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EPISODE #209 - State of HIV from White House

#209

How The White House is Ending the HIV Epidemic

February 5, 2024. 47:34

Have you ever wanted to know how not just the DMV but the entire nation is fighting to end the HIV epidemic? Have you thought about what it takes to make a policy that can impact people's lives nationwide? Are you always talking about the importance of lived experience, especially when talking about politics? Then this is the episode for you.

This week, Malachi and Tei are interviewing Harold Phillips, former Director of the White House Office of National AIDS Policy. They get into the who, what, when, where, why, and how of ending the HIV/AIDS epidemic in the US.  

This program contains language and subject matter that some audiences may find triggering or sensitive. We aim to encourage engagement in care and treatment; please consider your well-being before continuing.

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This program contains language and subject matter that some audiences may find triggering or sensitive. Our purpose is to encourage engagement in care and treatment; however, please consider your well-being before continuing.

Transcript

Harold Phillips: We have to get to a place as a people where we demand quality healthcare.
Tei Pearson-Hal...: Yes.
Harold Phillips: If your doctor is not offering you an HIV test, you are not getting good quality healthcare.
Malachi Stewart: Hello everyone in the DMB and Beyond. Welcome to another episode of Positive Voices and listen. Today we have a special guest all the way from the White House. So you're going to see me hitting my notes because I want to make sure we ask them every single question that you would have out there in the audience and in the community. So our guest today is Harold Phillips, but before we introduce him, I'm your host, Malachi Stewart.
Tei Pearson-Hal...: Hi, I am Tei Pearson-Hall.
Malachi Stewart: And Harold, thank you for being here first of all.
Tei Pearson-Hal...: Yes, thank you.
Malachi Stewart: We really appreciate a person of your stature. We've had celebrities here, we've done the grassroots community thing, but it's good to have someone to kind of talk about what goes on behind the scene, what goes on with policy. So introduce yourself and let people know what it is you do at the White House.
Harold Phillips: Sure. Thanks for having me and giving me this opportunity to talk to your viewers and listeners. I am Harold Phillips. I am the director for the White House Office of National AIDS Policy here in Washington DC.
Tei Pearson-Hal...: So what do you do in your capacity?
Harold Phillips: So in my capacity, and I think it's an important role that is part of the Domestic Policy Council here in the White House, the Domestic Policy Council covers every aspect of American life, and that's something I don't think I really realized or appreciated before I started working in the White House. The role of the director of the Office of National AIDS Policy is to help set our strategy for ending the HIV epidemic and then coordinate across the federal programs and the policies working with our Office of Management and Budget to figure out are we getting enough money for HIV work, working with members of Congress and their staff to get them to understand the importance of HIV as a priority, the populations that are impacted, and then also working with the community to make sure that our federal response is aligned with what the community actually needs. And then last but also important is also making sure that other aspects of American society, so our churches, our academic institutions, our private sector and business partners are all responding to help us end the HIV epidemic.
Tei Pearson-Hal...: Wow. So it sounds like the ending of HIV is not just a dream, it is something that is tangible. Right?
Harold Phillips: It is something that is very tangible. We have all the tools to end the HIV epidemic, which is incredible to think about in our lifetime. So when you think about HIV prevention and access to PrEP, when you think about the fact that somebody on HIV treatment who is living with HIV, who becomes virally suppressed, can't pass HIV on to their sexual partners. So right there, we've got all the tools we need, but it's an issue of access and also information so that the communities that need this information the most get it and then have access to medical care.
Tei Pearson-Hal...: [inaudible 00:03:03].
Malachi Stewart: As a person working in the field, I've seen people define ending the epidemic in a lot of different ways. So for our listeners, for our viewers who may not work in HIV, when you say that it's possible for the epidemic to end, what would that look like?
Harold Phillips: That would look like a couple of things. One, people who are living with HIV have access to the medical care and medications that they need to have a long, healthy life. Our medications are so effective right now that a person who is diagnosed with HIV today who gets into medical care and takes their medication appropriately and consistently can live to be 80, 90 years of age. So ending the HIV epidemic includes those folks who are living with HIV, allowing them to have a long healthy life, but also preventing new HIV transmissions. So access to PrEP, access to clean needles for those who are injecting. So we have these tools, making sure those are available to the communities is also part of ending the HIV epidemic. So we bring down our rate of new infections to about 3,000 or less in the United States on an annual basis. Right now we're about at 26,000. So we've got some work to do for sure, but it's possible.
