completed assessments before the intervention, immediately post-intervention, and 2 months post-intervention. The findings suggested that the intervention had high levels of feasibility and acceptability. We discuss the keys to success, challenges encountered, and future directions.

The disproportionate burden of HIV and STIs among male sex workers in Mexico City and the rationale for economic incentives to reduce risks.

INTRODUCTION: The objective of this article is to present the rationale and baseline results for a randomized controlled pilot trial using economic incentives to reduce HIV and sexually transmitted infection (STI) risk among male sex workers (MSWs) in Mexico City. METHODS: Participants (n=267) were tested and treated for STIs (chlamydia, gonorrhoea, syphilis and HIV) and viral hepatitis (hepatitis B and C), received HIV and STI prevention education and were randomized into four groups: (1) control, (2) medium conditional incentive ($50/six months), (3) high conditional incentive ($75/six months) and (4) unconditional incentive ($50/six months). In the conditional arms, incentives were contingent upon testing free of new curable STIs (chlamydia, gonorrhoea and syphilis) at follow-up assessments. RESULTS: Participants' mean age was 25 years; 8% were homeless or lived in a shelter, 16% were unemployed and 21% lived in Mexico City less than 5 years. At baseline, 38% were living with HIV, and 32% tested positive for viral hepatitis or at least one STI (other than HIV). Participants had a mean of five male clients in the previous week; 18% reported condomless sex with their last client. For 37%, sex work was their main occupation and was conducted mainly on the streets (51%) or in bars/discotheques (24%) and hotels (24%). The average price for a sex transaction was $25 with a 35% higher payment for condomless sex. CONCLUSIONS: The findings suggest that economic incentives are a relevant approach for HIV prevention among MSWs, given the market-based inducements for unprotected sex. This type of targeted intervention seems to be justified and should continue to be explored in the context of combination prevention efforts.