Together, the HIV & STD Community Must Fight Rising STD Rates

Paul Kawata recently wrote that he is willing to live with the “trade-off” of increasing STDs if it means we can end the HIV epidemic. I thank Paul for publicly raising what so many have raised in private – but I think this is the wrong framing of the issue. I argue that we cannot end HIV without acknowledging an inconvenient truth: the HIV and STD epidemics are inextricably linked and without combatting both, we won’t end HIV.

Here are the facts. Reported cases of chlamydia, gonorrhea, and syphilis are at historic levels. Neuro and ocular syphilis are on the rise. Hepatitis A transmission is increasing among gay men. Rates of congenital syphilis are high and growing. And gonorrhea is on the verge of becoming untreatable. These are infections that have real health consequences, make people more vulnerable to HIV infection, and ultimately imperil the progress we have made against HIV.

The rise in STDs cuts across community lines. If you are having sex, regardless of your race, gender, and sexual orientation, you are now at an increased risk of acquiring an STD. Regarding STDs as eminently treatable but inconsequential—as some in our community do—guarantees that women, young people, communities of color, and many others who lack access to basic health care and sexual health services will not get an equal opportunity to live the healthiest life possible.

Women, too often ignored in the fight against HIV, bear an unequal burden of negative health outcomes from STDs. Pelvic inflammatory disease, infertility, and cervical cancer are just a few of the life-threatening outcomes. Congenital syphilis, once trending toward eradication, has roared back to the highest rates in decades with dire outcomes. Roughly seven times more babies are born today with congenital syphilis than with HIV. Forty percent of babies born to women with untreated syphilis may be stillborn, or die from the infection as a newborn.  We should not — and need not — accept such a trade-off.

Paul writes that “not everyone wants or likes to use condoms,” and I agree; however, condoms are still one of the best ways to prevent STDs, HIV, and unintended pregnancy, and de-emphasizing their use has real consequences. A key lesson to be learned from the HIV epidemic is that we must be proactive and prepare for what new sexually transmitted infection may be around the corner. Let’s not pit biomedical interventions against condoms. Rather, let’s give our communities complete and honest information about both and provide the tools people deserve to fight HIV and other STDs, including PrEP, PEP, treatment, consistent testing, and condoms, so that people can make the choices that are right for them.

Biomedical advances have given us an unprecedented opportunity to end the HIV epidemic. To meet the full promise of PrEP, we must work hand-in-hand to address the intertwined HIV and STD epidemics. The same forces that drive HIV drive other STDs and fuel the same health disparities. There are real health and human costs to a sole focus on HIV and not a broader sexual health framework, one that includes STDs and sex positive approaches to informed decision making.

Thank you, Paul, for helping to raise the visibility of this important discussion. I urge our field to continue these conversations and work together to combat all sexually transmitted diseases, including HIV – lives depend on it.


David Harvey is the executive director of the National Coalition of STD Directors. We represent state health department STD programs and community-based partners across 50 states, seven large cities, and eight US territories.

Mark Your Calendars September 6-9 for the 2018 USCA

Please mark your calendar for the 2018 United States Conference on AIDS to be held September 6-9 in Orlando, Florida. NMAC initially moved USCA to Orlando to support a city that was devastated by the massacre at Pulse Nightclub. It was a tragic and unthinkable loss of life and, like the HIV epidemic, it left behind a community that was both broken and committed to rebuilding. Two years later, what are the lessons the HIV community can learn from this adversity? How do we honor this unspeakable loss while the rest of the world moves on to other issues?


This year USCA and NMAC will focus on Trauma Informed Care (TIC) as a roadmap to healing. Trauma informed care is an organizational structure and treatment framework that involves understanding, recognizing and responding to the effects of all types of trauma. TIC also emphasizes physical, psychological, and emotional safety for both consumers and providers and helps survivors rebuild a sense of control and empowerment. The trauma of violence, HIV, racism, homophobia, sexism, transphobia, and xenophobia cannot be underestimated in how they inform people’s willingness to get healthcare. As we all know, retention in healthcare is essential for people living with HIV. It is also necessary for people on PrEP. NMAC believes this is one of the primary reasons why people of color have such different health outcomes when compared to their white counterparts.


While overall last year’s USCA was amazing (please see final report), there were moments where NMAC was called out to be more responsive to communities that are over-represented by HIV, yet under-represented at the conference. As a result, NMAC is putting together Constituent Advisory Panels (CAP) to help inform USCA, the Summit, and other NMAC programs. A full announcement of this program will happen in February.

