What Is Fair?

A White Gay colleague recently shared his concerns about speaking out and not getting canceled. I appreciated his courage and honesty. This is a difficult time. Between COVID, Black Lives Matter, the Jan. 6th insurrection, and climate change, the paradigm is shifting, and we are still working out what that means.  There are no clear rules and that can be scary. What some White folks don’t understand is that the world was built to accommodate them and their culture. Making a world that works for people of color and people who are different means taking some of that away. For example, “what is fair” usually is code for “what is fair to White people?” When something is fair to people of color but not White people, then it’s usually deemed unfair. Or the transverse, when something is fair to White people but not People of Color, then it is usually deemed fair.

Last year White America woke to the over policing of Black people through the killing of George Floyd and too many others to name. What happens when something is unfair to People of Color but needed in White communities? This is the paradigm shift that America is working to answer. In our fight to end HIV, PrEP users are 75% White, yet the majority of people living with HIV and the majority of new cases of HIV are among people of color. PrEP is reaching Gay White men, but not Gay Black men. What does that mean?

I remember talking with a White straight cisgender male federal official who told me he had the answers for ending the epidemic. Yet his leadership brought no changes in the outcomes. What happens if we end the HIV epidemic in White America while HIV continues for People of Color? Some might say the fight is over and we won.

To my White friends, here is how I navigate these challenges. As an old fem Asian cisgender Gay man and the Executive Director of the agency formerly known as the National Minority AIDS Council, I am professionally aware of the privileges and discrimination that goes with how I present myself to the world. Part of my job is to hold-up communities that are often overlooked or undervalued. Most of my job is to listen and learn from those communities.

When I am in spaces for African Americans, Latinx, American Indians/Alaska Natives, women, the transgender community, people living with HIV, then I shut the fu** up and listen. When I am in spaces for People of Color, Asians, LGBTQ, or the general HIV community, then I fully engage and feel a responsibility to bring my perspective to the table. It’s been my experience that most people get in trouble when they try to fully engage at tables not meant for them. My experience of too many White people, especially cisgender White heterosexual men, is they believe all the tables are set for them because mostly they are.

Privilege is taking all the oxygen out of the room. I purposely use my privilege in rooms full of White people. I want them to understand that they are not the only important voices. It took me a long time to get comfortable, some would say too comfortable, with this privilege. As an Asian man, it was not something that came naturally. In the world of HIV, it is a very important skill. It is difficult if not impossible for many of you to understand what it means to present as White, yet it is something that every person of color intimately knows. Our value depends on how we present ourselves in the world. The closer we show up as white heterosexual men the better. For most of us that is impossible, yet that is the gold standard for power and wealth in America.

COVID has made us insane, and I think it is the catalyst for this paradigm shift. The virus has makes us rethink everything. If this is my new reality, who do I want to be? Where do I want to live? How do I want to present myself to the world? For some of us, it will change the way we work. Are you willing to commute 90 minutes to and from work? I could never have imagined NMAC’s staff would primarily work from home, yet that is what we do.

COVID, Black Lives Matter, the Jan. 6 insurrection, and climate change have forced a reckoning. We can probably end the HIV epidemic in the White community by 2030, but if we stay on the same course, I have real doubts about ending HIV in communities of color. This is my pledge to the HIV movement: what is fair cannot be based on White privilege. Our work must embrace the challenge of what is fair to communities who have lived under generations of discrimination and oppression. This is bigger than change; it is a shift in the paradigm. Ending the HIV epidemic in America starts by re-looking at what is fair.


God is Love and Love is for Everyone,
Paul Kawata

Paul Kawata






Remembering Carl

Archbishop Carl Bean passed last week. The funeral is Saturday. I’m going, but I’m not ready. I’m not ready to say goodbye to the man who changed the course of my life. It was Carl who talked me into taking the job at NMAC.

Carl’s many achievements were outlined in articles in the New York Times, the Washington Post, and on the Today Show. I knew a different Carl from the person in these publications. He was my friend and partner in crime. We were each other’s lifeline in the storm called AIDS. Together, we navigated some of the most difficult days in the epidemic. I knew the man who wanted to get away, if only for a moment, from the shackles of his position. I will never fully understand the burden of leading a religious movement, but I often saw it in his eyes as members reached out for answers. Why did God take my child?

