People living with HIV should be prepared to get an additional COVID vaccine booster. While there is no official recommendation, below is the critical slide that was presented at the July 22nd meeting of CDC’s Advisory Committee on Immunization Practices (ACIP). Click here to download the complete presentation.

Slide from July 22, 2021, meeting of CDC’s Advisory Committee on Immunization Practices

Should staff who work with People Living with HIV be required to be vaccinated? Given the data around COVID and HIV, this will be a very difficult question that the HIV workplace must answer. The Delta variant is very concerning, particularly break through infections. Given the unknowns, NMAC is reaching out to national partners, particularly people living with HIV organizations, to start important conversations about how the HIV workplace needs to manage COVID.

Beyond the HIV workplace, what is the world going to be like? Are we willing to go back into lockdown or does this mean we have to figure out how to live with COVID and break through infections? Thirty days ago, everything seemed to be moving in the right direction. Once again, we learn how much we don’t know and the difficult decisions in front of us.

Everyone needs to get vaccinated, particularly people living with HIV. We should hear shortly about the need for an additional shot. Closely monitor what is happening in Israel where they have begun to give another shot for immune compromised individuals and people over 65. I would wait for official approval but be prepared. The Partnership to End the Epidemics wrote last week’s letter to ensure that recent data released in Berlin about COVID and PLHIV gets considered when making these important decisions.

It is very disheartening and, frankly, a little scary. There are so many challenges coming together in this moment. Climate change, forest fires, heat waves, and hurricanes are taken for granted. Gun violence and mass killings, end of DACHA, Cuba unrest - and that is just last week. This amount of trauma cannot be good. As too many of us learned from the early days of the epidemic, there is a price to be paid. Even though this is the 40th anniversary of the first MMWR on AIDS, many of us are still dealing with the post-traumatic stress from the early days. What’s going to happen to our country after COVID? We cannot wait to talk about the trauma and manage the pain. If HIV has taught us anything, it’s that surviving is tough.

What are we going to do about the 2021United States Conference on HIV/AIDS? NMAC will follow the science. We’re not ready to cancel the in-person USCHA right now. We are thinking about mandating vaccines but have not reached any final decisions. Here are some of our plans: The 2021 USCHA leans into BLACK EXCELLENCE. The theme of Homecoming is much more than a fall football game, it is also a riff on Beyonce in Coachella. She honored Historically Black Colleges and Universities (HBCU) as examples of Black excellence. HIV services must honor and value the cultures of the communities hardest hit by HIV, to be unapologetically proud and to lead with culture that celebrates all the diversity in the HIV community. This year is about Black Excellence, while 2022, when we are in Puerto Rico, will be all about the Latinx community. We will celebrate Puerto Rican, Caribbean, and Latinx communities. Reducing HIV stigma and cultural humility are key to reaching too many who are missed.

Last week USCHA was pleased to announce that Assistant Secretary for Health Dr. Rachel Levine will open the federal plenary of the 2021 meeting. As the first openly transgender nominee to be approved by the Senate, Dr. Levine’s words are particularly critical to our work. Not only does she oversee the HIV portfolio at HHS, as a leader of trans experience, she is a role model for our movement. We are honored to have her address the meeting. There are several other requests into the Biden-Harris administration.

The closing plenary is on Critical Race Theory. NMAC has invited a certain Howard University professor (no commitments yet) to join us. Whether we want to or not, HIV is going to get caught up in America’s culture wars. Our movement encompasses too many of the communities that are hated by too many people.

While I have nothing definitive, I thought it would be important to share our thinking. As with everything right now, there are no clear answers. The world is not over COVID, and I’m concerned about another extended period in lockdown. If you have any thoughts, please email me. We will get through this together.

God is Love and Love is for Everyone,
Paul Kawata