Joint Statement from NMAC, Partner Organizations on Meeting with White House Officials on Monkeypox Response


Aug. 23, 2022 – Today, representatives from NMAC joined leaders from community organizations and individuals from throughout the country to meet with top officials from the White House National Monkeypox Response team. NMAC led the critical conversation to discuss the impact the fast-spreading monkeypox virus (MPV) is having on the LGBTQ+ community and communities of color.

Following today’s meeting with White House officials Robert Fenton, Dr. Demetre Daskalakis, and Harold Phillips, as well as Dr. Nick DeLuca from the Centers for Disease Control and Prevention, the coalition of organizations and individuals released the following joint statement:

“As the monkeypox virus (MPV) continues to spread throughout the United States, particularly in many underserved and underrepresented communities, we are appreciative of Robert Fenton and Dr. Demetre Daskalakis for meeting with us today to talk through ways the Biden Administration is addressing this national public emergency. It is crucial that the Monkeypox Response team fully understands the impact the virus is having in our communities to ensure a proactive and equitable response.

At the forefront of our concerns are three primary issues: is the government producing enough MPV vaccines to help mitigate the spread of the virus; does the Administration’s plan address vaccine equity to expedite deployment to communities who are disproportionately impacted by MPV; and what steps is the White House Response team taking to address vaccine hesitancy. We are troubled with the reporting that shows that the vast majority of new MPV cases are among people of color and within the LGBTQ+ community, and many have faced hardships seeking preventative care. We were pleased to hear that the White House understands the need and is listening to the stories like the ones we presented to them today as they continue to address and monitor the ongoing MPV situation.

We have learned many hard lessons from other national epidemics – particularly with HIV and recently with COVID-19 – on how communities of color and the LGBTQ+ community have been shut out of access to life-saving treatment, were left out of the public health response planning and deployment by previous administrations, and were stigmatized in the public with false, hateful messages and propaganda. We reiterated with Mr. Fenton and Dr. Daskalakis to remember that people who have had or are currently dealing with MPV are human beings first, and those communities that are being the most affected by the MPV should take priority in their response efforts.

We look forward to continuing our conversations with White House officials, government experts, and public health professionals to ensure that the constituencies we represent are not forgotten or left behind, and are treated with the respect and dignity they deserve.”

Joining the meeting on behalf of NMAC were Daniel Driffin and Damián Cabrera; David Garcia, Executive Director of Affirmations LGBTQ+ Community Center in Michigan; Antonius Minniefield, global health advocate from Georgia; and Julio Frausto, health educator at Bienestar Human Services in Los Angeles.


NMAC leads with race to urgently fight for health equity and racial justice to end the HIV epidemic in America. Since 1987, NMAC has advanced our mission through a variety of programs and services, including: a public policy education program, national and regional training conferences, a treatment and research program, numerous electronic and print materials, and a website: NMAC also serves as an association of AIDS service organizations, providing valuable information to community-based organizations, hospitals, clinics, and other groups assisting individuals and families affected by the HIV epidemic.

Welcome to Our New MPV Newsletter

This is the first of what will be a weekly NMAC newsletter on the latest developments in the monkeypox (MPV) epidemic. Production of this newsletter is supported by a grant from Gilead Sciences to NMAC to serve as the coordinating center for the policy response to MPV.

These newsletters are intended for service providers, people living with or at risk of MPV, and policymakers at the federal, state and local levels. Each newsletter will provide updates on the latest data pertaining to MPV, especially as it relates to public policy. These newsletters will center the individuals and organizations most heavily affected by MPV, profiling people living with or at risk of MPV as well as the organizations that are contributing to the fight against this national health emergency.

Why NMAC is helping lead the fight against MPV
NMAC leads with race in the effort to end the HIV epidemic in the U.S. This focus demands that NMAC become engaged in the fight against MPV. Gay/bisexual men – the population most heavily affected by HIV – account for at least 94% of people with MPV. People living with HIV make up 41% of people diagnosed with MPV.

As in the case of HIV, the communities of color for which NMAC advocates are disproportionately affected by MPV. Black and Latinx people account for about one-third of the U.S. population but for 54% of people with MPV. In Georgia, Black people account for 33% of the state’s population but for 82% of the state’s confirmed MPV cases.

Just as people of color are markedly less likely than white people to obtain PrEP or to achieve HIV viral suppression, Black and Latinx gay/bisexual men are being left behind in early efforts to roll out MPV vaccines. In the case of MPV, leading with race means immediate action to ensure equitable access to the prevention of MPV, timely treatment of MPV, and MPV vaccination.

