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 www.monkeypoxtruth.org. 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, www.monkeypoxtruth.org 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

USCHA Almost Sold Out

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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
NMAC

Living My Best Life

The plane broke into spontaneous applause as we safely landed in Puerto Rico. I’d forgotten about this sweet custom and was reminded why I love the islands. Some folks think the applause is a thank you to the gods for arriving safely, others believe it is gratitude for being home with their people. I’m in San Juan to celebrate Pride and hold a board meeting/site visit for the 2022 United States Conference on HIV/AIDS.

Words cannot describe how good it felt to be at Pride in PR. It’s been too long. I missed being with community. I’m too old to walk the entire route, so I want to thank Ariana’s Center for letting me ride on their float. To experience their Trans Pride was a gift. Right now, too many are using the transgender community as a punching bag. It was an honor to ride with them during this difficult moment.

Leadership means showing up for the communities hardest hit by HIV.

Congratulations and thank you to everyone working to hold Pride events in-person. The world is an awful place and it’s easy to be overwhelmed and depressed. Public events are not for everyone. There are real risks for getting COVID or Monkeypox. As we learned from our safer sex days, abstinence from the world is the only sure way to be 100% safe. COVID showed me the challenges of being alone. I need to be in the world, traveling and experiencing life. That’s why I was so grateful for San Juan’s Pride.


This year’s USCHA will be a love letter to Puerto Rico. Life is beautiful and difficult here. The meeting is at their amazing conference center (I took the photo myself) and will lean into the culture by highlighting the organizations and people working to end the epidemic in a country that is also a territory. The Opening Plenary will be in Spanish with simultaneous translation into English. USCHA did this to give attendees the experience that impacts too many non-English speaking clients. You are going to learn about the culture by tasting the food and listening to the music, but the best ambassadors are the people. There is a pride to being Puerto Rican. NMAC is working with an amazing local host committee to give you an authentic experience. USCHA is the first big meeting to happen at the center since COVID. There are many jobs and lots of economic development dependent on us.

The 2022 meeting has the largest pre-registration in history. Two hotels are already sold-out. Only 30% of the exhibit space is still available. People are ready for an in-person meeting. Our COVID protocols are stricter than Chicago. Everyone will be required to have initial vaccines and at least one booster. The meeting will also follow all local ordinances. Masking will be encouraged and celebrated. Rapid tests will be available for free for attendees. However, there are no guarantees. Of the 1,033 attendees at this year’s Biomedical HIV Prevention Summit, four people let us know they got COVID after the meeting. We’ve also had two people test positive at two different regional trainings (one per training). No one was seriously ill or went to the hospital. As a health organization that works with people who are immune compromised, we feel a duty to inform. As a gay man of color living in America, I understand risk. There is no one right answer for everyone. I hope you will join us this year, but completely understand if it is too soon.

The world is crazy and that makes Pride even more important. I reject being labeled a groomer. It’s just the Right’s dog whistle for pedophiles. Make no mistake, they are coming after all of us. I stand with Pride, not only for my own mental health, but also as a “fuck you” to all who would deny my humanity. We are headed for war because nobody wants to go back into the closet. There need to be a NATO pact between the oppressed. When they go after abortion, Black Lives, immigration, Asian Lives, climate change, Trans Lives, limits on guns, and the LGBTQ community, we must stand together in our outrage.

Yours in the Struggle,

Paul Kawata

Paul Kawata
NMAC

Covid Asterisk Year

I’m just going to say it: the world is going to shit. Last week saw another mass shooting at an elementary school and monkeypox. I’m reposting the pictures of the children. I know it hurts to see their bright young faces, but we can never grow complacent about gun violence. Unfortunately, experience says we will. The prior week 10 African Americans were killed in Buffalo in another racist mass shooting. Our failure to protect them is everyone’s responsibility.
Most of the children and adults killed in these massacres were people of color. NMAC is not a gun control nonprofit, but that doesn’t mean we don’t have a responsibility to speak out about the insanity of gun violence in America, particularly gun violence that is the result of racism. Our country is a house divided with little middle ground. The divisions turn mistrust and hate into violence. On one side you have anti-abortion, pro-gun supporters who want to take America back to the days where White cisgender heterosexual men sit at the top of the food chain. On the other side is everyone else. All of us understand it’s a fight for the soul of America. Our country is becoming more diverse but rather than create more seats at the table, some people want to go backwards. The good old days were not necessarily good for everyone.

Black Lives Matter saw hundreds of thousands take to the street to demand justice after too many police shootings of African Americans. We watched on video as George Floyd was killed, yet two years later what really changed? The world has witnessed too many atrocities. We are overwhelmed and numb to violence, death, and suffering. Just when you couldn’t imagine another thing, there is a monkeypox outbreak among gay men. What fresh hell is this? They say it’s not sexually transmitted, but the largest outbreaks happened at a bathhouse in Madrid. Most of the cases are among gay men.

