How Do You Advise the President About HIV When He Doesn't Want to Be Advised?

Part One of a Two-Part Interview With Gina Brown

Contributing Editor
Gina Brown, M.S.W.
Gina Brown, M.S.W.

Gina Brown, M.S.W., and I already had an interview planned when the community got the news of her resignation, with five other members, from the U.S. President's Advisory Council on HIV/AIDS (PACHA). That happened Friday, June 16, via fellow #PACHA6 resignee Scott Schoettes' Newsweek polemic on the Trump administration's poor handling of health care matters -- exemplified by his support for the American Health Care Act (AHCA). By Monday, when Gina and I met for lunch, the #PACHA6 story had mushroomed.

The Senate version of the AHCA, despite its sordid origins and wild unpopularity, could still see a vote in early July; the bill would be a nightmare for people living with HIV and others with preexisting conditions (not to mention uteruses). With the resignation of Gina, Scott and Grissel Granados, PACHA has now lost 60% of its members living with HIV.

"With this administration, I knew I couldn't play inside the sandbox with them," Gina commented, "So, I kicked the sand outside the box."

The original intention of our lunch was to talk about Gina's first six months as one of the Southern AIDS Coalition's community organizers -- and we did. Stay tuned for part two of our conversation, when Gina talks about how organizing work can be revolutionary.

Olivia G. Ford: Tell me about being part of what some are calling the "PACHA Six," who resigned last week because of the administration's scorn and dismissal of issues affecting the HIV community. How did you come to that decision?

Gina Brown, M.S.W.: I didn't resign out of some partisan desire. I believe the same is true for my comrades in the #PACHA6 (I came up with our hashtag!).

It wasn't about who was in the White House; it was about the policies that were being advanced from the White House. It could have been anybody: If these same policies had been on board, if that person had not agreed to meet with us, if that person had not ever said the word "HIV/AIDS" during their whole campaign, it would have been the same thing.

I think the biggest question for me was: How do you advise someone who does not want to be advised? Didn't Trump say about the wars [in the Middle East] that he was "smarter than the generals"? If you think you're smarter than everybody who's doing this work, then how are you going to effectively hear what we're saying?

When I think about health care, and I think about how they have tied Planned Parenthood into this American Health Care Act, just to defund it, out of spite, I think of the women who are going to be impacted by this. A lot of them are living with HIV. A lot of women get their diagnosis through a Planned Parenthood clinic.

I don't know why, in these crazy men's minds, Planned Parenthood is only about abortion. They don't know how many women find out they have cervical cancer at Planned Parenthood, how many women find out they have ovarian cancer, how many women find out that they cannot bear children or that they need a simple procedure to be able to have children.

They don't even get this. So, they're tying this health care around all these things that are going to impact women, and I'm supposed to sit on a council, sit at a table, knowing that I'm not even valued?

When we look at the budget: You talk about cuts to CDC [U.S. Centers for Disease Control and Prevention] and NIH [U.S. National Institutes of Health]. That's prevention programs. That's research.

We've been down this road before. We had a president who never said the word "AIDS" at the time. We had a president who buried his head in the sand. And then the epidemic exploded.

For the first time, we have a chance to truly make an impact in HIV. We have PEP [post-exposure prophylaxis]; we have PrEP [pre-exposure prophylaxis]; and we have treatment as prevention. Those are all biomedical tools that will move us towards containing this, more and more. Why wouldn't we want to keep doing that? If I know that it costs more to take care of you when you're sick, I'm going to do everything in my power to keep you healthy.

OGF: Precisely! It's just basic math, right?

GB: I weighed all of those things in coming to my decision. But the straw that broke the camel's back was them, with their AHCA, and that keg party they had in the Rose Garden, celebrating the fact that they were going to be stripping health care from millions of people. And a lot of those people are living with HIV.

We already have Southern cities that didn't expand Medicaid. This is another thing: If the Affordable Care Act is so bad, let's rewind and let's look at why it's so bad. It's so bad because a lot of your Republican governors said, "We're not setting up exchanges, and we're not going to expand Medicaid."

OGF: The ACA wasn't ever allowed to work. It wasn't allowed to do what it's supposed to do.

GB: Thank you. That would be like buying a new car and two of the wheels are missing. And then you're wondering why you can't get from point A to point B. All of the pieces needed to be there for us to see this thing succeed.

With this administration, I knew I couldn't play inside the sandbox with them. So, I kicked the sand outside the box and decided I'm going to play outside the box.

I can't play nice. This is my life. I've been living with HIV for 23 years. I didn't come this far to see things blow up behind some policies that are made by people who don't understand me, or nobody that looks like me, or acts like me, or talks like me. Millionaires and billionaires are making policy for people who make less than $50,000 a year. But they say they have our best interests at heart. Really? I don't think so.