MPV: The latest developments
MPV is spreading rapidly

The federal government has been slow to respond

  • There are shortages of every key tool needed to fight MPV (prevention, testing and treatment) – in large measure because of the federal government’s failure to plan and respond aggressively to protect the health of gay/bisexual men. TPOXX, the only drug available for the treatment of MPV, is in short supply, and doctors who have MPV patients must complete a 27-page application and obtain federal approval before they can administer the drug for their patients who are experiencing severe MPV-related pain.
  • The country has an acute shortage of MPV vaccines because the federal government, even though it owned millions of doses of the vaccine, failed to ask the manufacturer to bottle it for distribution. The federal government is now racing to close this gap, but current estimates indicate that the vaccine shortage won’t be resolved before 2023.
  • To make the limited supply of vaccines go as far as possible, the federal government has approved administration of a smaller dose between the layers of the skin rather than a full dose under the skin. CDC also recommends that people exposed to monkeypox receive post-exposure vaccination (ideally within four days of exposure).

The Biden Administration has declared MPV a national emergency

  • The President named Robert Fenton, an emergency response expert, and Dr. Demetre Daskalakis, of the CDC, to lead efforts to coordinate a national MPX response. It is hoped that the emergency declaration will open new funding for the MPX response and light a fire under the federal bureaucracy to overcome its early fumbles.

Building on the leadership of Black and Latinx gay/bisexual men to fight MPV
Given the disproportionate impact of MPV in communities of color, efforts to address this national emergency must elevate the voices of Black and Latinx gay/bisexual men. To help NMAC serve as the coordinating center for the national MPV policy response, Daniel Driffin has agreed to spearhead advocacy with the White House and other arms of the federal government. A Black gay man living with HIV in Atlanta, Daniel co-founded THRIVE Support Services, an innovative community-centered support and service program that aims to promote the health and well-being of Black gay men.

“Regardless of whether it is cancer, HIV, STIs, housing or other social determinants of health, Black gay men are often the last group for whom solutions are provided,” Daniel says. He has seen this with MPV vaccines in his hometown of Atlanta. “Anytime a local health department stands up a vaccine clinic, within minutes all of the available appointments are gone, and the slots aren’t going to the Black and brown men who are most affected.”

Although the challenge of ensuring vaccine equity is considerable, Daniel knows from his own experience that there are solutions to this problem. “COVID-19 has shown that with the right education and the right messengers, Black and brown people have the same uptake of vaccines as other people. Ensuring that Black and brown people are included in the response from the outset – from Day Zero – is critical if we want to ensure equity.”

Yours in the Struggle,

Paul Kawata

Paul Kawata

Dear Mr. Fenton

NMAC logo

Mr. Robert J. Fenton Jr.

National Monkeypox Coordinator
The White House
Washington, DC

Dear Mr. Fenton,

Congratulations on your appointment as the National Monkeypox (MPV) Coordinator. Kudos on the White House announcement on alternative dosing.

There are concerns about implementation. Like you, NMAC will follow the science.

NMAC (formerly National Minority AIDS Council) leads with race to end the HIV epidemic. Thanks to an unrestricted educational grant from Gilead, the agency has put together the moniker This program, like our mission, leads with race to stop MPV. Our work prioritizes MPV vaccine equity and overcoming vaccine hesitancy, particularly for gay men of color, the transgender community, Black women, and sex workers.

Thankfully, Dr. Demetre Daskalakis is on your team. He has our full support. Given the reality that gay and bisexual men, especially Black and Brown gay men, are 98% of people with MPV, there is a critical need to address equity.

Policy Priorities

  1. More MPX Vaccines
  2. Fight for Vaccine Equity
  3. Overcoming Vaccine Hesitancy
  4. Culture Wars

The number one priority is more vaccines. NMAC urges you to quickly overcome any impediments to getting vaccines into arms. While alternative dosing was a good first step, the virus is quickly spreading. Each day, I read the new US case count and worry. Community is watching and losing patience.

Recent data said 63% of people with MPV are people of color. NMAC is concerned that history will repeat itself and this becomes another on a long list of challenges impacting communities that are overwhelmed by too many issues. If COVID taught us anything, there needs to be vaccine equity plans at the start. We cannot be an afterthought.

Given the numbers, will hold-up and tell the stories of Black and Latinx gay and bisexual men. We will also tell stories from the frontlines. Leading our efforts are:

 Daniel Driffin         Damián Cabrera

On Wednesday, our first monkeypox e-newsletter goes out for free to the entire NMAC mailing list. You will get three pieces of email each week which could be annoying, so we ask for your patience. We are still working out the kinks. At some point, we hope MPV will just go away or at least the need for a weekly newsletter will.

Vaccine hesitancy is a challenge when reaching gay men of color, particularly Black and Latinx men. The White House needs to support targeted education and training. General outreach won’t work. While the HIV community has decades reaching these communities, as we’ve seen from PrEP, it has not always been successful. Do not let history repeat itself.

MPV may be used by extremists to say gay men are sick and undeserving. Once again, it all sounds too familiar and impossible. The political, moral, and ethical contradictions abound. Vaccine education programs may require outreach and campaigns that they will find offensive. Let’s not kid ourselves: MPV sits in the middle of the culture wars.

I hope you can visit an LGBTQ clinic. During these times without enough vaccine, your support and work to get them shots is critically needed. As we’ve learned with COVID, we must take care of our heroes on the front lines.

