I’ve had to learn how to survive society’s contradictions. Even though it shouldn’t matter, the color of my skin impacts people’s perception of my value. People might assume I’m straight until I open my mouth. Being gay means more judgements that have nothing to do with my actual worth. These are the contradictions that face the communities we need to reach to end the epidemic. Daily, they must negotiate a world that minimizes them because they are different. HIV impacts some of the most stigmatized communities in America. Our programs to end the epidemic must reach gay men, particularly young gay men of color, the transgender community, black women and Latinas, and drug users.
Last week the administration released the “conscience rule” for health care providers. This federal rule lets people discriminate based on their personal beliefs. At the same time, $291 million was recommended by a House Appropriations subcommittee to support the administration’s plan to end the HIV epidemic. The irony of this contradiction is not lost on NMAC. On one hand the administration wants to end the epidemic; on the other hand, they want to codify discrimination in HHS-funded programs against the same people they need to reach to end the epidemic.
While NMAC is very thankful for the federal government’s commitment to end the HIV epidemic, that does not mean we give up our values or our voice. Our movement must speak out against injustice. It is the only way to lead. I live with and manage society’s contradictions on a daily basis. I’ve learned how to work with the administration to end the epidemic and call out policies that are unjust.
Our plans must reach people who know they are HIV-positive and still don’t see a doctor. This contradiction is also not lost on me. According to the federal plan there are 400,000 Americans living with HIV who have fallen out of care or are unaware of their HIV status. Given the stigma and discrimination these communities face, it is easy to understand how the conscience rule is not helpful to our work.
To all my friends in the federal government, I know you walk and chew gum at the same time (I stole that line from Terrence Moore @ NASTAD) to fight to end an epidemic while enforcing the conscience rule that hurts the people we need to reach. Can you understand why community might need you to take a back seat? Not ending the epidemic means 40,000 new cases per year as HIV continues to overwhelm communities already marginalized by life. This is why ending the epidemic will be one of the greatest tests of our leadership.
Yours in the struggle,
Paul Kawata