This year we are also adding Webinars to improve your USCA experience. NMAC will host three webinars on the following topics:

  • Abstract Submission (April)
  • Scholarship Submission (June)
  • New Attendee Orientation (Aug)

These webinars along with an enhanced web site will guide participants through the process of submitting abstracts or scholarships. It will also orient new attendees because USCA can be overwhelming to people who have not previously participated.

This year USCA will have three rounds of Scholarships:

  • Youth Scholars (April)
  • People Over 50 Living with HIV (May)
  • General Scholarships (July)


In our effort to be more transparent, look for future announcements about these initiatives. Members of the CAP will be asked to review applications.

Finally, USCA is bringing back the Executive Director’s Leadership Institute. It will be all day on September 5 in Orlando. This year’s Institute will be limited to 75 people. More details will be released in March. It will be an intensive learning experience on trauma informed care and how it can shape HIV services.


Welcome back, it’s going to be a busy year.

Yours in the Struggle,







Paul Kawata
Executive Director
(202) 277-2777

NMAC’s Treatment Division: From 2017 Successes to 2018 Goals

Under the leadership of Moises Agosto-Rosario, Treatment Director, and the additional members of NMAC’s Treatment Division team (Matthew Rose, Policy and Advocacy Manager; Fernando De Hoyos, Treatment Coordinator; and Sable Nelson, Policy Analyst) achieved these successes in 2017:

  • Creation of the HIV/STD Partnership of five HIV/STD organizations to strengthen our efforts to influence federal HIV policy.
  • Helping to Prevent the full repeal of the Affordable Care Act
  • Helping to prevent cuts to HIV/STD federal funding through January 19, 2018
  • Organizing HIV/STD Action Day prior to the United States Conference on AIDS (USCA) on September 6, 2017
  • Recruiting speakers and presenters for the Biomedical HIV Prevention Summit in New Orleans from December 4-5, 2017
  • The creation of the HIV 50+ Mini-Grant Program for empowerment & community building

We could not have completed any of our work without your support. We sincerely appreciate the input and participation of our community! In 2018, the Treatment Division looks to build upon these successes by engaging in the following activities:

Here is a preview of some of the exciting activities of the Treatment Division for 2018:

  • Opening applications for the HIV 50+ Strong & Healthy 2018 USCA Scholarship (application available March 2, 2018 / application due date: June 1, 2018)
  • The Treatment Division will release a best practices guide for biomedical HIV prevention at USCA 2018 in Orlando, FL.
  • In the next few weeks, the Treatment Division will release Part II of the Blueprint for HIV Biomedical Prevention in collaboration with the O’Neill Institute for National and Global Health Law at the Georgetown University Law Center.
  • Our 50+ Strong and Healthy Program will host monthly webinars for long-term survivors.

For more information on NMAC’s Treatment Division, please visit our page.

Early Program Highlights from the Leadership Pipeline

Building Leaders of Color (BLOC) National Leadership Training Project

The BLOC Regional Trainings will be hosted January – March 2018 in Atlanta, GA, Linthicum Heights, Maryland and Phoenix, AZ (The application process is closed and announcement letters will go out in January 2018). The program will train 60-70 new HIV-positive leaders through a seven-month training program to include a three-day training in person, monthly webinars, conference calls, and mentorship. The BLOC program will train this new group of leaders to increase the number of Persons of Color Living with HIV who are prepared to engage in leadership roles and activities related to HIV service delivery. The new BLOC leaders will identify opportunities to actively engage and participate meaningfully in decision making bodies and planning boards in their local community to improve health outcomes for people living with HIV.

It’s back: BLOC TOT- NMAC, the National “Building Leaders of Color (BLOC) Training of Trainers (TOT) Training Institute May 2018. The TOT builds on the National and Regional Trainings and partners Ryan White Part A & B grantees with a local partner of color living with HIV. The teams train on the BLOC program curricula so they can return to their local communities and train People of Color Living with HIV.  Each team will conduct three local/regional trainings over the period of seven months. The 2018 applications will be launched in March 2018.

The Youth Initiative is sponsored by NMAC in collaboration with ViiV HealthcareMagic Johnson Foundation, and Advocates for Youth. In 2018, the Youth Initiative Scholars will engage in numerous community and national opportunities to bring awareness to needs of youth impacted by HIV. The Youth will engage in activities for HIV Youth Awareness Day (April 10) and National HIV Testing Day (June 27). NMAC will launch applications in March 2018 for a new cadre of Youth Scholars to join the Youth Initiative to take action to end HIV/AIDS in their communities via educational training, professional development, and networking opportunities. Scholars will also will attend an in-person training institute during the US Conference on AIDS (USCA) September 6-9 in Orlando, FL.