Monkeypox, like HIV, is more than numbers. There already is too much stigma. Sometimes with social media it feels like the early days on steroids. Please come out of the gate fighting MPV stigma. Like HIV stigma, it comes from a place of homophobia and racism. In this political climate, it is particularly dangerous.

Yours in the Struggle,

Paul Kawata

Paul Kawata

Gilead Sciences and a Coalition of LGBTQ+ and Human Rights-Focused Organizations Mobilize to Address Monkeypox Public Health Emergency


– Gilead Will Provide up to $5 Million in Global Grant Funding to Immediately Support Public Education and Vaccine Hesitancy Communications, a Public Policy Response and a Global Outbreak Emergency Fund for Community Organizations in Regions with Active Monkeypox Outbreaks –

Foster City, Calif., August 9, 2022 – Gilead Sciences, Inc. (Nasdaq: GILD), GLAAD, the Human Rights Campaign (HRC), the National Black Justice Coalition (NBJC), the National Center for Lesbian Rights (NCLR) and NMAC today announced immediate action in response to the emerging monkeypox virus (MPV) outbreak, which is disproportionately impacting the LGBTQ+ community, particularly men who have sex with men (MSM), as well as those who are living with HIV. Gilead will provide up to $5 million in global grant funding to help support three areas of focus: a public education and vaccine hesitancy communications campaign, a public policy response and a global outbreak emergency fund.

The MPV outbreak was declared a public health emergency by the U.S. Department of Health and Human Services on August 4. A recent study in the New England Journal of Medicine looked at 528 MPV infections diagnosed between April 27 and June 24, at 43 sites in 16 countries. Of that group, 98% of the cases were among gay or bisexual men and 41% were living with HIV.

“Throughout our history, Gilead has worked to address critical public health challenges and healthcare disparities, particularly those faced by the LGBTQ+ community or impacted by the HIV epidemic,” said Deborah Telman, Executive Vice President, Corporate Affairs and General Counsel, Gilead Sciences. “Today we are proud to work with our longtime collaborators around the world to help meet the immediate needs of impacted communities and to help identify longer term solutions to this emerging crisis. At Gilead, we are also accelerating and expanding our early-stage antiviral drug screening program to identify new molecules for potential future treatment of MPV infection.”

Funding will help support three key areas of response.

Gilead’s Global Monkeypox Outbreak Emergency Fund will provide grants of up to $50,000 to existing grantee organizations working in regions with active MPV outbreaks to respond to this growing emergency. Funds may be used to cover expenses such as community mobilization activities specifically addressing MPV outbreak in communities disproportionately impacted by HIV, operating costs related to HIV testing and service interruptions and essential safety materials.

GLAAD, HRC, NBJC and NCLR will help continue to ensure that critical information about MPV reaches impacted communities. This comprehensive communications campaign will help LGBTQ+ people and people living with HIV receive accurate, accessible and targeted information so they are able to make informed decisions about how to prevent and treat MPV. Public education efforts from the national coalition will include creation of videos, graphics and other information resources focused on vaccines, prevention and treatment to be distributed to media, community centers and organizations, as well as organizers and managers of LGBTQ events and venues.

“As we saw with HIV, COVID-19, and now MPV, disinformation continues to challenge the LGBTQ+ community,” said Sarah Kate Ellis, President and CEO, GLAAD. “This new collaboration will enable creating and distributing content and resources to help our community know the facts and to understand prevention and treatment for MPV. When communities receive accurate, timely information, they are empowered to take appropriate action, leading to long-lasting, positive health outcomes.”

“As MPV continues to impact our communities, we’re witnessing a concerning amount of misinformation and confusion,” said Joni Madison, Interim President, HRC. “That misinformation is especially harmful to BIPOC communities who historically are sidelined when it comes to equitable access to care and treatment. Over the past several weeks, we’ve also seen the LGBTQ+ community doing what we’ve always had to do: caring and advocating for each other. In the same vein, we look forward to working together with Gilead and other partner organizations to combat the stigma that prevents people from seeking the care they need.”

“The National Black Justice Coalition is excited to be a part of this coordinated effort to prevent the spread of MPV across the U.S., especially among the Black LGBTQ+/SGL community and people living with HIV/AIDS,” said David J. Johns, Ph.D., Executive Director, National Black Justice Coalition. “We have engaged with key decision-makers since the outbreak emerged to ensure our community is included, in non-stigmatizing ways, in public health campaigns, is educated about the dangers of this virus, and is connected to care. Responses must be democratized so information, testing, and treatment resources reach people who have the greatest need and the fewest resources.”

“There has been a lack of accurate information about MPV and that has, and will continue to negatively and disproportionately hurt the health and well-being of the LGBTQ+ community, communities of color and people at the intersections of these underrepresented identities,” said Imani Rupert-Gordon, Executive
Director, NCLR. “We are seeing the number of MPV cases across the country increase and our community expects and deserves access to education and resources to help combat the virus, and feel safe in their communities.”

NMAC will act as the policy response organizing center to help address policy issues related to HIV and MPV. Funding from Gilead will help NMAC inform public policy to drive a more comprehensive, swift and coordinated community response.

