Author: Jesse Carter

Monday, March 29th is the Virtual HIV Advocacy Day at the Texas capitol.

The HIV community has a long-rooted history in public advocacy.  In truth, all advances in HIV treatment, including funding and medical advances, can be traced to community mobilizing to demand action.  One of the first, and best known, HIV advocacy and protests that began in the first decade of HIV is ACT UP.  Begun in 1987, ACT UP was created in response to the silence and inaction of the Reagan administration as the HIV epidemic ravaged communities across the country.

Early HIV advocacy, such work to draw attention to the need to develop and release treatments were successful in creating new fast track processes at the FDA.  These processes shortened approval processes to allow lifesaving medications to be released without protracted and often bureaucratic processes.  Today we can trace the rapid approval of COVID vaccines to the early days of HIV advocacy that resulted in new review and approval processes.

These early advocacy efforts also lead to the creation of the Ryan White CARE Act.  First passed in 1990, the Ryan White Care Act is the largest funder of HIV treatment in the United States.  In 2020, the Ryan White program provided $2.39 billion to support programs providing care and treatment to people living with HIV. 

More recently, the HIV community has led efforts to effectively end the HIV epidemic.  Communities across the country have worked to develop plans and lead efforts to stop the continued spread of HIV.  Here in Texas, community members have come together to develop the Achieving Together plan to lay a framework and vision for reducing the number of people who contract HIV annually and effectively end the HIV epidemic in our state by 2030.

Progress has been made but has now been heavily impacted by the COVID pandemic which has interrupted prevention programs, created barriers for HIV treatment programs, and has stretched local and state public health systems.  The COVID pandemic has threatened the safety net programs across the state, most notably the Texas HIV Medication Program.  Advocates from across the state have mobilized to address these challenges locally and at the state. 

The 2021 Texas HIV Advocacy Day is organized by multiple agencies and organizations to draw together community to ensure that the voices of people living with and affected by HIV are heard.  Advocates from across the state will gather on Monday, March 29^th to meet with HIV change-makers and state policy makers to discuss some of the most important HIV legislation of the 2021 Texas legislative session, including HIV treatment and prevention, HIV education, HIV criminalization, and funding for the AIDS Drug Assistance Program (ADAP).

To learn more about the 2021 Texas HIV Advocacy Day and to get involved visit and register at:

Texas HIV Advocacy Day

February 7^th is National Black HIV/AIDS Awareness Day.  It is a day to raise awareness and spark conversations on the disproportionate impact that HIV has on Black communities.

There were 35,834 Black Texans living with diagnosed HIV in 2019.  Black Texans are about 13% of the total population of Texas but disproportionately carry roughly a third of Texans living with diagnosed HIV. 

The number of Black Texans acquiring HIV each year has fallen over the last decade, and progress has been made to ensure that Black Texans living with HIV are aware of their status. In 2019, 88% of Black Texans living with HIV were aware of their HIV status, close to reaching the Achieving Together goal of 90%.

More work must be done to address the impact that HIV continues to have on Black communities in Texas.  While significant progress has been made to address and decrease HIV among Black women, they still carry a disproportionate burden among women in Texas.  The number of Black gay, bisexual, and other men who have sex with men who acquire HIV each year has remained flat for almost a decade and more must be done to support this community in reducing the impact of HIV.

As we approach National Black HIV/AIDS Awareness Day, we asked several partners across the state to share with us their perspectives on what we all need to focus on in order to end the HIV epidemic among Black Texans.

From my perspective, ending the HIV epidemic among Black Texans requires a focus on systems; 

• Ensuring access to economic, educational, and political opportunities;
• Transforming organizations and building capacity within Black communities where we are able to make decisions and affect change for ourselves;
• Ensuring social and environmental safety where we live, learn, work, worship, and play – and working with Black communities to identify what this means (it does not mean increased police presence)
• Offering culturally competent, appropriate, and affirming health care when the need arises

We have to understand the historical context that has created the inequities we see today and allows them to persist. The first step towards doing this is realizing that a problem exists and making a commitment to be a part of the solution. For some, this may mean stepping back and allowing people with the lived experiences to take the lead.