Carl and I traveled the world together. He loved to go on cruises, so we went to Alaska to see the glaciers, the Caribbean to look for gentleman callers, and ultimately, a trans-Atlantic crossing from New York to Southampton. We visited the Vatican, the Louvre, and the west end of London. Most of these trips were work related because Carl was asked to preach all around the world to bring his unique voice of liberation theology that God is love and love is for everybody.

I never knew Carl the Broadway entertainer, but from his stories, I imagine he was amazing. He could talk and I could listen for hours about performing on Broadway or touring the country. It was his work in the entertainment industry that would later support his fight to end HIV. I remember sitting next to him when Whitney Houston performed at a benefit for his agency. It was very heavy times. He had Dionne Warwick on speed dial, and Maxine Waters not only returned his calls, but also called to check in. While it might seem glamorous on the outside, it was also a huge burden.

People would cry as they reached out to hug him. Members of his church would copy his sermons because his words were touched by the Holy Spirit. I think it can mess with your mind and was part of the reason Carl went into seclusion. For many years he did not leave his home or welcome visitors.  However, Carl always had God.

I was not religious. I felt the church had turned its back on me and my kind. Before meeting Carl, I had never attended services in a Black church. Going to Carl’s church was mind blowing. My friend was singing and preaching like he was touched from above. You could almost watch him go to another place as he spread the gospel of the Lord. As a child I went to Japanese Presbyterian Church. We were the polar opposite of my experience in Carl’s church. To be in a room full of love was transformative, especially because this was in the mid 1980s during some of the most difficult times in the HIV epidemic. What we take for granted now was truly revolutionary when Carl started the Unity Fellowship Movement. He started a religious movement for the African American LGBTQ community at the height of the HIV epidemic. Out of his work with Unity Fellowship Movement, he opened the Minority AIDS Project (MAP), the first minority-led HIV organization. As the Executive Director of MAP, Carl worked nationally as one of the founders of the National Minority AIDS Council (NMAC)

It was our work on NMAC that served as the foundation for our friendship. Together we would travel the country, him preaching and me teaching about HIV. Back then, people of color were too often marginalized. Carl and I became a team to fight the stigma and racism that was too prevalent in our work. We would spend hours talking about race and our frustrations with people in power. His concerns for his communities became the corner stone of the work. Carl was a living example of liberation theology.

I got to talk to Carl the day before he passed. He was in a coma, so they had to hold the phone to his ear. I thanked him for being a gift to my life and our movement. I let him know that it was OK to let go. His was a life well lived. Finally, I told him that I loved him and will miss him. This is a ritual from the early days of the epidemic that too many of us know too well. Thank you, Carl, for being my friend. My life is better because you were in it.

God is Love and Love is for Everyone,

Paul Kawata

A Special Announcement on USCHA

This is the letter I didn’t want to write. When we announced the 2021 United States Conference on HIV/AIDS was going to be in person, I was joyous about the thought that we could come together. Unfortunately, the Delta variant of COVID is too easily transmitted, even by people who are fully vaccinated. What seemed like a reasonable decision in May now feels impossible. After a long discussion with our board, NMAC will move USCHA to the virtual space. I am so sorry. I know this is very disappointing. NMAC must always prioritize the health and well-being of people living with HIV (PLWHIV). Data from Berlin about the impact of COVID on people living with HIV along with new information about the Delta variant made an in-person meeting with thousands of participants too much of a risk.

The virtual USCHA will be pushed back to December 2-3 (World AIDS Day Adjacent). These later dates give staff time to close-out and pivot to a virtual meeting. Also, the Biden-Harris Plan to End the HIV Epidemic is slated to be released on World AIDS Day, so there is much to be discussed.

I’m sure you have a lot of questions. Join us for a Facebook Live chat this Thursday, Aug. 12, at 1:00 PM on our Facebook page. Our Conferences Director Tara Barnes-Darby, and our Treatment Director Moises Agosto will be available to answer questions. You can also check out the FAQ page on the USCHA website.

This decision was based on data from two key reports.  The first was the report out of Provincetown that revealed that vaccinated people can transmit the Delta variant as easily as those who are not vaccinated. The second was the study of people living with HIV over 65 in Berlin that found high risk of death from Covid. Those two reports convinced us that we could not guarantee the safety of conference attendees.

Dr. Fauci Speaks @ Opening Virtual Plenary
Dr. Anthony Fauci will be part of USCHA’s Opening Virtual plenary. He will join Dr. Rachel Levine to update our movement on efforts to end two epidemics. We all know how busy COVID is keeping him, so NMAC is extremely grateful that he will be part of this session. Given his busy schedule, it will be recorded in advance. It is not easy being the face of the Trump and Biden COVID response. He has shown a grace and grit that he learned fighting HIV/AIDS.