In late February 2018 NMAC will launch Youth- Building Leaders of Color (Y-BLOC) National Leadership Training. Y-BLOC, a specially designed BLOC training targeted to engage youth of color living with HIV ages 18-24. The program will identify 20-25 youth of color living with HIV to engage and train Youth on leadership development, community engagement, how to effectively participate on planning bodies, medical and support care teams, boards of directors, and other efforts to address the goals of the National HIV/AIDS Strategy. Additional program descriptions and requirements will be available with the application launch.

The Leadership Café -Webinar mini- series: The Leadership Pipeline will host a summer series of webinars created by you. In Spring 2018, we will launch a request of topics to build PLWH capacity of PLWH leadership development, opportunities of engagement, and the HIV movement. The series will invite key leaders from the movement to partner with to bring you the most tools and expertise needed to advance our fight to end HIV.


Make the NMAC Connection!

You’ve probably noticed that our newsletter is now very different from what we’ve done in the past. We felt it was time to give our newsletter a complete overhaul to give you more and better information about what’s going on here.

Going forward, we’re planning to limit our newsletters to once-a-week issues with about three stories in each. While the newsletter will give you the opening, you’ll have to visit our website to get the full story!

Now, we still will have standalone newsletters as needed for events, special announcements, or urgent calls to action. We’ll try to keep those to a minimum but there will be some of them this year.

Finally, we want our newsletters to be more educational than promotional of NMAC. We’re recruiting presenters and speakers from USCA and the Biomedical Summit to contribute pieces on their work to give you more information about the epidemic and how we can better combat it.

We want to make sure that our newsletters fit our mission to not only fight HIV but to combat racism and inequality that help to fuel the epidemic. And we hope that the “NMAC Connection” will become a useful educational tool for you.

If you haven’t signed up already, please do so now!

We look forward to keeping you informed in 2018!


CDC’s Seven Banned Words

Nation’s Leading HIV/AIDS Organizations Condemn Efforts to Ban Words at CDC, Erase Transgender and Diversity

Washington, DC — Five of the nation’s leading organizations focused on ending the HIV and STD epidemics in the United States – AIDS United, NASTAD, the National Coalition of STD Directors, NMACand The AIDS Institute – expressed alarm over reports that the Trump Administration barred staff at the Centers for Disease Control & Prevention (CDC) from using certain words in its FY2019 budget justification to Congress.

While we continue to be in contact with the Administration, CDC, and other agencies regarding these reports, restrictions on these terms, in any manner, demonstrate this Administration’s troubling lack of commitment to science and we are seeking further clarification. Thanks to bipartisan support in Congress and the Executive Branch we have made incredible progress against HIV over the last decade. But budget proposals delineate policy priorities, and in rejecting science and evidence along with other commonly understood health language, this Administration calls into question its commitment to science and the health of all communities, including racial, ethnic, and sexual minorities.

Discouraging use and reference to “evidence-based” or “science-based,” is concerning enough. However, any attempt to remove “transgender” and “diversity” from CDC vocabulary would represent an outright dereliction of the stated duties of the agency. Such efforts are unacceptable and cannot go unanswered. Transgender people and people of color live under constant threat of systemic and specific discrimination and violence. Erasing them from official CDC documents ensures ongoing discrimination and undermines the ability of CDC to effectively respond to their health needs.

Evidence suggests the transgender community is particularly vulnerable to HIV and STDs. As citizens and residents of this nation, they should be treated with fairness and respect. As human beings, they are entitled to dignity and affirming care. AIDS United, NASTAD, NCSD, NMAC, and The AIDS Institute remain committed to ensuring that diversity is celebrated by our public health system and that its work is rooted in science, not politics. We stand with transgender staff, constituents, clients, and family, and will not relent in our demands that their health and the health of all marginalized and minority communities be prioritized by this Administration and the U.S. government.

AIDS United (AU), NASTAD, the National Coalition of STD Directors (NCSD), NMAC, and The AIDS Institute (TAI) are national non-partisan, non-profit organizations focused on ending HIV in the U.S. They have been working in partnership to identify and share resources to sustain successes and progress we have made in HIV and STD prevention, care and treatment in the United States. 

NMAC Announces National HIV And PrEP Navigation Landscape Assessment

NMAC Announces National HIV And PrEP Navigation Landscape Assessment

“Ending AIDS must be more than a slogan. It requires real plans, community mobilization, funding, and collaboration between the communities highly impacted by HIV. It is essential that community based organizations, health departments, healthcare providers, researchers, industry, people living with HIV, activists, feds, and people on PrEP have access to critical information about best practices […]

NMAC Announces Aging Mini-Grant Awardees!


