Reflections on the 2023 Biomedical HIV Prevention Summit

This year’s Biomedical HIV Prevention Summit was a risk. I’m sure some thought we were crazy. Honestly, I had concerns, especially in this political environment. Thank you to the over 1,300 attendees. To be clear, there was no federal funding for the meeting. In fact, most feds stayed away. I understand, especially right now. NMAC is very privileged to talk about issues that others can’t, especially people in government. It is also hard for some to fully comprehend the damage caused when every day on the news your people are called sick and demented because of whom they love or how they express their gender. Attendees are requested to submit their final Summit evaluation.

Communities highly impacted by HIV are demonized and weaponized in the courts, state legislatures, governors’ offices, and churches. Their prejudice and misinformation create my communities’ trauma and shame. Folks are making impossible decisions about how to live, especially if they reside in a deep red state. Families with transgender children are literally moving. NMAC celebrates what bigots try to vilify. That’s why the 2023 meeting was so transformative. We do not accept judgements from people who have not walked in our shoes. We are more than enough.

Open discussions at the Summit shined a spotlight on the trauma and shame felt by too many. Even the most evolved of us are suffering. This amazing email helped to crystalize my thinking…

“There was something different about this conference—something magical and for me, transformative.  Even as I sit here writing this message and reminiscing on the last two days, tears are starting to well up in my eyes.  I’ve spent the last several hours trying to figure out why this particular conference evoked such strong emotion from me.  Is it because of the looming legal perils that our communities face?  Is it because of the raw emotion that was felt in the room during the plenaries?  Is it just being so angry and tired of constantly being under attack for being who I am?  The answer to all of these is a resounding ‘yes.’”

HIV is mostly sexually transmitted, yet we’ve minimized discussions about sex because it makes us and our donors, especially government donors, uncomfortable. Politics drive the message and too many HIV prevention efforts have bought into that shame. When the extreme right calls us “groomers” or other ridiculous lies, we validate their stupidity when we stay silent. Sex is something to be celebrated and treasured. I hope the 2023 Summit reminds our movement to never apologize for who we are and whom we love.

Being the oldest Queen in the room, I remember when explicit discussions about sex were essential to HIV prevention. Our movement had to educate gay men about condoms using bananas. It was revolutionary. Over time and thanks to pharmaceuticals, the conversation moved to taking your meds and being adherent. Yet safe sex and not transmitting HIV remains a major motivator for why people go on PrEP or become undetectable.

There is something very liberating about a standing room only space where presenters talked about HIV prevention and sex without shame or judgement.


How does this political environment impact the Biomedical HIV Prevention Summit? We wanted to announce the 2024 meeting in Tennessee but decided against it. Rather than make a political statement, the safety of attendees comes first. Some may think this is unnecessary. Just know LGBTQ organizations are getting Department of Justice briefings about how to manage the safety of events during these divided times, especially with Pride in June. Yes, it is that bad. Look for an announcement later this year.

Thank you to everyone who joined us. You are heroes in the fight for equality and justice in this crazy world. This meeting was made possible thanks to our Presenting Sponsor, Gilead. I look forward to seeing YOU at the 2023 United States Conference on AIDS. The 2023 USCHA is NMAC’s love letter to Black women (cis & trans).

Yours in the Struggle,

Paul Kawata