From my perspective, in order to end the HIV epidemic among Black Texans, we need to launch a full-on campaign in the churches, schools and in the African American families’ homes.  Some Black Pastors don’t want to talk about HIV or recognize that members of their congregations are affected by HIV.  Also, a lot of black families do not want to acknowledge that they have gay family members or that their children are having sex or that the community needs accurate information and education.  The public campaigns must saturate all of Texas saying “I’m Black and I’m Proud”, “Black Lives Matter”, “Black Girl Magic”, “Black Men are Strong Providers,” and “The Black Family is Loving, Caring, Kind and Beautiful.”  In other words, Black Texans need to know that they are important and loved and worth life.  Texans everywhere must speak-out to sisters and brothers everywhere and say “We Love you No Matter What and We are in this Fight with You!”  After all, “Together, We Can Beat AIDS.”  

We need to change the lens from which we view HIV in Texas and be prepared to do the hard work that will get us to an end. Ending stigma, access to affordable healthcare, housing, and equitable and fair wages are key.  However, if we are going to truly end HIV and its impact on Black people in Texas, we will have to change the lens to one that is informed by anti-Black racism and its direct connection to why in 2021 Black people continue to carry the greatest disproportionate burden of HIV in Texas.  The existence and practice of implicit biases among the folk who write and pass policy, run programs and serve those most marginalized in this state must be rectified if we with intentions want to end HIV. How we see people is how we treat people. I believe we can end HIV among Black people in Texas. In order to do so we must deconstruct these systems of oppression that continue to disenfranchise and deprioritizes the most vulnerable folk in its society.

The biggest question I thought I had for the week at first was: Why would J.Lo shout “Let’s Get Loud” in her America the Beautiful and This Land Is Your Land mashup performance? It was a very bizarre and confusing moment for me. But as the 2021 Inauguration of President Biden and Madam Vice President Harris continued, my attention was drawn closely to President Biden calling out white supremacy in his inaugural speech. After realizing he was the first president to do so, I wonder how many people in public health were actually listening?

As a Black queer health care worker working through COVID-19, I helped many black patients access HIV pre-exposure prophylaxis (PrEP) and HIV treatment, and most shared their sentiments with mistrust of the medical industrial complex in America. As a black boy born in the eighties, by the time I blossomed into a full queer, HIV had already become a black person’s problem that was disproportionately impacting Black MSM more than any other population. I must admit watching COVID-19 evolve into another health epidemic that began to impact black people at alarming rates became very triggering and I had to reach into my toolbox to cope with the new trauma I was experiencing as a person living with HIV.

“We do know that health inequities at their very core are due to racism,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “There’s no doubt about that.” After that comment came in 2020, medical institutions and doctors were declaring racism as a public health crisis across the nation. I even had to write a statement as a Black health administrator managing several sexual health clinics in response to Dr. Benjamin’s comments. But very little seemed to follow. I soon realized that for many declaring racism as a public health crisis, they were also mistaking representation for actual change.

HIV-related stigma has continued being a factor as to why many black people don’t get tested or want to get into treatment. HIV-related stigma and discrimination continues to negatively impact African Americans living with HIV as well. The focus on ending the HIV epidemic among Black Texans and black folks across the nation should start with the acknowledgment of medical mistrust in public health amongst black people. The medical institutions must move past declaring racism as a public health crisis and take responsibility for why black communities have been impacted by HIV and other chronic illnesses at disproportionate rates. It is proven that black people are treated differently. We have data showing us that Black people get different quality of care. Why not create HIV prevention campaigns with the intention of boosting morale and trust in medicine with Black people? I no longer believe that it is ethical to use Black people as the face of HIV simply because we are mostly impacted without historical truth and justification. Let’s start having the conversations around racism in public health that’s been absent in HIV prevention and care and begin to change policies and attitudes. HIV is not the epidemic it once was thirty years ago but the racial inequities that lead to poor outcomes for black people are thriving more now than ever before.

Cordella Lyon, Baptist Hospitals of Southeast Texas

In honor of Martin Luther King Jr, we share excerpts from “The American Dream” speech given at Drew University in February, 1964. 

In developing this blog, we reflected on the past year of civil rights protests, the groundswell of interconnected social justice movements, and the momentous Black Lives Matter movement.  We reflected on the approaching inauguration of Joe Biden as the 46^th president of the United States and the violent terroristic response that saw our nation’s capital gripped by violence. 