Telling the Truth & Asking for Help
As you can imagine, ending an in-person conference creates financial issues. Our cancelation insurance does not cover meetings that we cancel. NMAC will be fine in the long haul, but we ask for your grace and patience. We hope that most attendees, exhibitors, and sponsors will still be a part of the virtual meeting. This is the second year that we were unable to hold USCHA and your support is needed and appreciated. The agency also understands this is not the event that we all wanted, so we will give refunds.

During the week of August 9, NMAC will send out an email from the registration portal to all registrants with instructions on transferring or cancelling your registration. If you have not received your email by August 13, contact the Conferences division at conferences@nmac.org. Please be patient; refunds will be processed in 3-4 weeks.

The registration fee for the virtual USCHA is $295. NMAC will automatically refund the difference. If you do not wish to attend this year’s USCHA, you can either:

  • Option 1: Keep your registration to attend the virtual USCHA Conference. NMAC will refund the difference.
  • Option 2: Transfer your registration to the 2022 USCHA in Puerto Rico.
  • Option 3: Cancel your registration and get a full refund.
  • Option 4: Donate your registration payment to NMAC.

If you need immediate assistance, please contact the Conferences Department at conferences@nmac.org. Raise any concerns directly with me, Paul Kawata. I am an old Asian queen who knows my value.

Wonderful Sponsors
This is not the USCHA that was discussed. NMAC hopes Sponsors will continue to support this important meeting and NMAC. These are scary times for all nonprofits, so please know how much we appreciate and need your support. Sponsors will get a call from Robert York. A new prospectus will be available soon. Thank you for understanding as we navigate these challenges.

Amazing Exhibitors
If you purchased an exhibit booth for the in-person conference, please let us know if you’d like to have a virtual exhibit or if you’d like to cancel your booth purchase. The virtual exhibit fee is $595. NMAC will refund the difference. If you’d like a full refund, then send an email to conferences@nmac.org by September 24, 2021. Thank you for your support.

Virtual Meeting & Presenters
Information about the virtual meeting will be posted shortly. We hope that most of the in-person workshop presenters are willing to switch to virtual. Presenters will get an email from Conferences offering you options for moving forward. You can expect the email by the end of August. If you can’t wait, then please email the wonderful Alison McKeithen.

Scholarship Applicants
USCHA will continue to give out scholarships, but now they will be for a virtual and not an in-person meeting. Since staff must address these other issues and the virtual meeting is being pushed back to World AIDS Day Adjacent, notifications about 2021 scholarships will be pushed back to October 1, 2021.

Hotel Cancellations
If you have made a reservation in the USCHA group block at the Marriott Marquis hotel they will automatically cancel your reservation and process refunds for any deposits.  Refunds will be issued in 4-6 weeks. It is not necessary to contact the hotel to cancel your reservation.

If you made a reservation OUTSIDE of the USCHA group block, you should contact the hotel directly to cancel your reservation.

Additional information about cancellations for the Courtyard hotel will be posted soon.

This was not an easy decision and probably no one is more disappointed than the board and staff of NMAC. I am truly sorry. Thank you for your continued support.

God is Love and Love is for Everyone,
Paul Kawata

Paul Kawata






Free HIV Jobs Board – One Place to Look

Health departments, community-based organizations, and federal agencies are all looking to hire qualified people to fill their job openings. NMAC is building a free online jobs board called the EHE Workforce Jobs Bank that will be a centralized place for HIV, STD, and Hepatitis job openings. Funding to end the HIV epidemic in America means thousands of new positions. Our site was created by Career Builders and uses their platform to house the information.

Jobs posted on the site have hyperlinks for people to upload their resume. We only have a few jobs right now, including openings at NMAC. We need your help to grow. Organizations with job applications can post them for free by contacting Jas Florentino. They will set up an account for you so you can post on your own.

People looking for jobs should join our Talent Network. The Talent Network will send out alerts when a new job is posted that matches your interest. It will also allow you to forward any job announcements to friends or colleagues.

Professional employment is a matter of justice for people living with HIV, people of color, the transgender community, women, LGBTQ, and the recently incarcerated. This is how our movement can hire people from the communities they need to reach. Our goal is to build bridges between the communities hardest hit by HIV and the organizations who need to reach them.