“NMAC is grateful to Gilead for their leadership on this critical issue,” said Paul Kawata, Executive Director, NMAC. “Through our extensive contacts at the federal level and with the support of our community partners, we will work with both the White House and Congress to provide the necessary resources to deal with this outbreak. Our top priorities will include making sure that vaccine access is equitable for all communities at risk and that any outreach plans will include ways to deal with vaccine hesitancy in a culturally competent way.”

Collaboration is crucial to support the sustainability of community partners and these groups will work together to monitor the evolving MPV landscape to impact response.

About Gilead Sciences
Gilead Sciences, Inc. is a biopharmaceutical company that has pursued and achieved breakthroughs in medicine for more than three decades, with the goal of creating a healthier world for all people. The company is committed to advancing innovative medicines to prevent and treat life-threatening diseases, including HIV, viral hepatitis, cancer and inflammation. Gilead operates in more than 35 countries worldwide, with headquarters in Foster City, California.
Gilead has promoted equity, particularly healthcare equity, since the company brought its first therapies to the market. Through global partnerships, Gilead’s medicines today reach millions of people in low- and middle-income countries around the world.

For more than 30 years, Gilead has been a leading innovator in the field of HIV, driving advances in treatment, prevention and cure research. Today, millions of people living with HIV globally receive antiretroviral therapy provided by Gilead or one of the company’s manufacturing partners.

GLAAD rewrites the script for LGBTQ+ acceptance. As a dynamic media force, GLAAD tackles tough issues to shape the narrative and provoke dialogue that leads to cultural change. GLAAD protects all that has been accomplished and creates a world where everyone can live the life they love.

About the Human Rights Campaign
The Human Rights Campaign Foundation is the educational arm of the Human Rights Campaign (HRC), America’s largest civil rights organization working to achieve equality for lesbian, gay, bisexual, transgender and queer (LGBTQ+) people. Through its programs, the HRC Foundation seeks to make transformational change in the everyday lives of LGBTQ+ people, shedding light on inequity and deepening the public’s understanding of LGBTQ+ issues, with a clear focus on advancing transgender and racial justice. Its work has transformed the landscape for more than 15 million workers, 11 million students, 1 million clients in the adoption and foster care system and so much more. The HRC Foundation provides direct consultation and technical assistance to institutions and communities, driving the advancement of inclusive policies and practices; it builds the capacity of future leaders and allies through fellowship and training programs; and, with the firm belief that we are stronger working together, it forges partnerships with advocates in the U.S. and around the globe to increase our impact and shape the future of our work.

About National Black Justice Coalition
The National Black Justice Coalition (NBJC) is America’s leading civil rights organization dedicated to the empowerment of Black lesbian, gay, bisexual, transgender, queer+, and same gender loving (LGBTQ+/SGL) people, including people living with HIV.

About National Center for Lesbian Rights
For 45 years NCLR has worked to achieve and advance LGBTQ equity through litigation, legislation, advocacy and public education. NCLR has held a unique space in the LGBTQ civil rights arena as an organization founded by lesbians and fighting for justice for all LGBTQ people – bringing a fierce, longstanding commitment to racial, economic and gender justice for the most underrepresented people in our communities. The first LGBTQ civil rights organization to create programs specifically for youth, elders and immigrants seeking asylum, NCLR is also the first organization of its kind to create a transgender youth program, a focused reproductive justice initiative, a campaign ( to combat conversion therapy and NCLR is the co-founder of the National LGBTQ Anti-Poverty Network.

About NMAC
NMAC leads with race to urgently fight for health equity and racial justice to end the HIV epidemic in America. Since 1987, NMAC has advanced our mission through a variety of programs and services, including: a public policy education program, national and regional training conferences, a treatment and research program, numerous electronic and print materials, and a website: NMAC also serves as an association of AIDS service organizations, providing valuable information to community-based organizations, hospitals, clinics, and other groups assisting individuals and families affected by the HIV epidemic.


Gilead and the Gilead logo are trademarks of Gilead Sciences, Inc., or its related companies.
For more information about Gilead, please visit the company’s website at, follow Gilead on Twitter (@GileadSciences) or call Gilead Public Affairs at 1-800-GILEAD-5 or 1-650-574-3000.

USCHA Almost Sold Out

Thank you to everyone who registered early for the 2022 United States Conference on AIDS. The meeting had the largest number of early bird registrations. Close to 3,000 folks are on the list to attend. As a result, NMAC made the difficult decision to keep registration open for only 500 more delegates. It is first come first served and we will close when we reach capacity.

The conference made this difficult decision because it is unfair to take people’s money when there are so few reasonably priced hotel rooms still available in San Juan. USCHA has sold out of the group rate at five hotels. Hotel rooms are still available in San Juan, just not at the lower negotiated USCHA group rates. Now the gathering must refer people to Airbnb or more expensive hotels. While USCHA gets no support, most of Airbnb’s rental fees go to locals who can use the money. We will only provide buses between official conference hotels and the Puerto Rico Conference Center. Please make sure your Airbnb is close to an official hotel so you can catch the free USCHA bus.