Given the overwhelming sad news of last week, some may have missed the Centers for Disease Control and Prevention announcement that new HIV diagnoses decreased by 17% in 2020 vs. 2019. Normally this would be something to celebrate. The reality as noted in the article was the 2020 data could not account for the COVID impact on HIV services. Good news with a *COVID asterisk. Maybe that’s the best we can expect. Under impossible circumstances with no clear pathways, we did the best that we could. This is not normal. It’s not supposed to be like this.

Yours in the Struggle,

Paul Kawata

Paul Kawata
NMAC

Hiring People of Color

Change is hard. It requires great effort and lots of anxiety. Many White-led HIV and LGBTQ agencies recently hired their first person of color to lead the nonprofit. I’m very proud because so many have fought for so long for this representation. At the same time, I worry for our new colleagues’ success. Will these leaders be judged by a different standard? The unfortunate reality is “yes.”

There are no playbooks for how to be the first leader of color of a mostly White agency. I know, because I was the first person of color in too many rooms during the early days of the epidemic. Suki Ports and I would joke that we were a caucus of two at most HIV conferences. Back then, leaders of color started their own agencies because they did not see their reflection in the boards or staffs of AIDS service organizations and/or health departments.

The inequity became a flashpoint. It’s taken decades but change is happening. How should our movement support leaders of color? I talk about race because of its impact on leadership. Our movement needs to fund leadership development for people of color not because it is politically correct, but because it is the right solution. It is not easy to manage white people. I am still amazed at White fragility. Also, too many people of color living with HIV have fallen out of care. Too few people of color benefit from PrEP. I’m not saying throw the baby out with the bath water because there is lots of good. I’m just asking for leadership development to support people of color in key management roles in the organizations working to end the HIV epidemic.

There are so many sad stories of agencies who hired their first leader of color only to have it blow up in everyone’s face. Nobody wins those fights. Agencies need to do internal work before hiring their first executive of color. When you’ve hired one person of color, you’ve hired one person of color. You have not solved racism in the agency, community, or planet. Unreasonable expectations make excitement about new hires go off the rails. While I am grateful to all the health departments and community based organizations who are hiring people of color, please make sure it’s not just entry level positions.

Our community is so quick to judge when someone makes a mistake. As an executive director who has made many mistakes, I appreciate that my board understands the challenges of leading while colored and who understands that people are going to get mad because I lead with race and call out White privilege. It is a very difficult line that leaders of color must walk, particularly when they are new. Many are accused of overusing racism as an excuse but, once again, we all live in different worlds with very different realities. As a person who walks in both, some of you are not as “woke” as you think. It takes work to understand, work that too many are not willing to do.

Thank you to all the agencies committed to diversity, equity, and inclusion. It is an important next step, but there is still more to do. Too often values and systems in the workplace continue while clients and staff change. Too many HIV meetings happen where community is diverse, but government is not. Health departments are not exempt from the need to be diverse. Besides color, that diversity must include gender, gender identity, sexual orientation, and NMAC wants to talk about education.

As a highly educated individual, I think educational requirements for employment are bogus, particularly in the HIV field. Our work requires staff to know communities that you can’t learn about in textbooks. Sometimes lived experience is more important than a BA. It’s time to value community. Another reason I talk about race is that our work is missing too many. Systems led by community need to be supported and valued. Professional standards are not necessarily community standards. Existing systems retain 49% of all people living with HIV in care, but they do not reach everyone needed to end the epidemic. Once again, we need to keep the good and use new funding to figure out ways to reach those who have fallen out or are not reached by existing systems. It is time to expand our business model to include the urban market.

My plea is not only to hire people of color, but to also give them the support and resources needed to succeed. Things you take for granted may not be their reality and vice versa. Too many executives of color have experienced horror stories of donors that are friends to the movement but less than understanding on race or gender identity. Unless you’ve been there, it’s almost impossible to appreciate the trauma these meetings create, having to smile while a person with wealth says, “you’re one of the good people of color.” This really does happen. I have too many stories and too many names of donors who just don’t get it.

It comes down to dignity and respect. It’s what we all want and deserve. In the ideal world everyone would be treated like cisgender White heterosexual men while also keeping their community identity and values. Until that day, it is important to understand that our worlds are not the same. Being a leader of color is hard, especially when people say they don’t see color. There are no roadmaps for how to lead a predominately White agency as an authentic person of color. But understand you will be judged based on values that are not yours and/or you may not even know. Pass these life lessons to the next generation. Hopefully, there will be a time when no one is judged by the color of their skin. A boy can dream! Thank you for the privilege of saying difficult things.

Yours in the Struggle,

Paul Kawata

Paul Kawata
NMAC