God is Love and Love is for Everyone,

Paul Kawata

Paul Kawata





This Jobs Board was funded by ELEVATE. This program is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $796,749.00 with 100 percentage funded by HRSA/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA/HHS, or the U.S. Government.

The Fight About Critical Race Theory is Also Our Fight

America’s latest culture battle is the weaponization of Critical Race Theory.  Any government program that works to address racial equity should be prepared for resistance and lawsuits. The core question facing the Biden-Harris administration is how to include race as a factor in federal procurement that can also pass muster in the Supreme Court.

Race and racism highly impact HIV care and prevention programs. The fight against critical race theory is a fight the HIV community cannot ignore. According to Education Week, “Critical race theory is an academic concept that is more than 40 years old. The core idea is that racism is a social construct, and that it is not merely the product of individual bias or prejudice, but also something embedded in legal systems and policies.”

HIV results document that racism is more than an individual’s bias. Why are the majority of people living with HIV also people of color? Why are 75% of people on PrEP White? There is something systemic that creates this differential. People focus on the social determinants of health, but the outcomes almost always break down along lines of race. It is past time to directly speak to race and racism in America.

It will not be an easy fight. People are organizing across the country on both sides, and HIV needs to be part of the solution. If not, we will continue to see racial disparities in HIV that is mirrored in too many other diseases and social challenges impacted by race. The HIV movement can set the example for how America responses to race and ends an epidemic. Ultimately, the fight about using race in federal procurement will go to the Supreme Court where we will most likely lose given the court’s current make-up. Our job is to make it as difficult as possible for the courts to find against us.

What can the federal government do to include race as a factor in HIV federal procurement and not get stuck in endless court battles?

  1. Race can be a factor but not the only factor
  2. Look at education models like the one used at the Harvard Law Review
  3. Use Minority AIDS Initiative as a “test case”

NMAC believes that race can be a factor in federal procurement, but not the only factor. Our shared goal is to build the justification for using race that can also hold up in the courts. Affirmative action case law is the primary source of legal jurisdiction. So far, the courts have clearly said that race can be a factor, but not the only factor for affirmative action programs in universities. By the same token, race can be a factor in federal procurement, but not the only factor.

The selection process for the Harvard Law Review is a potential model for how a diversity of awards can be created. At the Harvard Law Review, 18 of the 48 editors are selected through a holistic but anonymous review that may consider race, disability status, gender identity, sexual orientation, and socioeconomic status. Maybe part of HIV contracting can also speak to the value of diversity in HIV grantees.

Given the weaponization of Critical Race Theory, the federal government might consider a pilot project that solidifies the value of “diversity” when using race as a factor in federal procurement. NMAC believes the Minority AIDS Initiative (MAI) is the ideal test case. The MAI was created to support minority-led organizations; however, the Bush administration had concerns about any type of affirmative action in federal grant making, so they changed the MAI from minority-led to minority-serving organizations. Given the Biden-Harris administration’s commitment to racial equity across government, now is the time to review implementation of this critical HIV funding stream.

NMAC is asking Harold Phillips, the new Director at the White House Office of National AIDS Policy to pull together a working group of federal and community leaders to examine ways to use race when making funding decisions about the use of the MAI. It will be essential to include legal experts who can help minimize challenges that will inevitably follow.

NMAC does not want to take any funding away from existing MAI grantees. Given the deadlines to end HIV, our hope is that the federal review is truncated to impact FY22-23 funding. Everyone wants to end the HIV epidemic but we will not reach this audacious goal if we continue with the status quo. HIV has led the way on so many issues. Now it’s time to lead with race.

God is Love and Love is for Everyone,

Paul Kawata

Paul Kawata






Free Summer HIV Trainings – Lots of Deadlines

NMAC is hosting a series of free summer virtual trainings, I hope you can join us.

  1. National Training for Transgender/Gender Non-Conforming PLHIV (July 6-9)
  2. National Training for PLHIV in Indian Country (Jul 12-14)
  3. National Training for PLHIV in the Latinx Community in Spanish (July 19-23)
  4. National Training for Gay Black Men living with HIV (Aug 2-6)
  5. National Training for Cisgender Heterosexuals living with HIV (Aug 9-13)
  6. National Training for PLHIV in the Latinx Community in English (Aug 16-20)
  7. Midwest Stigma Training (Aug 23-27)
  8. Southern Stigma Training (Aug 30-Sep 4)
  9. Southwest Stigma Training (Sep 13-17)

This summer NMAC will hold a mix of regional and national virtual trainings. Given feedback, some trainings will engage communities highly impacted by HIV like the transgender/gender non-conforming community, Indian Country, Latinx community (Spanish and English), Black Gay Men, and Heterosexuals, as well as regional trainings on stigma.