Hotel rooms have been set aside for scholarship recipients. They do not need to worry. Thanks to our major sponsors Gilead, ViiV Healthcare, Janssen, and Merck, USCHA is giving away a record number of scholarships. However, we still turned down many very qualified applicants. Moises Agosto, NMAC’s Treatment Director, put together an article about the scholarship process for Thursday’s e-newsletter.

There is very limited exhibit space. Around 90% of the exhibit hall has been reserved. It will be sold out soon. Exhibitors get passes to attend the conference. Click here to reserve a booth. Given the challenges of shipping to Puerto Rico, we encourage them to use San Juan based companies for printing, booths, receptions, and give aways. Not only does this bring much needed resources to the local community, but it also lets you bypass shipping headaches. Many partners host private receptions, so please consider working with the local community to identify locations and businesses that support the HIV community. USCHA is the first large conference in PR to happen since COVID and locals are excited for our meeting.

As an example of working with regional providers, USCHA contracted with Connecting Paths to sew all the conference bags. Connecting Paths is a local nonprofit that fosters community entrepreneurship in Puerto Rico. Since hurricane Maria (2018) they have trained 87 women and 20 of these women are sewing the conference bags. Please watch their Spanish language YouTube video to learn more. USCHA is an opportunity to bring much needed economic development to Puerto Rico. Please support the businesses that support the local HIV community.

While space is very limited, we want to encourage our federal partners to send key staff to meet with attendees. The community desperately needs your leadership and partnership to complete our mission to end the HIV epidemic by 2030. Show up to show your support for the leaders on the frontlines. There may be budgetary issues since the meeting happens in the new fiscal year and NMAC is willing to work to make any needed accommodations. Please contact Tara Barnes-Darby for assistance.

NMAC wants to thank the local host committee co-chairs:

I’ve put hyperlinks to their emails so that you can contact them about restaurants, bars, and companies that support the HIV community in San Juan and Puerto Rico. NMAC also has staff who live in San Juan. Damian can answer questions about local agencies, culture, and community. Please email Damian with any questions.

It’s only July and the meeting is almost sold out. Most people will think it’s because we are going to PR. I want to believe our movement is committed to language justice, reaching the Latinx community, and learning in an environment when English is the second language. Building a movement is key to our ability to end the epidemic. USCHA is the place where we come together to check-in, learn, and nurture our family. The world is going crazy, and we need each other more than ever.

Damian Cabrera-Candelaria
Program Manger Treatment

Yours in the Struggle,

Paul Kawata

Paul Kawata

A Call to Plan

This is not a joke. In the middle of a world out of control, it’s time for the CDC to review the science on monkeypox (MPX) and recommend that all sexually active gay and bisexual men, regardless of their HIV status, get the MPX vaccine. NMAC makes this request to trigger the development of national, state, and local plans. Between the World Health Organization’s (WHO) declaration and the data in the New England Journal of Medicine (NEJM), where 41% of the people who got MPX are also living with HIV, it’s time to move from monitoring to planning.

Last weekend the WHO declared monkeypox a public health emergency of international concern. There are over 16,500 cases in 74 countries. In the US, there are 2,800 cases in 44 states, DC, and Puerto Rico. A recent article quoted the NEJM that said 95% of MPX cases were transmitted through sexual activity. Ninety-eight percent of the people who got MPX were gay or bisexual men. Forty-one percent were living with HIV. The declaration and science cannot be ignored. There needs to be a new standard of care that recommends and implements initiatives so all sexually active gay and bisexual men get the MPX vaccine.

While the recommendation prioritizes sexually active gay and bisexual men, vaccination targets may need to be expanded if we are unable to control MPX. Plans should include the transgender community, sex workers, and staff who work where there is sexual activity (bathhouses, saunas, and sex clubs). Due to shortages, there is not enough vaccine. This failure will not be forgotten. Hopefully, the system will be fully stocked in September. The next 45 days should prioritize planning. Vaccine equity and overcoming vaccine hesitancy are key. NMAC is particularly concerned about reaching people of color. The COVID vaccine roll-out showed it’s not enough to just make the vaccine available. There are too many who are unaware of MPX and/or who do not trust the system. Plans must prioritize hard to reach communities.

The WHO declaration validates the need for leadership and funding from the White House. Since the White House’s MPX response is coordinated by the National Security Agency (NSA), it’s time to bring everyone together to plan how to plan. Vaccine equity and overcoming vaccine hesitancy may create new pathways to educate about PrEP and/or U=U. While MPX and HIV impact the same communities, we don’t know much about the specific impact the virus that causes HIV has on MPX. Does viral load impact MPX outcomes? Since there are different versions of the MPX vaccine, is there a need to recommend a specific vaccine for people who are immune compromised? While there is a shortage, should we prioritize getting at least one MVA vaccine?

