In February, the national advocacy groups AIDS United and Black AIDS Institute partnered to announce that they would be creating a Racial Justice Index.
The Index, currently being created by a special committee within AIDS United’s Public Policy Council of 55 leading HIV groups, will ask HIV agencies nationwide to quantify factors like how much their leadership and board look (racially) like the communities they serve and whether their hiring, training, and decision-making practices allow for entry, promotion, and substantial participation among BIPOC (Black, Indigenous, and people of color) staff.
According to AIDS United President and CEO Jesse Milan Jr., J.D., on a March 3 call with TheBody, the survey will go out first to the 55 groups in the Public Policy Council, then likely to HIV agencies beyond the PPC. He said that the Racial Justice Index partnership hoped to publish results before the end of the year.
In a February 4 press release, Milan, a Black gay man living with HIV, said he was proud of AIDS United’s commitment to racial justice, adding, “We are in a moment where the HIV sector—and the health care sector as a whole—must look inward and ask ourselves if our structures and decisions truly reflect the people and needs of those most impacted by the epidemic. ... We cannot end HIV without ending the systemic racism that is too often embedded in processes that result in the disparities in new infections and lack of access to care.”
On the call, Milan said that the racial unrest sparked last year by the police and civilian murders of George Floyd, Breonna Taylor, and other Black Americans kicked an already long-brewing idea within the PPC into high gear.
“We made a commitment well over two years ago to use a racial-justice lens for our policy and advocacy work,” he said. “But it was truly ignited by the events of last year, after which both African Americans and white people within the PPC agreed that we needed to do something that would truly make a difference.”
The HIV sector is not the only field to turbocharge a look into its own racial power structures since last summer’s events. From the corporate world to academia to arts nonprofits, organizations and institutions are under more scrutiny than ever before when it comes to the racial makeup of their leadership and boards—and the extent to which their budgets, hiring practices, and internal culture and protocols limit or advance racial equity.
High-profile media platforms like Condé Nast’s Bon Appetit and Vogue have come in for unprecedented scrutiny, in some cases leading to firings based on things white leadership had said or done in the past. And in the past year, the BIPOC-led coalition We See You, White American Theater has waged a powerful social-media campaign that has led to dramatic changes in both leadership and policies at many of America’s leading stages.
“The murder of George Floyd, which we all witnessed, opened up a long-festering wound of how pervasive systemic racism is,” said Milan. “If we don’t use this teaching moment to make a change, then we’ll have missed the opportunity to change the future of this country.”
Beyond what he said was the “wide consensus” to participate among the groups in the PPC, Milan was unclear as to how far the new effort would go in terms of pressuring HIV agencies beyond it to participate—or calling out those who ignore or only pay lip service to the project.
For those who express an interest in improving, he said, “Our partnership with Black AIDS Institute will lead to trainings and curricula that can help guide and inform them around moving forward with the information they receive from the Index.”
He said that the partnership currently had no baseline statistics on the ratio of BIPOC people in leadership at HIV agencies versus those served as clients in the community. However, in 2019 and 2020, while TheBody was doing extensive profiles on nearly 50 HIV agencies nationwide, it found that perhaps roughly half of HIV agencies that served substantial BIPOC populations did not have significant top leadership that looked like those communities.
It also found that almost no agency had leadership or even midlevel positions filled by transgender women of color—one of the groups currently most affected by HIV in the U.S.
Beyond staff representation, said Milan, the survey will likely be asking agencies if they prioritize lived experience as well as diplomas and degrees when considering filling jobs or promoting staffers. An over-emphasis on academic achievement has long been a means of not allowing some BIPOC to rise within HIV organizations, according to some experts, including the University of Houston’s Marcus Stanley, M.P.H.
Milan said he hopes that improvements in racial equity among HIV-agency staffing and practices will translate to more racial equity among client outcomes, such as viral suppression on HIV meds and access to the HIV-prevention regimen PrEP.
“Having more equity in our staffing will improve these outcomes,” he said, “because structures of systemic racism have to be addressed as barriers that have prevented people of color—and African Americans in particular—from getting the kind of care they need.”
“The connective tissue here is trust,” he said, going deeper. “I hear a lot of organizations ask, ‘Why aren’t “they” here?’ And ‘they’ can be any particular demographic. And that’s augmented by laments about ‘retention in care.’ ‘Why are people not coming back?’ But those are not the sole or right questions. The real question is why aren’t the ‘they’ part of the ‘we’ inside the organization? When organizations are led by the community they serve, they create new opportunities and possibilities for serving the community that might never be conceived of within existing structures of leadership and management. The Index can be a tool to open up our sector to those possibilities.”
TheBody will follow up on this story later in the year, once the project has released findings from its survey.