The Transgender/Gender Non-Conforming training (July 6-9) will be coordinated by Lauren Miller. Please email or phone (202-997-0951) with questions. The trainers for this session will be Aryah Lester, Tori Cooper and Ja’Mel Ware. The goal is to create a safe space for the transgender/gender non-conforming community to share, learn, and build community.
The Indian Country training (July 12-14) will be coordinated by Christopher J. Paisano. Please email or phone (202-997-0396) with questions. The goal is to create a safe space for American Indian/Alaska Natives living with HIV to share, learn, and build community.

There are two trainings targeting the Latinx community (July 19-23 in Spanish & August 16-20 in English). Cora Trelles Cartagena is the coordinator for these trainings. You can reach her via email or phone (202-870-0481). The goal is to create a safe space for the Latinx community to share, learn, and build community.

The Black Gay Men living with HIV training (August 2-6) will be coordinated by Charles Shazor Jr.. Please email or phone (202-302-7515) with questions. The goal is to create a safe space for Black Gay Men living with HIV to share, learn, and build community.

The training for Cisgender Heterosexuals living with HIV will be coordinated by Gabriella Spencer and Lauren Miller. Lauren’s information is above. You can email or phone (202-738-0935) Gabriella with any questions. The goal is to create a safe space for heterosexuals living with HIV to share, learn, and build community.

Additionally, NMAC will host three regional Stigma Reduction trainings (Aug 23-27, Aug 30-Sep 4, & Sep 13-17). These trainings will be coordinated by Terrell Parker and Christopher J. Paisano. Christopher’s information is above. You can email or phone (202-997-5598) Terrell. The goal of these trainings is to bring PLHIVs together with their Ryan White service provider to reduce HIV stigma in the HIV workplace.  The deadline to apply for the stigma trainings is July 9. In addition to the trainings, we will also provide Agency level Technical Assistance and Learning Collaboratives.

Our goal is to build communities of people living with HIV who are ready to work to end the HIV epidemic in America. We also hope to address HIV stigma in the HIV workplace because too many PLHIV are not retained in HIV care.

Yours in the struggle,
Paul Kawata

Paul Kawata







ESCALATE is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) and the Minority HIV/AIDS Fund as part of a financial assistance award totaling $1,600,906.100 percentage funded by HRSA/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA/HHS, or the U.S. Government.

ELEVATE is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $796,749.00 with 100 percentage funded by HRSA/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA/HHS, or the U.S. Government.

God is Love and Love is for Everyone

I recently flew to Long Beach to be with my friend Archbishop Carl Bean as he begins his hospice journey. Normally this would be a very private moment, but Carl needs our help. He is a proud man who would be mortified that I am sharing his Go Fund Me campaign, but he needs support. Some of you might not know Carl but, in the Black LGBTQ community, he is a hero, preacher, and fighter against HIV in the African American community. If you never got to see him preach (watch), you missed something special. Carl fought against discrimination and oppression. He is the founder of the Unity Fellowship Church Movement, the Minority AIDS Project and NMAC.

Carl spent his life fighting for the poor. He built the largest national movement of Black LGBTQ churches. As a minister, he never took a salary or paid into social security. As a result, he finds himself at the end of his life well lived without resources. While his hospice is clean and safe, he is sharing a room with two strangers who are also dying. There is a sheet that separates these odd roommates. It was hard to see him in these conditions. The world is not a fair place for people who are poor, even with friends like Congresswomen Maxine Waters (who visited Carl three days earlier). While friends are writing checks, he still needs some help. Please go to his Go Fund Me page.

This photo of us was taken by the Los Angeles Blade after the Rodney King verdict and the riots in LA in 1992. Carl asked me to join him to facilitate conversations between the African American and Asian communities. Back then, it felt like we were fighting two different epidemics: one that was well funded and one for the poor. For Carl, the work would always be centered on the poor.

