As gay rights increase in Latin America, gay people face dwindling asylum grants from the United States, The Washington Post reports.

“For a time, it seemed like it was a slam dunk if you were gay, from Mexico and filed for asylum in the United States,” said Arthur S. Leonard, a professor at New York Law School. “But there’s been a turning point. The gay rights movement has started to make progress in Mexico, and it’s a little harder to show” that asylum is necessary, he said.

According to the article, gay men in Mexico are 109 times more likely to have HIV than the general population. A report by the Foundation for AIDS Research estimates that men who have sex with men (MSM) in Latin America are 33 times more likely to have HIV than the general population.

This small shift in U.S. immigration policy could have serious public health implications. Asylum is perceived as a path to better HIV treatment and freedom from stigma in a culture of “machismo.”