2018 Vision

2018 Vision

2017 was a difficult political year. Unfortunately, 2018 looks to be equally challenging. President Trump requires that we up our game. There are real lives and real money on the line. Our movement’s long-term success or failure will be greatly shaped by what happens over the next three years. 2018 is particularly important because of the midterm elections, implementation of the tax reform, getting rid of the individual mandate for health insurance, and Congress looking to cut $1.5 trillion in federal spending to pay for the tax cuts. They are seriously considering cuts to Medicare and Medicaid.

NMAC’s 2018 Vision centers on four priorities. These priorities require significant collaboration (internal and external). NMAC remains committed to lead with race to end HIV/AIDS. Biomedical HIV prevention is our greatest hope for building pathways to end the epidemic.

 

2018 Priorities
Constituent Advisory Panels
Trauma Informed Care
2018 Midterm Election
FY19 Budget

The four priorities address concerns from constituents about not being heard, provide a model that might explain why people are color are not retained in healthcare, and make a priority of NMAC’s collaborative efforts to fight for the federal domestic HIV portfolio.

2018 will be a real test of partnerships. NMAC will rely on our colleagues like never before and, hopefully, they can also rely on us. We must show up ready to fight and collaborate. Our ability to bring together diverse coalitions will be our major contribution. Last year taught us that we are stronger together. In this messy political world, NMAC must never cower. Even in the most difficult of situations, we must speak truth to power, lead with race, and continue to believe that we can end the epidemic. 

2018 Political Environment Scan
2017 was a wild ride.  As a country, we jumped from one challenge to another. While most were not directly about HIV, the challenges were definitely HIV adjacent and gave pause. 2018 won’t be different. 

The good news is that whenever HIV hit the press, many communities stood in defense. When the Washington Post published its story on banned words, many others came to the defense of free speech. The same is also true when the administration disbanded PACHA. Our field is deep and strong and has many allies. Unlike during other administrations, our community is not going to sit back and take it. People will stand with our movement, mostly. 

In order to cover the $1.5 trillion deficit caused by the tax cut, some Members of Congress want to cut programs that directly and indirectly impact the lives of people living with HIV. Not only is HIV funding at risk, but healthcare in general is at a tipping point. The bill to cut taxes also got rid of the individual health insurance mandate, which will destabilize health insurance markets in many states. Will the marketplaces survive when premiums significantly increased because healthy people are no longer required to get insurance? 

 

2018 Priorities
Constituent Advisory Panels (CAP)
NMAC needs to respond to concerns raised by constituents during USCA and the Summit. Constituent Advisory Panels or CAPs are a 2018 priority. While most of the anger was not about us, it is important for the agency to seriously address their concerns. NMAC will hire a new position in Conferences to oversee CAP. However, addressing NMAC’s issues with constituents will not end the frustration and anger that our people feel. Life in Trump’s America is very difficult for people who are different.

CAPs are still a fluid concept and Conferences will lead NMAC’s efforts to identify final solutions. NMAC is committed to creating real solutions to set up CAPs that really support the agency to do better and to give our constituents the respect and love they deserve. 

Trauma Informed Care (TIC)
Why are people of color retained in care at lower rates than their white counterparts? Studies show this is the major reason why we have poor health outcomes, not access. Rather than just point out this inequity, NMAC seeks solutions from the concept of trauma informed care (TIC), particularly when the trauma is connected to racism, sexism, transphobia, xenophobia, homophobia, or HIV-phobia. There is significant post-traumatic stress from the early days of the epidemic. While the virus does not cause isolation and depression, too many people over 50 living with HIV suffer with these and other challenges.

It’s time to bring HIV-related depression out of the closet. Folks do not have to suffer.  There is help and medications that can make it better. That’s why TIC is so interesting. 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 experienced by many members of our community cannot be underestimated. TIC may not be the ultimate solution for what faces people of color living with HIV, but it’s important to have options that start to address this inequity.

2018 Midterm Elections
The results of the midterm elections could impact the next generation of our work. Since HIV care = HIV prevention, our ability to end HIV depends on our ability to implement a comprehensive biomedical HIV prevention strategy. Ending HIV also needs money.  Only the federal government has the resources needed. NMAC must work with either party, but there is a huge difference in strategy when Republicans vs. Democrats are in power. 

As a nonprofit, NMAC cannot tell our constituents who to vote for, but we can work to get out the vote. Can a small organization like NMAC do anything to make a difference in the midterm elections? The sensible answer is “no.” But can we live with doing nothing?

FY19 Budget
Once again, we find ourselves in a battle to save the domestic HIV portfolio. As was said in the past, this really is a real critical year. The House wants to balance the budget by cutting everything but defense.  They need to cut $1.5 trillion in federal spending to pay for the tax cuts.  Certain members have suggested cutting entitlements. Cuts in Medicaid or Medicare will have profound impact. This is especially true for PLWH who get their health insurance via expanded Medicaid. 

The federal budget is not usually cut in election years; however, these are not ordinary times. We need to be ready for a fight. Last year NMAC started its “Golden Ticket” editorial and social media campaign. NMAC will continue this work and once again use the August recess to target members.

This 2018 Vision requires lots of hard work and collaboration (internally and externally). Our constituents demand that we work together to shape and fight for a world without HIV. This vision is how NMAC can survive and fight back during these difficult political times. 

Yours in the Struggle,


Paul Kawata
Executive Director
NMAC

 

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!