Tei Pearson-Hal...: So the work that you do at the White House, does it have a personal touch for you?
Harold Phillips: It does.
Tei Pearson-Hal...: If so, could you share?
Harold Phillips: Absolutely. So I am not the first, but I am a director of the Office of National AIDS Policy and a black gay man living with HIV. I've been living with HIV since August of 2005, so almost 18 years. And so for me, and also in addition the loss that I've experienced. I think I initially got into doing HIV work because I had lost friends to HIV and I saw what they went through, and those challenges. And when I started working in the federal government, I started thinking about how do I make these systems work differently so that people don't have to deal with the stigma, the discrimination, the lack of information, the lack of access to care. So it became personal for me in terms of my initial involvement. And then there was a point where I was like, "Now this is about me." And so bringing that perspective to the job has also been something I've been able to do as well.
Tei Pearson-Hal...: Good stuff.
Malachi Stewart: Do you find, and this is me asking you this personally, but do you find that people are often surprised to know that there is a black gay man living with HIV in such a prominent position in a White House? Is that usually the reaction you get?
Harold Phillips: Yes. And I'm not the first. Douglas Brooks was the first one before me and the Obama administration. Yeah, it is often surprising, but I think it's really important to have people with lived experiences in those policy positions.
Malachi Stewart: Absolutely.
Harold Phillips: And I said this to someone else, I said it recently that sometimes me just showing up at work is an act of defiance, because I'm not supposed to be there. One of my first meetings in the White House was they were hosting a meeting of transgender women of color. They were meeting with our then director of domestic policy, Susan Rice, she was the director until May of this year. Susan was having this meeting of transgender women of color. It was my first week on the job, and I had sort of written and said, "Do you think it would be important to have the director of the Office of National AIDS policy at this meeting? Because these are my people."
And so they were like, "Oh yes, absolutely, please come to the meeting." So I show up at the meeting, and so we're all around this table. Many of the transgender women I had known from previous work and meetings in the community and conferences and we're all talking about their issues, their issues of access to housing, employment, HIV, STIs, and there we are. And I left the meeting and I walked out and I looked over at the White House and it was the first time that the gravity of it all sort of hit me. And the fact that we were having this meeting, this real meeting with real talk in the White House in a place that was built by slaves, and here I was black gay man-
Tei Pearson-Hal...: Come on now.
Harold Phillips: Having this conversation. And then there were community members that were having the conversation and telling the administration what they needed from them. It was real. And it was like, yeah, this si real.
Malachi Stewart: That was like a moment.
Harold Phillips: It was a moment.
Tei Pearson-Hal...: So when we talk about different groups at the table that is helping in the epidemic, who else do you think needs to be at this table to help push the EHE mission?
Harold Phillips: It's going to take, I always say it takes a whole of society effort. And by that I mean our schools, our academic institutions, our faith-based organizations. Many times the church has done so much harm to our community. And when I talk to them, I try to get them to realize just don't do any harm. It's important that as those institutions that many of us go to grew up in, that we have leaders in those institutions who are able to talk about wellbeing and wholeness and quality of life.
You don't have to talk to me about accepting me. Talk about how I can get access to care, talk about how I can take care of myself and my family, give us the information to be able to be, well. That should be part of the spiritual mission. So those institutions need to be there. Our schools, many of our schools are not doing sexual health education. And so young folks are coming up and out and they don't have the understanding about PrEP or PEP or Doxy PEP, all these things that are what ... Gonorrhea, what does it look like? What does it feel like?
Malachi Stewart: They don't even know what that is.
Tei Pearson-Hal...: I don't even think sexual education talks about STIs anymore. I think they pulled that a long time.
Malachi Stewart: It doesn't. We do it.
Harold Phillips: Oh, when you all do it, it's good.
Tei Pearson-Hal...: Not by your teacher at school.
Malachi Stewart: But that's the conversation, right?
Tei Pearson-Hal...: Yeah. That's the conservation.