I met Carl in the mid-‘80s when he opened the Minority AIDS Project as a program of the Unity Fellowship Church in South Central Los Angeles in his community, the Black LGBTQ community. At the time it was revolutionary. There were services for the LGBTQ community in West Hollywood and services for African Americans in Compton, but Carl understood the unique need for HIV services targeting Black gay men. He was very concerned about discrimination his community would face. He created a religious movement and nonprofit HIV agency that would provide services in a nonjudgmental fashion, services that were grounded in the history and legacy of the African American community but targeting Black gay men.

We served unique roles in each other’s lives. I was his safety net, the place where he could let his hair down and not be the archbishop. He was my traveling buddy, the person I counted on to get me away from the crazy lives we led as leaders in the HIV movement. In one day, Carl might visit someone who was sick with AIDS, then go preside at a memorial for someone he did not know because too many churches denied burials. He might close the night with a family that must make too many difficult decisions. This was the groundswell of both our lives, a never-ending onslaught of death and sickness that is still too difficult to describe.

Our shared pain was the bond that brought us together like so many in the early days. Carl introduced me and got me to love the Black church or at least his version of one. He preached liberation theology where “God is Love and Love is for Everyone.” Every Sunday his church was packed with mostly African American LGBTQ parishioners, but it could be any Black church in America. People of all genders wore their crowns as all good church mothers do. The choir was singing “come to the light” at the top of their lungs. Just as the organ had everybody standing and clapping, Carl would emerge. He knew how to give them a show. His message of love and acceptance was particularly important to Black LGBTQ people, but everyone was welcomed. His church was a place where people could be themselves and know that God loves them.

To be honest, I was not that close to God. AIDS left me feeling betrayed and lost. How could there be a God when there was so much pain and death? I could not adjust my mind to this contradiction until Carl came into my life. He asked for nothing as he took care of people who had been rejected by their families and friends, people facing multiple issues with drugs, incarceration, and HIV. Soon it would be in numbers that are still too hard to fathom. Through his work I could see God.

I think the constant pressure of leading a religious movement and the PTSD from the early days of AIDS came to a breaking point around five years ago. Carl had a stroke and essentially became home bound. He could not leave his home or see his friends for long extended periods. On my last day at the hospice, I thought it would be nice to share a meal. I asked Carl about his favorite foods. Carl loved to eat. He wanted “steak, baked potato, and carrot cake.” Thank God fUber eats could deliver to the hospice. We used adult diapers as a tablecloth and quietly chowed down. There was so much that I wanted to say, so much that I needed to say, but I chickened out. I was not ready to say goodbye. I was not ready for the ritual of death. Instead, I jumped up and said that I would see him soon and abruptly exited. Not my best moment.

I wasn’t ready to tell Carl how much I loved him, to tell him that his life changed the world. His friendship made me a better person. I will, just not today. It was too soon, and I wasn’t ready. The plane back to DC is packed. Thankfully, everyone is wearing masks, so no one pays attention to the old Asian man crying. He wants to be strong but sometimes it is so hard.

Yours in the struggle,
Paul Kawata

Paul Kawata






Addressing HIV Stigma in the HIV Workplace: Training, Technical Assistance & Learning Collaboratives

Ending the HIV epidemic in America starts with addressing HIV stigma in the HIV workplace. NMAC believes the best way to create real change is by building partnerships between people living with HIV (PLHIV) and their Ryan White HIV/AIDS Program (RWHAP) service providers. Thanks to funding from HRSA-HAB, NMAC put together this new stigma reduction program with three different learning modalities: 1) trainings, 2) technical assistance, and 3) learning collaboratives in a program called ESCALATE (Ending Stigma through Collaboration and Lifting all to Empowerment). Click here to find out how to register. Participants can only register if they are part of a team that includes a PLWH and their RWHAP service provider.

NMAC believes the best way to reduce structural HIV stigma is through honest dialogues that are followed with updated policies and procedures that focus on HIV stigma reduction in the workplace. We are looking for real solutions that are client centered. NMAC wants to provide a neutral safe space to have these difficult discussions.

This work will not be easy. HIV stigma sits at the intersection of race, gender, gender identity, and sexual orientation. Because it’s NMAC, we’re going to prioritize race and its impact on HIV services. Yes, we are going there. The solutions are not cookie cutter. We understand the need to tailor policies and procedures. Our efforts will address HIV stigma in the RWHAP workplace. It will not reduce HIV stigma in the larger world.