Why is HIV getting involved in MPX? These viruses impact the same communities and HIV has the infrastructure to support this huge lift. However, it is too big a task and requires coordination across multiple movements. Vaccine experts may not understand how to reach the target communities. The data and experience of vaccinating all sexually active gay men could support efforts to end the HIV epidemic. While many health departments have already started, there needs to be a coordinated national response. The sooner we vaccinate, the better our chances of stopping MPX from becoming another epidemic. It starts with an emergency transfer of $100 million to be drawn broadly from HHS. Federal guidance to health departments to reprogram HIV and COVID funds. Support for the National Coalition of STD Directors request for $100 million in new federal funding. But we can’t wait for Congress.

This is too much and our plates are already full. I really hoped to avoid this burden, but the virus had other plans.  The thought of vaccinating all sexually active gay and bisexual men is overwhelming. This is a very heavy lift that is going to take money, planning, and coordination across multiple sectors.

I got the monkeypox vaccine (MPXV)! Normally I would not share this information, but there is too much slut shaming, particularly from other gay men! I’m shocked I tell you. It’s a vaccine, not a lifestyle. Getting it says I care about my health. It’s the same smallpox vaccine that has been around for decades. Many older Americans got the shot; however, routine vaccinations stopped in 1972. If you don’t recall getting the vaccine, it is OK to get another dose. Talk to your doctor.

There are multiple versions. I got the MVA vaccine which is built around a weaker version of the virus and is much safer. The ACAM2000 vaccine contains active virus and is not recommended for immune compromised individuals. Are PLHIV considered immune compromised if they have an undetectable viral load? Once again, the role of treatment education is critical to our field.

Like the COVID vaccine, MPX vaccines needs to be free. Given the large percentage of PLHIV who might also get MPX, HRSA needs a MPX strategy for Ryan White clients. Can their infrastructure be used to vaccinate sexually active PLHIV? What about gay men who are HIV negative? While the data is clear, more science is needed. Hopefully, answers and strategies will be shared at the International AIDS Conference and/or the National Ryan White Conference. NMAC’s Treatment Division will have MPX updates at the 2022 United States Conference on HIV/AIDS. We will also try to get vaccines onsite at the meeting.

I got my MVA vaccine in Canada. It’s free, even for tourists. Why does Canada have enough MVA vaccines, even for tourists, but we have to wait until September in the US? You’ve got to love the Canadian healthcare system. Mobile vaccine clinics are set-up in the Gay Village of Montreal. A handsome young man in scrubs asked me to talk about monkeypox (MPX). I said, “I’m a tourist”, he said “it didn’t matter.” For folks going to the International AIDS Conference in Montreal, schedule an appointment and visit the mobile clinics in the Village. The site is in French, so click on the FR language icon in the upper right corner and it will change to English. When putting together plans, think outside the box. Set-up clinics in the places where gay and bisexual men gather.



Thank you to the National Council of STD Directors for their leadership on this issue. For more information on MPX go to their Command Center. There is also a letter from community to Secretary Becerra that outlines multiple requests. Also check out the O’Neill/amfAR brief on Monkey and Meningococcal Disease Outbreaks that more fully outlines concerns.

The White House needs to lead with community to develop a domestic strategy to stop MPX before it becomes another epidemic. Sexually active gay men, regardless of their HIV status, need to get the MVA vaccine. Because there is a vaccine, MPX might go away quickly, another in a long list of faded viruses, but right now no one knows. Unfortunately, this is not a joke.

Yours in the Struggle,

Paul Kawata

Paul Kawata

The Reckoning Is Here!

I got COVID! What fresh hell is this? Thankfully, I’m double vaxxed and double boosted. It was the perfect ending to an awful couple of weeks. Just when I thought it couldn’t get any worse, two lines on a plastic tray said different. The reckoning is here! It seems like the planet and its inhabitants can’t catch a break. Just when we might get a respite, the world says “ah.” Here’s the assassination of the former Prime Minster of Japan, war, recession, more guns, no abortions, school prayer, new variants, and it’s just July. What do you think the fall is going to bring?

To be honest, I’m pissed I got COVID. Like everyone, I’m doing the best that I can, but it is not possible to live in a bubble and still have a life. I am over it. By “it” I mean all the things that don’t make sense. Why are we having culture wars in the middle of a pandemic? When we most need to be united, we find ourselves divided. Instead of working together, we are fighting of the soul of the country. Maybe the pandemic really was the catalyst for change. The virus brought to the surface what had been badly hiding for too long.

I was on a zoom with Dr. Rachel Levine, the Assistant Secretary for Health. Yes, I’m that Queen, dropping names like I drop bombs. I shared concerns about a certain member of Congress and was Dr. Levine OK? She says she’s fine, but I’m worried. The congresswoman’s dog whistles can lead to real harm. She put Dr. Levine in the crosshairs of hate. The White House and HHS have made sure she is safe. In addition to being a pediatrician and four-star admiral, she is living proof that we are everywhere, and we are not going away.

If the radical right follows their regular formula, they will begin to question the abilities of multiple senior LGBTQ officials, trying to generate fear about the large number of homosexuals working in the administration. Our pride makes another community afraid and angry. Dr. Levine gives me hope, but to the some she is a sign of the end of days.

