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Updated: Jan 31, 2026

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Who is accessing PrEP in Mexico? Profiling users and identifying the unreached among high-risk MSM

Fernando Macías-González1, Heleen Vermandere2, Alicia Piñeirúa-Menendez2

  • 1Center for Research on Population Health, National Institute of Public Health.

AIDS (London, England)
|January 29, 2026
PubMed

Insights

Equitable access to pre-exposure prophylaxis (PrEP) remains a challenge in Mexico. The program may be missing up to 60% of high-risk men who have sex with men (MSM), particularly younger and less educated individuals.

Area of Science:

  • Public Health
  • Epidemiology
  • Health Equity

Background:

  • Pre-exposure prophylaxis (PrEP) is a key HIV prevention strategy.
  • Expansion of PrEP programs in Mexico faces challenges regarding equitable access.
  • High-risk men who have sex with men (MSM) are a priority population for PrEP interventions.

Purpose of the Study:

  • To evaluate the reach and equity of the PrEP program among high-risk MSM in Mexico.
  • To identify demographic and geographic factors associated with PrEP access.
  • To quantify the proportion of high-risk MSM potentially not reached by the current PrEP program.

Main Methods:

  • Utilized counterfactual prediction and propensity score matching.
  • Compared a nonprobability sample of PrEP users with a national survey sample of high-risk MSM.
  • Analyzed demographic profiles and geographic location to assess program reach.

Main Results:

  • The PrEP program may be missing up to 60% of high-risk MSM.
  • Younger and less educated MSM are significantly less likely to access PrEP.
  • Geographic location and individual profiles are key factors influencing PrEP access.

Conclusions:

  • Significant gaps persist in the equitable access to PrEP for high-risk MSM in Mexico.
  • Targeted strategies are needed to improve PrEP uptake among underserved subgroups.
  • Further research should focus on understanding barriers to PrEP access for vulnerable MSM populations.

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