Trainings are the entry level learning modality. They are for RWHAP funded agencies and PLHIV that are starting to work on stigma reduction. The trainings will bring together teams (providers and clients) to provide an overview of HIV stigma. By the end of the training, teams will develop their first steps to reduce stigma in the workplace. Technical Assistance (TA) is for RWHAP providers who are looking for one-on-one assistance. TA will be specific to the agency seeking assistance and will look at the implementation of tailor-made stigma reducing activities. Learning Collaboratives (LC) are for the advanced RWHAP provider teams (to include PLHIV) who want to be a part of an ongoing group that will implement tests of change using an improvement framework and share their experiences with the other teams. LCs will focus on cultural humility and its role in HIV stigma reduction. We provide different modalities because organizations are in different places among the HIV stigma spectrum, and we want to meet you where you are at.

This HIV stigma reduction initiative is centered on NMAC’s work to end the HIV epidemic in America. There are too many PLWH who have fallen out of HIV care. We believe that providers need to address HIV stigma in partnership with PLHIV. The TA will be provided by Abt Associates, and the LCs will be coordinated by NORC. NMAC will be the lead for the trainings. These learning modalities will start this summer virtually with in-person work slated for 2022. Our stigma reduction efforts are part of a four-year cooperative agreement with HRSA-HAB using the Minority HIV/AIDS Fund. For more information, please email ESCALATE@nmac.org.

Yours in the struggle,

Paul Kawata

Paul Kawata

ESCALATE is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) and the Minority HIV/AIDS Fund as part of a financial assistance award totaling $1,600,906.100 percentage funded by HRSA/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA/HHS, or the U.S. Government.

Dear Harold

NMAC logoJune 8, 2021

Mr. Harold Phillips
The White House
Washington, DC  20500

Dear Harold,

Congratulations on your well-deserved selection as the next Director of the White House Office of National AIDS Policy. Please thank the President and Dr. Rice for including community in this important decision. You have NMAC’s support, and we look forward to working with the administration to end the HIV epidemic.

Your life is about to change. As a Black Gay Man leading our nation’s efforts to end the HIV epidemic, you stand on the shoulders of Reggie Williams, Calu Lester, Alvin Ailey, Tim Offutt, Craig Harris, Max Robinson, Ron Simmons, Willli Smith, Sylvester, and many other Black Gay heroes we lost to HIV. While most people know you from your work at HRSA-HAB, I get to brag that you got your start at NMAC.

With your new appointment, community needs you to deliver. There are too many people living with HIV who have fallen out of care. There are too many people who need PrEP, but we can’t seem to reach them. While the solution to ending the HIV epidemic might be biomedical, it is not simple. That’s the problem with the previous administration’s strategy. They believed you just needed to make medications available. The reality is so much more complex and nuanced.

COVID has pressed pause on everyone’s work but, as America reopens, it’s time to get back to planning to end HIV. While we appreciate the President’s commitment for more HIV funds, we also need to make sure the funding goes to where it is most needed. I believe the Biden-Harris administration is looking for ways to bring racial equity to government. HIV sits at the intersection of that search. What does it mean to bring racial equity to our fight to end the HIV epidemic in America? How will HHS, HUD, CDC, HRSA, SAMHSA, CMS, NIH, OAR, NIAID, and other federal agencies be required to carry out this White House mandate?

With your new appointment, community needs you to fight. While we are very happy that you got this job, it only works if you fight for us. As a member of the White House’s Domestic Policy Council, we need you to bring the fight to end HIV to them. Too many people think the epidemic is over. Your voice represents more than you, it is the voice of the multitude of communities fighting HIV.

It is time to reconstitute the President’s Advisory Council on HIV/AIDS (PACHA), and it needs to be real. Your office needs the support of a Council that embraces the White House’s commitment to racial equity across government, a Council that understands it’s here to support you and the President to end the HIV epidemic.

The HIV community is extremely diverse and you can’t please everyone. There will be times when community may disagree with the administration. Please do not take critiques personally. As your job is to stand-up for the President, our job is to stand for community. I believe there will be lots of agreement, as the White House has shown their commitment to healing America.

As you prioritize tasks, we look forward to the Biden-Harris plan to end the HIV epidemic. There is no need for a completely new process; however, the previous plan did not directly address race and its impact on ending the epidemic. As I know you understand, addressing the racial divide in HIV is core to ending the epidemic. For too long we’ve danced around race and racism and focused on things like the social determinates of health. The color of your skin should never be a factor in your health outcomes, yet for too many diseases this is true. HIV can be the example for how to use race to address too many health disparities in America.

