It Breaks My Heart
Every time a minority community-based organization closes its doors, a part of me feels like NMAC failed. After all, our mission is to support and train these agencies, our constituents. Unfortunately, it's not quite that simple. If it was just a matter of transferring skills, then these agencies would still be in business. All the training and capacity building cannot change the skin color of these leaders. It cannot stop conscious or unconscious bias that some people have about the competency of people of color, including other people of color. It cannot bridge the huge financial divide between rich and poor that is often also a racial divide.
Even more then minority CBOs, I worry about minority communities. In 2014 people of color went from being disproportionately impacted by HIV to the majority of new infections and the majority of people living with HIV. Why? What are we doing or not doing that caused this shift? Is this reality different from all the other challenges that disproportionately impact people of color or is this just another issue on the long list of confrontations that face our communities. I hope you can appreciate the frustration. Are we fighting a battle that we are destined to lose?
Black Lives Matter opened America's eyes to a reality that most people of color already knew; the police treat black men differently than white men. In the spectrum of discrimination, where does HIV fall? When the CDC tells us that 50% of Black Gay Men will get HIV in their lifetime, is that inevitable or preventable? When 75% of the people on PrEP are White, what does that mean to communities of color? The results of our HIV prevention and treatment initiatives show that race is a determining factor for who stays in healthcare, who goes on treatment, who has an undetectable viral load and who lives longer. I don't believe this is a conscious bias, but the reality speaks for itself. In a movement that is committed to diversity and inclusion, why did African Americans go from being disproportionately impact by HIV to the majority of new cases?
Isn't it interesting that minority community-based organizations reached their peak closures at the same time that people of color became the majority of new infections and the majority of people living with HIV? I don't think they are directly related, but it makes you wonder. Some people will read this and think I'm just making excuses for CBOs that closed. That might be true if I was a new executive director, but I've been an ED of an HIV organization as long as, if not longer than anyone else in America. Believe me when I say I don't need to use race as an excuse. My longevity and ability to overcome challenges have given me the perspective to say difficult things in a way that hopefully asks for dialogue, not accusations. I just want to end this epidemic and go home to my family, but we can't do it without talking about race.
So What Do We Do?
No one has solved racism in America. I'm not sure that is in any of our job descriptions, but that is the task at hand. We have to figure out how and why the racial divide in America gets reflected in the HIV divide. Our movement is full of good caring people who unfortunately are perpetuating systems that don't work for everyone. I know they don't work because black women are 20 times more likely than white women to get HIV. I know they don't work because gay men of color have surpassed white gay men in new HIV infections. The LGBT community educates about not wanting "special" rights, we just want to be treated the same as everyone else. The same is true for people of color, we just want to be proportionally impacted by the disease, to be proportionally retained in care and on treatment, and to live our life so that the color of our skin does not determinate our health outcomes.
One of the reasons NMAC is so supportive of protests is because we don't want our movement to become complacent. We will never end the epidemic, we will never find a cure and a vaccine if we stay in our lane. HIV accomplished so much because we defied the rules, colored outside of the line, and didn't settle for the status quo. The world said that AIDS was God's punishment, an FDA said that drug approval could not be changed, world leaders who told us we can't provide treatment to Africa. HIV didn't listen and we changed the world.
I still feel bad when a minority community-based organization closes its doors, but time has given me the perspective to understand that it's more than NMAC. The world isn't fair and I choose to fight this reality by leading with race. The system doesn't work for everyone, my part is to urgently stand for health equity and racial justice. I continue to believe in us, to believe the HIV community can change the world. It won't be easy, but nothing important is ever easy.
Paul Kawata is executive director of NMAC.