Malachi Stewart: A lot of times, as a person who works at the health department, schools are asking us to come. So even when I was a disease investigator, we were being pulled off duty and my favorite thing to do was to go to these schools. But it was because a lot of the schools were recognizing that they either didn't have the capacity to have the conversation as far as knowledge and ability to communicate it, or they really just didn't know enough themselves. And so I think that really does speak to the point. Can I ask you, we talked a little bit about EHE's mission, but can you define what it is?
Harold Phillips: Sure. EHE is sort of shorthand, because we love our acronyms here.
Tei Pearson-Hal...: We do.
Harold Phillips: Ending the HIV epidemic. It is an initiative that targets, and by targets, I mean there are 57 areas of the United States that contribute to more than 50% of the new HIV diagnosis. Washington DC is one of those places. Within those 57 places, there are seven rural states that are also part of that makeup. But what we have done is added additional money and additional focus to those 57 areas of the country. We can reduce new infections in those 57 areas, we'll bring our HIV rates down in the United States. So the EHE initiative puts additional money into those areas of the country. Again, DC is one of them and really sort of I think focuses not only the new federal resources, so additional federal money, but also galvanizing the community and also the federal agencies that are doing this work to really and truly get on board and really make it happen. So it's been in existence since 2019. The Biden administration has incorporated it into our national HIV AIDS strategy. It's a key component of the work that we're doing to end HIV across the country.
Tei Pearson-Hal...: When we talk about the movement, if you will, how does that move? Is that move with funding? Is it moved by the general small people kind of putting money into their communities? How can we keep EHE moving, right? Long-term.
Harold Phillips: Right. I think that's a really great question. Like I said, it started in 2019, but then we had COVID, which was the biggest public health crisis in our lifespan since most of us weren't here for the Spanish flu in 1918. But COVID really got in the way of our HIV work.
Malachi Stewart: For sure.
Harold Phillips: Our public health departments people were scrambling, even sending people home. So where do you even go to get an HIV test? So the movement really is getting back on board since COVID and turning that corner. Now there's opportunities for people to be involved at the community level. There are at the planning body level as well because we have our HIV planning council here in DC, which people are invited to be a part of and to engage and help make decisions about program services and funding for your area. I think our private sector businesses also should be involved. Business community can move faster than government.
Tei Pearson-Hal...: That's true.
Harold Phillips: We saw that in COVID and we learned it. And so having them as a partner in HIV has been one of the things that I've been able to accomplish and put some energy behind to get private sector partners more involved and engaged. I would say also there's an opportunity for not just those working in healthcare because HIV is an issue that impacts housing, transportation, employment. So job training centers can be involved in this work as well. If you're training homeless youth to help them get jobs, they don't have to do sex work, which will put them at risk for HIV.
Tei Pearson-Hal...: There you go.
Harold Phillips: So there's an opportunity on all levels to be involved in the initiative to end the HIV epidemic.
Tei Pearson-Hal...: Thank you for that.
Malachi Stewart: Where do you see that going? What should the community know about what some of the future goals are for EHE work? You mentioned some things that we know in the field is a problem, like youth homelessness. Where do you see the trajectory?
Harold Phillips: One thing, I think in terms of the overall trajectory, we need to have conversations about HIV. There are so many people who think HIV is over, HIV is only a gay thing.
Malachi Stewart: That's why we're here.
Harold Phillips: It's why we're here. This conversation that we are having, folks need to be having that conversation. Black women, which one of the things that we've done in the White House is release the national HIV AIDS strategy, which outlines the priority populations. By that I mean the people who are most impacted by HIV. And of course it is gay men, especially gay men, gay and queer men of color, transgender women, black women are specifically called out and youth. Now in most spaces when I'm talking to women, they don't realize black women are a priority population? I didn't know that. Or if you ask black women about when's the last time you were offered an HIV test or did you know that PrEP is available for you? Or black women will say, oh, I saw those commercials. I didn't think it was about me or I didn't see myself in those commercials. So we have a lot of work to do in having these conversations in places and spaces where it might be uncomfortable, but the conversation needs to be had because our community is being impacted by it.