Today, NMAC is honored to announce the recipients of the 2017 HIV 50+ Strong & Healthy Mini-Grant Program. The mini grant program allows our 2017 USCA HIV 50+ scholars to get involved in their community by developing and implementing a project to educate and engage HIV 50+ community members who need to connect with other peers. The grantees are affiliated with an organization that will act as the fiscal sponsor for the grant. NMAC understands that our movement needs leaders who are living with the virus. Our HIV 50+ scholars have important lessons to share with our HIV community.

Fourteen applications were awarded up to $2,500 in the categories of community education, community outreach, and community engagement.  The grantees and the projects are:

  1. Robert Riester, Aurora CO, “From the Past by Our Future” a storyteller videos project.
  2. Dean Edward, Columbia, SC, “Engage to Lead” a project of engagement of HIV 50 Men.
  3. Nancy Shearer, Santa Monica, CA, “Positive Singles Mixer” a project to empower people living with HIV to expand their social networks, reducing feelings of stigma and isolation.
  4. Michael G. Smith, Santa Fe, NM, “Phoenix Rising 2.0” a project to enhance and encourage financial stability.
  5. Erik Jannke, Palm Spring, CA, “Manual on HIV & Aging” an explanatory manual on HIV & Aging.
  6. Cynthia Marker, Lakeside, CA, “Fellow Advocate Mentorship (FAM)” a project to increase health literacy, self-efficacy, and social support networks among women living with HIV who are 50+.
  7. Randal Lucero, Albuquerque, NM, “50 + Healthy and Strong Summit” a project to bring community leaders, 50 + individuals living with HIV and their allies together to improve the lives of older adults living with HIV.
  8. Lilibeth Gonzalez, New York, NY, “Thriving at 50 and Beyond” a full-day community education event for 50 HIV-positive people aged 50 or older.
  9. Teresa Sullivan, Philadelphia, PA, “Sister to Sister: Women of Color Long Term – Survivors Building Our Voices of Resilience” a project to provide interactive educational sessions, on health and wellness to Women of color over fifty years old and living with HIV and end self- isolation.
  10. Rob Quinn, Boston, MA, ““Healthy Aging with HIV Community Wellness Day” a one-day weekend event targeting holistic health services, resources, and education for PLWH 50+ and Long-Term Survivor.
  11. Bryan Jones, Cleveland, OH, “Building leader for tomorrow among people of color” a project to instill purpose in those over 50 to empower those under 35 who are not engaged in planning bodies or decision-making opportunities.
  12. Jesus Guillen, San Francisco, CA, “The Chronicles of the Phoenix” a project to educate, engage and entertain.
  13. Jennifer Chang, Los Angeles, CA, “Puppy Love” a communal meet-and-greet, and dog-walking event for 50+ survivors of HIV/AIDS who are otherwise socially isolated.
  14. Esther Ross, Greenville, NC,” ‘Leaders Advocating and Mentoring other leaders for Personal growth and Support (LAMPS)” a project to educate persons of Color living with HIV over the age of 50 to mentor, train and support one other peer.

NMAC is very excited to be able to fund these projects and look forward to a fruitful collaboration. Successful projects will be showcased at the 2018 USCA. NMAC wants to thank Gilead for their support of these mini-grants. We can change the world and end the epidemic as we support and build community in the over 50-year-old people living with HIV.

Yours in the Struggle,

Moisés Agosto-Rosario
(202) 836-3669
Director of Treatment

Nation’s HIV Leaders Raise Alarm Over Lack of HIV, STD Mention in HHS Strategic Plan

Nation’s HIV Leaders Raise Alarm Over Lack of HIV, STD Mention in HHS Strategic Plan

Washington, DC – Five of the nation’s leading organizations focused on ending the HIV and STD epidemics in the United States have collectively expressed their grave concern with the lack of focus on HIV and other sexually transmitted diseases (STDs) in the Department of Health and Human Services (HHS) Strategic Plan, FY2018-2022. Despite the crucial importance of the intersectional issues of HIV and STDs, including hepatitis, to our nation’s public health, the report is relatively silent on these issues.  The document contains no mention of other STDs, mentions HIV only twice and hepatitis just once.

This lack of specificity regarding these diseases is of paramount concern, as is the failure to reference even once, the unique health needs of America’s Lesbian, Gay, Bisexual and Transgender populations, who bear the greatest burden of the nation’s HIV and STD epidemics.  The report only barely mentions the health needs and disparities facing racial and ethnic minorities.  At the same time, the Plan seems to prioritize faith-based approaches that have the potential to lead to discrimination against religious and sexual minorities.

