The Future of HIV Prevention

With this letter, our movement enters a new phase of HIV prevention…

HIV prevention used to be about testing, PrEP, and PEP. Our movement must now figure out how to work around Governors, state legislatures, and/or the courts as they work to deny, stop, or turn back federal HIV support. This is not a fight anyone wants, and the struggle has almost nothing to do with HIV, and everything with the communities highly impacted by HIV. We’ve been weaponized by bullies to prove they are anti-woke.

For decades we’ve fought against the virus and prioritized disease prevention, care, and treatment. Now the people we service, people like me, are vilified for political gain. This is not about the effectiveness of PrEP or HIV treatments. The medications work. For the court case in Texas, it’s about Christian employers who don’t want to pay for HIV PrEP for gay men and challenging the way members of the Prevention Task Force are selected to throw the ACA into chaos. The lower court agreed, asserting the Religious Freedom Act gives these employers the right to discriminate like the case of the baker who did not want to make a wedding cake for same sex couples. Except with this win, the courts are denying access to HIV medications based on the sexual orientation of the employee. NMAC believes there is a huge difference between not baking a cake vs. denying access to live saving medications. In Tennessee (TN), we are not sure why the Governor made this decision. There were no reviews of the state’s prevention programs, so this decision has little to do with HIV in TN.

Since this is the first state to turn down their core HIV prevention funding, there is no playbook. We are working on solutions with only months before the May 31st deadline. Thank you CDC for working so closely with community, NMAC appreciates your collaboration. TN is a deep red state and solutions are different in places with a supermajority in the state legislature. NMAC is working with local agencies along with multiple national partners to figure out meaningful solutions.

While HIV used to enjoy bipartisan support, more and more the people we serve are caught in the crosshairs of the culture wars. Like Title X, the HIV movement needs workarounds that directly fund FQHCs, community-based organizations, hospitals, pharmacies, universities, and healthcare providers. People living with HIV need healthcare and meds for the rest of their lives and people on PrEP need healthcare and meds for as long as they are sexually active. Actions in TN will impact multiple systems. Pharmaceutical companies, universities, hospitals, research institutes, pharmacies, and health systems have billions at risk. These corporations cannot be neutral and need to step to the table with real money to fight back against misinformation. I believe HIV is too big to fail but worry about the amount of pain that will be inflicted by bullies using us for political gain.

As too many already know, these actions are really about hate, prejudice, and discrimination. Another lesson in HIV stigma that our movement understands all too well. The stakes could not be higher. Hundreds could lose their jobs, thousands access to HIV prevention services, and an unknown number of Americans will get HIV. NMAC will address these challenges by…

2023 Biomedical Summit Plenary
Join us for an important plenary at the 2023 Biomedical HIV Prevention Summit on the Future of HIV Prevention in America. The session will be coordinated by NMAC’s Coalition for Justice and Equality Across Movements. Toni Newman will work with Tennessee and national partners to discuss critical next steps. The Summit will work to prepare attendees for the next phase of HIV prevention, fighting to keep our federal HIV support.

Tennessee State Gathering
NMAC is interested in holding a gathering in Tennessee after CDC has a work around. The gathering needs to happen prior to the May 31st deadline; however, it can’t happen without the CDC. They are very interested in our conversations. Given all the issues, CDC’s participation needs to be cleared by legal.

Other State Gatherings
While we hope it won’t happen, NMAC is concerned that other states could follow TN or Texas. Let’s all stay in close communication. What happens in TN can be a template for other states. NMAC is willing to support additional gatherings. While most states are well organized, I’m concerned about the ground game in some regions. Our state borders are porous. Work, funding, and sex are all interrelated.

Coalition Across Movements
This fight is so much bigger than HIV. It’s about what divides America: woke vs. anti-woke, race vs. racism, gender, gender identity vs. sexism, and the fear/hate of homosexuals or anything outside of the mainstream. The same sex marriage law is amazing, but that legislation also affirms religion’s right to discriminate. The unintended result is to codify actions by Christian employers in Texas. Now more than ever, the HIV movement needs to work and build support between movements impacted by these anti-woke policies. Together we can be a force for good.

Taking Back the Narrative
Our movement needs to take back the narrative. We’ve allowed their fear of who we serve to drive the discussion. Let’s tell the stories of lives we saved, the science developed, and people who are still here after being told they were dying. Nothing we do will make us acceptable to those who hate us, we’re trying to reach our natural allies. There are plenty of people who disagree with the divisive work of people at the extremes.
NMAC is working with The Raben Group to get our stories out, but these efforts take everyone. The Raben Group will put together a training at the 2023 United States Conference on HIV/AIDS to educate our field about the multiple platforms open to HIV messages. We don’t need The New York Times; we can tell our own stories ourselves.

In the early days, we were fighting for our lives, literally. Friends and partners were dying and too many turned their backs on us. It was confusing and scary. This time it’s about bullies and not the virus. Please be part of the Biomedical HIV Prevention Summit or the United States Conference on HIV/AIDS to be part of the solution. Bullies have a vision for America that criminalizes, marginalizes, and denies access to HIV meds for the communities highly impacted by HIV. We cannot let them define us or our country.

Yours in the Struggle,

Paul Kawata

Paul Kawata