As you know, the population of people living with HIV is aging. While this is wonderful, it was not something fully anticipated when the original Ryan White program was envisioned. Now we need to make sure the HIV service mix includes specialty care like gerontology. While PLWH are living longer, they also face multiple challenges from aging and HIV. The Biden-Harris administration needs to create and implement a comprehensive “standard of HIV care” for this growing community.

The White House needs to tell the Centers for Disease Control and Prevention (CDC) to stop classifying people with transgender experience with gay men in their HIV epidemiology profiles. Justice for the transgender community starts by having CDC understand the difference between gender identity vs. sexual orientation. Too many administrations have promised to make this change, yet nothing ever happens. Ideally, we hope Assistant Secretary for Health Dr. Rachael Levine leads this charge.

The Biden-Harris plan should take a systemic approach to ending infectious diseases in America. It’s not enough to focus on HIV. Now is the time to also address Sexually Transmitted Diseases (STDs) and Hepatitis. You can end three more epidemics that have challenged America for too long. Our solutions should focus on the whole community and not any one disease. As COVID has shown us, there is a great need for comprehensive health infrastructures in too many communities in America. The plan to end HIV should serve as the foundation for bringing healthcare to communities that are too often overlooked. As we used the HIV vaccine infrastructure to test the efficacy of COVID vaccines, now we can use the HIV prevention and care infrastructure to bring long term health to communities in need.

Harold, I am so proud of what you accomplished. Now is the time to take those years of experience working at NMAC and HRSA-HAB to build the plan that you know is needed to end the epidemics. NMAC stands in solidarity with you and the administration. We will see you at the Opening Plenary for the 2021 United States Conference on HIV/AIDS, so please bring your boss.

Yours in the struggle,

Paul Kawata
Paul Kawata's Signature




40 Years of HIV

Thousands of people march past the White House during a candlelight vigil in support of funding for AIDS/HIV research Washington, DC, May, 1993.

This week there will be lots of stories about the 40th Anniversary of the first reported cases of a disease that would later be known as AIDS. Back then, this milestone was unthinkable. All we wanted to do was get through the next week without someone dying. To mark this important anniversary, NMAC invited four longtime activists to talk about the impact that report had on their lives. Over the month of June, we will release those conversations in our social media and via our weekly newsletters.

While people aren’t dying from HIV in the same numbers and new cases have dropped by 9% from 2015 to 2019, there are still widespread disparities. African Americans are eight times more likely to get HIV when compared to White America. Latinx are four times more likely. NMAC is still fighting for all the communities hardest hit by HIV. We are still committed to addressing the racial disparities that has plagued HIV for too long. Does the Harvard Law Review hold the key for including race as a component of HIV funding? A May 31st article in the New York Times noted:

“The Harvard Law Review, for instance, selects 30 of its 48 editors based on some combination of a writing competition and grades. Another 18 editors, a statement on its website says, are “selected through a holistic but anonymous review” that may consider “racial or ethnic identity, disability status, gender identity, sexual orientation, and socioeconomic status.”

The question of whether this diversity produces a better result was answered by a study that looked at 13,000 research articles. It found the “median citations of the Harvard Law Review increased by 23% in the five years after the adoption of diversity programs.” According to the authors of the study, this is statistically significant.

Can the same rules be applied to federal HIV funds? While most of the awards are given out on a competitive basis, there is a certain number of awards that are holistically and anonymously reviewed that may consider racial or ethnic identity, disability status, gender identity, sexual orientation, or socioeconomic status.

There is a racial reckoning coming to America after the death of George Floyd and protests from Black Lives Matter. Critical race theory is at the center of the culture wars and neither side will give up without a fight. The fight for racial justice is a fight for the soul of America. Who do we want to be as a country?

I believe the Biden-Harris administration is looking for strategies to fight racism by prioritizing racial equity across government programs. They understand there is a problem, but like most of us get lost trying to figure out solutions. Taken as a whole, the problem is overwhelming. How do you end racism in America? And it doesn’t stop at racism. Justice for people of color can lead to equity for the transgender community, women’s community, and LGBTQ community. That is why the Harvard Law Review is such an interesting example.

It’s hard to believe that the world has now been living with HIV for four decades. Time has moved much too quickly, and I am now an old man. I just want to live long enough to be here for the end of HIV and to see America on the right side of the fight for  justice and equity.

Yours in the struggle,
Paul Kawata

Paul Kawata