The problem is there is no compromise or middle ground. We are not going back into the closet. I am a Queen, not a punching bag. I deserve to live a life free from prejudice and discrimination in all my outrageousness. Some people may see me as an exaggeration, but they underestimate me at their peril.

We have decades of experience fighting against a world that wished us dead, literally and figuratively. Our ability to work in coalition with like minded communities serves everyone. It starts with a strategy for survival in a world that hates us, who we love, the color of our skin, our gender, or how we choose to express our gender. If we spend too much time trying to fit into their box of acceptability, we lose everything that makes us special. Don’t be less so somebody can feel more. We deserve to be here and to sit at the table. In the fight to end HIV, our voice is critical.

It may be the fever from COVID, but I can’t believe the Supreme Court and, as a result, our country are again reviewing the legality of abortion, sodomy, school prayer, and affirmative action. Issues that were long ago decided are now at risk. Justices who sold themselves as conservatives are actually very radical. While it may have been a smart short term power play, I don’t think they are prepared for the civil unrest that will follow. This Supreme Court is just starting to reveal its true nature and will set off the reckoning that is coming for all of us.

Since I had to isolate at home, I got to catch up on RuPaul’s Drag Race. I love the show because it celebrates being different. This program showed the world the art of drag. If Mama Ru taught us anything, it’s to tell your unique story in all its beauty and drama. Take the things that caused shame and transform them into your greatest strengths. I can’t imagine living the life my good Japanese parents envisioned for me. Coming out was one of the most courageous acts of treason I’ve ever accomplished. I murdered the man my parents wanted me to be to become the Queen I was supposed to be.

Yours in the Struggle,

Paul Kawata

Paul Kawata

More Guns, No Abortions, and School Prayer

More guns, no abortions, and school prayer. So what’s next for America? This week  the world watched history as one of the pillars of government let us down in an unprecedented reversal of constitutional rights. How do you lead when the world is going crazy? While I’m not saying panic, this is a moment to be concerned.

We live in a representative democracy, where citizens elect officials to represent them in Washington, DC. This November is a call to the ballot box! The America we want can only happen if we get people who believe in choice, equality, housing, and healthcare to vote in their interests. As leaders, our job is to educate our communities. To help them understand that this really is a fight for the soul of America.

We must stay together! It is too easy to pick off causes as a strategy to create community infighting. There are real enemies, and it’s not each other. Some feel protected because of their urban bubbles. Please understand no one is safe. Justice Thomas clearly telegraphed next steps. He literally gave state Attorneys General a roadmap for the next issues to bring to the Court. There is no secret agenda. It is all out in the open.

His confidence comes from the nature of Supreme Court rules. They are appointed for life so, even with the first Black women to be on the court, it is a numbers game, and they have the justices to radically change our world. Our only recourse is Congress and the Presidency. That is why November is so important. We all have a part to play in this fight.

There are very specific rules for nonprofits including federal, state, county, and city regulations. NMAC would never suggest illegal activities, but now is the time to walk that line. Ending the HIV epidemic in America requires funding at a level that only the federal government can provide. Private HIV donors should consider supporting voter registration and getting out the vote activities in HIV, STD, and Hepatitis organizations. Without financial support, it is difficult to ask already over stretched nonprofits to take on more work.

It starts by getting staff, clients, and donors to register to vote. Given the divisive nature of the issues, there is little middle ground. Both sides have outlined their priorities and now it is a fight for the hearts and soul of Americans. Can we get people to care enough about our issues to vote? Unfortunately, we must lean into the trauma of not voting.

SOCTUS decisions put November in play. People are pissed, and we need to channel that energy into voter turnout. We don’t need to stoke the fire; the urgency is self-evident when you watch the news. Just give our constituents constructive options that can lead to lasting change.

As we learned from the early days of the HIV epidemic, we must fight while also being gutted by the realities of the moment. After Trump, flipping the Supreme Court, COVID, Black Lives Matter, climate change, immigration, the election, Jan. 6, wildfires, gun violence, police killing Black men, record number of murders, Asian violence, don’t say gay, withdrawal from Afghanistan, inflation, gas prices, BA2 variants, one million Americans dead from COVID, a war in Ukraine, recession, and Supreme Court decisions on guns, abortion, and school prayer, we have more than enough justification. Fighting for Our Lives is the theme for the 2022 United States Conference on AIDS. Our HIV legacy speaks to the current moment.

Yours in the Struggle,

Paul Kawata

Paul Kawata

The White House is So Gay

The White House is so Gay. I felt at home amid their rainbow fringes. Thank you, President and Dr. Biden, for the invitation to the 2022 White House Pride Celebration. It is good to know that during these divided times, the White House stands with us!

Once again, people like me are being used to scare voters. The right exploits fears of homosexuals as a wedge issue to get their base to the polls. They also use abortion, gun control, and liberals. This year’s Pride Reception was not just a party, but also a statement of support, one that is needed and appreciated. The world is going crazy. As seen in Idaho, it’s not a safe time for homosexuals. Going to the White House felt even more critical.

