Decentralization and Interinstitutional Coordination for a Healthy Future

In 2026, the fight against AIDS in Mexico City enters a new stage focused on decentralizing services, expanding coverage, and establishing interinstitutional agreements, all from a metropolitan perspective for epidemic control. This vision aligns with the directives of our Secretary of Public Health, Nadine Gasman Zylbermann, who seeks to more effectively involve sectors that, from different fronts, share the goal of controlling HIV infection. Pre-exposure prophylaxis (PrEP) will remain universal, though adjusted to the operational capacity of the clinics. This will be achieved through timely diagnosis, comprehensive patient care, and combined prevention. HIV/AIDS cannot be controlled without effective coordination with the Mexican Institute of Social Security (IMSS), the Institute for Security and Social Services for State Workers (ISSSTE), as well as IMSS-Bienestar and community services linked to this joint effort. The expansion of services will be outlined next year with the creation of the third Condesa Specialized Clinic in the Gustavo A. Madero borough, the opening of 13 Condesa Stations, and the implementation of a mass detection strategy in the general population. This will be complemented by detection in populations where HIV transmission has historically been concentrated. The purpose of these measures is to address several challenges: expanding detection in low-prevalence populations, reducing perinatal transmission, offering treatment, and optimizing processes to facilitate treatment adherence, while reducing pharmacy saturation and bringing services to the periphery of the city. Additionally, we are returning to CONASIDA (National Council for the Prevention and Control of AIDS) as a vocal member, participating in the development of a coordination protocol to prevent the interruption of antiretroviral therapy when patients change health units or lose their social security due to regulatory provisions. To reduce HIV transmission, we will continue to offer combined prevention strategies, particularly the distribution of condoms among the most exposed populations to the virus and other sexually transmitted infections. It is crucial to remember that our challenge is enormous and sensitive, as HIV is almost always transmitted through sexual relations, a private sphere that requires professional and prejudice-free interventions. Likewise, the detection and treatment of Hepatitis C virus infection, as well as the detection and treatment of syphilis, will be maintained, complemented by the vaccination of our patients with the biologics available in the 2025 National Vaccination Plan. Regarding the metropolitan approach to the epidemic, interventions will be oriented to coordinate with the authorities of the State of Mexico for the detection and priority care of late diagnoses, as well as the construction of an operational model that allows interventions in the border area, due to the high population mobility between both entities. The epidemic must be faced based on its social dynamics, adapting strategies and processes accordingly. During 2026, the programs and various interventions that the Condesa Specialized Clinics have implemented in recent years will also be strengthened.