OGF: What's been the reaction in the community to your PACHA resignation?

GB: I'm grateful that I have such a strong support system. I have not had one person tell me, "You were wrong for doing that. You shouldn't have done that." So many people have said: "I respect you even more now for doing this. You showed that you have principles." It shows that the compassion that I talk about, I walk about. I don't just say it; I do it.

I think about when I got on PACHA, how we were working on updating a national HIV strategy, and thinking, "I'm a part of history; this is a historic event" -- never knowing that in a matter of years, a couple of years, somebody would try to take that progress and throw it in the garbage can.

OGF: Did this current administration ever make any effort to reach out to PACHA? What's the difference between how engaged the group was previously versus what happened after January 20?

GB: Prior to January 20, we were very engaged. We had a director of the Office of National AIDS Policy [ONAP]. One thing I can say about number 44 -- my favorite president, Barack Obama -- he was in tune with the HIV community, and he put some really good people in the position of director of ONAP -- from Jeff Crowley all the way to Douglas Brooks, even Amy Lansky, Grant Colfax. But I'm saying Jeff and Douglas because those are the two people that worked on the National HIV/AIDS Strategy as ONAP directors.

Jeff was the one: We never had a strategy until we got a Jeff. When Jeff came on board, we got a strategy. When Douglas came on board he heard what the community was saying: "Wait a minute. You're not talking about trans women. You're not talking about black women. You're not talking about youth enough." [He] went back to the drawing board and gave the community a chance to weigh in. Everybody weighed in.

We wrote out the finished product in Atlanta, at the Morehouse School of Medicine. The response was amazing because people saw themselves in that strategy. I saw me in it. Now we're talking about women in the South. We're talking about women who are on drugs. You know?

Prior to January 20, we always got a White House statement for those important days of awareness, or days of observation. We haven't gotten one since -- and we've had four awareness days since 45 has been there. He hasn't said anything. I think the way we were engaged with HIV in the previous administration -- those days are gone.

But I must say, I commend my brothers and sisters who stayed. I really do. Because we need them there, just like they need us out here. Because we're not going to get this work done doing it one-sided.

OGF: It sounds as if those of you who resigned from PACHA are still in conversation and solidarity with the folks who stayed.

GB: Nic [Carlisle, my co-worker and executive director of Southern AIDS Coalition (SAC)] and I were part of an article talking about why I left and why he stayed. SAC was strategically placed. We had two people on PACHA. Before I made my decision, I talked to Nic. It was really exciting to do this article with him, and to really think about: Why did you leave? Why did you stay?

It can't be all grassroots organizing, and it can't be all boardroom talk. We have to merge those two, and we have to figure out how to do that.

I'll tell you, Olivia: I'm worried. I'm worried because 23 years ago I gave birth to a daughter and because I was on a study she does not have HIV. But, if all of the pieces that are in place right now go away, she has a really good chance of acquiring HIV for the simple fact that we're poor; we live in poverty -- even having a master's degree. I guess if I was in another city doing this work, my pay would be a little different.

Those ingredients would be there for my daughter to go through what I went through. So, I'm fighting for her. I'm fighting for other young men and women. I'm fighting for my trans sisters and brothers. It breaks my heart when I think about how they're already at the bottom of the totem pole, really. We continue to leave them behind. We don't talk about them in a really concrete way in this work. And we sure don't go and listen to what they have to say and figure out how we can help them.

This administration, we know, does not care about a whole lot of people. We know this administration cares about themselves, and -- I really, truly believe this -- if it's not a dollar in it for them, forget the rest of us.

I can't let that happen. While I am nervous, I'm still really, really optimistic. Because I think we, the HIV community, learned from the past. We didn't let that history go to waste. We looked at ACT UP. We can take from their playbook. We know that the squeaky wheel gets the oil. And we will squeak, squeak, squeak till they get so sick of us squeaking they're going to make sure that people living with HIV have our voices heard and our needs met.

OGF: I know that everyone's being really supportive, but at the same time, the response of some community members has been: "Don't give up! Stay on PACHA; be in there for us." What's your response to that idea?

GB: I want people to truly understand that stepping away from PACHA was not a form of quitting or of giving up. I stepped away from PACHA so I could be stronger in the HIV community, so that I can do what I need to do for the people that I care about, so that I can ensure that, when there's a call of action, I don't have to sit on the sidelines because I'm on PACHA.

On PACHA, we take an oath of office. I know a lot of people [in Congress] are exhibiting that they don't care about their oaths. But we take the same oath that Congress takes, basically saying that we will defend this country against our foreign and domestic terrorists. I feel like right now we are under attack. The HIV community is under attack -- whether we know it or not. And to me, that's a domestic terrorist. So, I have to be able to defend this country.

This transcript has been lightly edited for clarity.