We reread many works by Dr. King in considering what to share today.  Finally, excerpts from this speech seemed to carry messages that resonate with today’s struggles to fulfill the American Dream. We encourage you to read the entire speech online at the Drew University archives “The American Dream”

I would like to use as a subject from which to speak tonight, the American Dream. And I use this subject because America is essentially a dream, a dream yet unfulfilled. The substance of the dream is expressed in some very familiar words found in the Declaration of Independence. “We hold these truths to be self-evident: that all men are created equal; that they are endowed by their Creator with certain inalienable rights; that among these are life, liberty, and the pursuit of happiness.” This is a dream.

Now one of the first things we notice about this dream is an amazing universalism. It does not say some men, it says all men. It does not say all white men, but it says all men which includes black men. It doesn’t say all Protestants, but it says all men which includes Catholics. It doesn’t say all Gentiles, it says all men which includes Jews. And that is something else at the center of the American Dream which is one of the distinguishing points, one of the things that distinguishes it from other forms of government, particularly totalitarian systems. It says that each individual has certain basic rights that are neither derived from nor conferred by the state. They are gifts from the hands of the Almighty God. Very seldom if ever in the history of the world has a socio-political document expressed in such profound eloquent and unequivocal language the dignity and the worth of human personality.

But ever since the Founding Fathers of our nation dreamed this dream, America has been something of a schizophrenic personality, tragically divided against herself. On the one hand we have proudly professed the great principles of democracy. On the other hand we have sadly practiced the very antithesis of those principles. Indeed, slavery and racial segregation are strange paradoxes in the nation founded on the principle that all men are created equal.

But now, more than ever before, our nation is challenged to realize this dream. For the shape of the world today does not afford us the luxury of an anemic democracy, and the price that America must pay for the continued oppression of the Negro and other minority groups is the price of its own destruction. The hour is late and the clock of destiny is ticking out, and we must act now before it is too late.

We must all learn to live together as brothers or we will all perish together as fools. This is the challenge of the hour. No individual can live alone, no nation can live alone.

Somehow we are interdependent.

Due to the ongoing impact of the COVID-19 pandemic, the 2020 Texas HIV/STD Conference will be virtual. The conference will still deliver the same quality you’ve come to love and expect, but now in the form of a FREE virtual experience. We hope the virtual event will expand the conference’s reach and provide the opportunity for all HIV/STD health professionals throughout Texas to attend. 

The purpose of the Texas HIV/STD Conference is to educate and inform HIV/STD health professionals who serve Texans living with and affected by HIV and other STDs. The conference typically draws 800 to 1,000 HIV/STD health professionals from throughout Texas.

Topics include:

• National and State Ending the HIV Epidemic Initiatives
• Treatment as Prevention (TasP)
• Effective Messaging to Reduce Stigma
• Test and Treat
• Status Neutral Prevention and Treatment Cycle
• Pre-Exposure Prophylaxis (PrEP) 
• Ending STDs and Viral Hepatitis in Texas
• Health Equity/Community Mobilization
• Focus on Affected Communities
• Sexual Health
• Trauma-Informed Care
• STD Prevention and Clinical Care
• Hepatitis C Prevention, Testing and Treatment

You won’t want to miss out! Register for free at: 2020 Texas HIV/STD Conference Registration

September 27^th is National Gay Men’s HIV/AIDS Awareness Day.  HIV in the United States continues to disproportionately affect gay, bisexual, and other men who have sex with men.  In 2018, nearly 25,000 gay, bisexual of other MSM were diagnosed with HIV.  In Texas, 70% of newly diagnosed people living with HIV in 2018 were gay, bisexual, or other men who have sex with men.  The number of new diagnoses for gay, bisexual and other men who have sex with men has not changed significantly in more than a decade in Texas.

To achieve our goal and end the HIV epidemic in Texas, more must be done to stop the continued transmission of HIV among gay men, while also recognizing the real lived experience of those men.  Strategies must continue to be developed to empower gay, bisexual, and other men who have sex with men to live full and complete lives while reducing the chance of acquiring HIV. 

A key strategy to ending the HIV epidemic in Texas and among gay/bi/MSM is wider use of pre-exposure prophylaxis (PrEP).  Taken daily, PrEP prevents sexually active HIV negative men from contracting HIV if they are exposed.  While PrEP use continues to increase each year, according to AIDSVU, only roughly 14,000 people in Texas were utilizing PrEP in 2018.  Wider and easier access to PrEP will increase use, but we must also address the stigma and sexual shaming that exists in communities, and among gay/bi/MSM men in order to fully realize the benefits of PrEP. 

For more information visit the CDC’s page highlighting HIV among gay/bisexual and other men who have sex with men