It was the who’s who of Washington. This administration has so many senior LGBTQ staff, not all of them could join him on stage when he signed an Executive Order aimed at protecting LBGTQ people. There was a time when we were welcomed into the East Room. I moved to Washington at the start of Reagan’s second term to fight an epidemic. Back then it was impossible to think about a time when community would be welcomed into the White House. The world is changing and that is why so many people are up in arms. Any shift in power, no matter how slight, can have long term ramifications. Dr. King said, “the arc of the moral universe is long, but it bends towards justice.”

I loved the rainbow flowers under the portrait of President Lincoln in the State Dining room. What would Lincoln think about this reception? The Civil War was a fight for the soul of America. The South lost, but the memories lingered. Unfortunately, there are too many who want to go backwards. The country couldn’t even unite behind the fight against COVID! As the world continues to slug it out, homosexuals will be used to create unfounded fear and anxiety.

In this mess, how do we end the HIV epidemic? How do we provide care and prevention services to communities who are regularly vilified by too many elected officials? HIV programs must accommodate and speak to the pain that our communities endure on a regular basis. This impossible balance is what makes the work so hard. Right now, there are states with governors who want us silenced. They are searching textbooks and bathrooms. It is only a matter of time until they get to HIV. Are we ready to be part of the culture wars? In the past, our work had bipartisan support. Who knows in this America?

My concern is some government officials might think appeasement and water down HIV programs. PrEP campaigns must be sex positive and speak to the realities of the communities hardest hit by HIV. We can’t go backwards. Technology and TikTok have changed the game. If we are serious about reaching the communities needed to be reached, then the work must be real and fearless. But that is easier said than done.

While the food was wonderful, the reception was more than a party. It was a public declaration of the administration’s support. Since we have a friendly President, now is the time to take risks with HIV initiatives that speak to the communities we’ve missed. Everything could change after 2024.

In his remarks, President Biden said that “we are in a fight for the soul of America. And that we will win.” I needed his words in ways I hadn’t understood. The lies and misrepresentations of my communities seem never ending. To have the most powerful man on the planet use his bully pulpit to stand with us is critical, especially at this divisive moment in history. As we’ve seen from Sweden and Finland, you can no longer be neutral. People, countries, and the world must take a side. It’s a fight for the soul of America, and I am hopeful.

Yours in the Struggle,

Paul Kawata & my new best friend,
White House Press Secretary Karine Jean-Pierre Worth

What Fresh Hell is This?

If there was not enough on our plates, monkeypox has been identified in gay men around the world. What fresh hell is this? Hopefully, this will not become an epidemic like HIV; however, there are reasons to be concerned. HIV service providers, STD clinics, and health departments need to be prepared to pivot as more cases are identified.

How does the HIV community educate about monkeypox and not stigmatize gay men? As we know, HIV is not a gay disease and gay men are the majority of people living with HIV. Our work must thread the needle between the need to educate gay men about monkeypox while not adding to the disease burden of a community traumatized by HIV, STDs, and Hepatitis.

The world has lots of judgements about people who are different. Between monkeypox, “don’t say Gay,” and the anti-transgender bathroom, sports, and school bills, it’s a tough time to be LGBTQ in America. The radical right feels emboldened to lie and label us as groomers in a not too veiled attempt to equate gay men to pedophiles. Have they no shame?

HIVphobia, homophobia, transphobia, racism, sexism, and ageism create the trauma that I believe are major contributors to why 49% of people living with HIV fall out of care and why overall enrollment for PrEP is so low. It’s not enough to offer services, even if they are free. There needs to be active and ongoing outreach to community that provides trauma informed care and prevention services. The CDC has developed six guiding principles to a trauma-informed approach:

The communities we need to reach are the same people who are traumatized because they live in America. COVID, Black Lives Matter, Jan 6, climate change, inflation, immigration, war in Ukraine, fires, baby formula shortages, elementary school shootings, crime, Asian violence, racist mass shootings, abortion, Supreme Court, monkeypox, and the upcoming midterm elections are the trauma impacting our family, clients, staff, donors, and government officials.

We’re trained to wait for the “other shoe to drop.”  Monkeypox is just another on a long list of “what fresh hell is this?” Two years after the initial outbreak of COVID, we are still trying to figure out how to live in a world that has gone upside down. Too many Americans are suffering from some form of trauma, and many do not know how to cope. The trauma is coming from multiple sources/directions and feels never ending.

Not only do we need to support family, clients, staff, donors, and government officials, we also need to take care of ourselves. Do not minimize the stress and trauma of leadership while flying blind. The control queen in me is having a particularly difficult time. I’m learning to lean into the reality that I don’t have the answers. We are making the best decisions we can and there are too many unknowns to be definitive.

After my signature there is a resource list prepared by the White House on monkeypox. Given everything that is happening, it is comforting to know that the President stands with the LGBTQ community. We see it in his words and deeds. By the end of June, the Supreme Court will issue their much-anticipated ruling on abortion. Reproductive health and HIV are connected in our commitment to the sexual health and wellbeing of all Americans. Their fight is our fight.

Yours in the Struggle,

Paul Kawata

Paul Kawata