In comments submitted to HHS, AIDS United, NASTAD, the National Coalition of STD Directors, NMAC, and The AIDS Institute urged the Trump administration to adjust its approach. At a time when STD rates have increased to their highest levels ever and four out of every 10 people living with HIV are not engaged in care, we should be refocusing our national resources on addressing these challenges, not turning our attention away from them. The HHS Strategic Plan is an opportunity to not only reinforce the national goals and priorities of the United States, but it is an opportunity for the United States to effectively plan to end the HIV epidemic and to address the worsening trends in STDs.  Unfortunately, the latest version fails to accomplish either goal.

AIDS United (AU), NASTAD, the National Coalition of STD Directors (NCSD), NMAC, and The AIDS Institute (TAI) are national non-partisan, non-profit organizations focused on ending HIV in the U.S. They have been working in partnership to identify and share resources to sustain successes and progress we have made in HIV and STD prevention, care and treatment in the United States.

Reaction to President’s Opioid Emergency


Leading HIV and STD organizations in the United States are both alarmed by the nation’s growing opioid epidemic and determined to do everything in our power to end it. Thus, we have watched with great interest as President Trump has directed his Secretary of Health and Human Services to declare our nation’s growing opioid epidemic a Public Health Emergency. While we agree that there is a need for a coordinated high-level response to the opioid epidemic, we do not believe that the President’s declaration meets that need.

In addition, our organizations strongly oppose efforts under the Public Health Emergency Declaration to redirect funding from HIV/AIDS programs. By ordering a Public Health Emergency Declaration rather than a Declaration of Emergency, the Administration essentially ensured that agencies and organizations would have to rely on funding that has been repurposed rather than making new funds available.

Instead, this Public Health Emergency Declaration should include specific actions designed to address the infectious disease-related aspects of the epidemic –namely, the rising cases of HIV, other STDs, and hepatitis C related to injection drug use. The opioid epidemic is a public health crisis that affects all Americans and all aspects of American life. But because injection drug use can be a means of HIV transmission, addressing it is particularly critical in the fight against HIV, other STDs and hepatitis C. We witnessed the stark consequences of failing to take action in 2015, when injection drug use was the primary factor in the Scott County, Indiana HIV and hepatitis C outbreak, which resulted in more than 200 people becoming infected with HIV and over 400 hepatitis C infections.

Our organizations call on the president to submit an emergency supplemental appropriations request to grant additional funds to local health departments and community-based organizations, which are disproportionately bearing the burden of both the opioid, HIV and hepatitis C epidemics. 

Secondly, additional syringe services programs must be created to simultaneously address overdose deaths and HIV and hepatitis C transmission related to the opioid epidemic. Ninety-three percent of counties vulnerable to HIV infectious outbreaks, as identified by the Centers for Disease Control and Prevention, do not have a syringe service program. It is estimated that in 2014 alone, lack of access to syringe services programs lead to the majority of the over 30,500 new hepatitis C infections and over 3,850 new diagnoses of HIV in the United States.

Additionally, we call for additional funding in order to purchase naloxone for police departments, substance use treatment programs, syringe service programs, and other programs that serve injection drug users. There are widespread reports of jurisdictions and programs having to ration naloxone.

Public health officials and criminal justice advocates agree that we must break from traditional approaches that would treat the opioid epidemic solely as a criminal justice issue or an issue of morality. Therefore, wecall upon the Administration to ensure that funds are not used for these responses. We reject any response that may increase incarceration or perpetuate stigma.

Because of its devastating effects on the fight to end the HIV epidemic and on Americans in general, the opioid crisis must be addressed with a public health and harm reduction approach to protect Americans’ lives and their wellbeing.

It is vital that the Trump Administration establish new funding rather than transferring funds that are already being used to address both public health issues effectively. Agency directors within the Trump Administration should utilize the resources and evidence at their disposal to address the opioid crisis to the fullest extent possible. Our organizations stand in solidarity with all working to end the opioid epidemic and believe that taking strong public health approaches will allow Americans to fully address this public health crisis and also bring us closer to ending the HIV epidemic in the United States.

AIDS United (AU), NASTAD, the National Coalition of STD Directors (NCSD), NMAC, and The AIDS Institute (TAI) are national non-partisan, non-profit organizations focused on ending HIV in the U.S. They have been working in partnership to identify and share resources to sustain successes and progress we have made in HIV and STD prevention, care and treatment in the United States.