Tei Pearson-Hal...: I have a question for you. So as we talk about diagnosis and just testing, right? And when you mentioned about black women, I'm like, I'm sitting there thinking, when was the last time I was offered a HIV test? I couldn't tell you. And I've been to several doctors, several specialists. They've all ordered blood work for different things. But it's not until I say so to my OB, right and say, so when you're doing your screen testing, can you test me for HIV too? And then it's part of the conversation. But as a black woman that has to sit in those spaces, it's kind of uncomfortable to be the first one to negotiate or to ask for HIV tests. Right?
Harold Phillips: Right.
Tei Pearson-Hal...: Can you test me for HIV because now I got to sit with this stigma of you looking at me like, so what you got going on? And so do you think that if we can get the HIV testing as part of the STI testing, like an automatic run through versus someone having to ask for it, do you think that would help push the agenda a little more?
Harold Phillips: Absolutely. I think a couple of things in what you just said. One, trying to make HIV testing more routine. Just like they're coming in there, getting your blood for your cholesterol and all the rest of it. They check your blood pressure. They need to be checking for HIV. So we've tried to do some additional work to train healthcare providers to make this just part of routine medical care. Take the stigma out of it. One of the things that I'm also really excited about is some of the new technology coming along, AI, artificial intelligence, just automatically sort of putting that out there. Are you having sex? Yes. Would you like an HIV test? The computer, no stigma, no judgment.
Malachi Stewart: There's no [inaudible 00:16:58]. You don't have to identify [inaudible 00:16:59].
Harold Phillips: You don't know, and I'm not telling you how I'm having sex. You just answered the question, are you having sex? Right. So there are new technologies that are being embedded in our HIV work that will make some of this easier.
Tei Pearson-Hal...: Good.
Harold Phillips: But I also want to say that we have to get to a place as a people where we demand quality healthcare. If your doctor is not offering you an HIV test, you are not getting good quality healthcare.
Tei Pearson-Hal...: There you go.
Harold Phillips: And I want to challenge everyone out here. If you haven't had an HIV test, ask for one at our next medical appointment or go to our public health department and get a test or go to one of our community-based agencies and get a test. It's the gateway and important for you to know so that you can get linked to either prevention or care and treatment. In my government work, I once asked several of my black female coworkers, I said, at your next medical appointment, ask for an HIV test.
Tei Pearson-Hal...: What happened?
Harold Phillips: They came back and they said, were like, "Wow. Wow. I couldn't believe some of the responses I got." One friend said, her doctor said, "Well, aren't you an old married woman? What do you need with an HIV test?"
Malachi Stewart: That's crazy to me.
Harold Phillips: Crazy, right?
Tei Pearson-Hal...: It falls. It does.
Malachi Stewart: [inaudible 00:18:26].
Harold Phillips: We're talking to somebody who works in the HIV AIDS bureau for the federal government, you know what they do and that's what you say-
Tei Pearson-Hal...: It's very assumptive responses from doctors.
Harold Phillips: Another one, my single black female friend, her doctor said, oh, I didn't think you were out there like that. These are doctors who know what these women do. And so we used it as a teachable moment. I said, "Now if this is happening to you all with good government health insurance, private doctors, what's happening out there in the community?" So we've got a lot of education to do with our healthcare workforce to take the stigma, the discrimination, and the judgment out of HIV testing.
Malachi Stewart: For sure. And I can't even say I'm surprised because I go to a medical office and I had a provider who knows what I do, who knows where I work and who knows that I've been living with HIV since 2008 and I'm undetectable, and who told me that I shouldn't get a tattoo. I had just got a tattoo in my hand and she was like, "Oh, why would you get that tattoo? You know you're living with HIV." And I changed providers. I didn't want to have to, didn't want to ... Because I can't even have the patience for that conversation. But that leads me into, we kind of talked about, and you hinted on what it means to be at the table. You were at the table you were representing and intersectional identifiers. I recently had the privilege of moderating a conversation between Prince George's and DC's LGBT Affair offices and both just talking to the community. And so one of the things that came up from the audience from their sort of town hall was that they don't feel like they're represented at the table.
So I was like, well, who, let's name it. We have everybody here in the room who are the people? And so some of the things we were hearing was that they felt like enough black MSM were not represented at the table, that Latino MSM weren't represented at the table, that lesbian women weren't represented at the table. And that the resulting factor or obvious ways we see that demonstrated wasn't like how capital pride is a celebration of queerness and black pride feels more like a celebration of or a time to reach out for sexual health. And Latino pride feels like they use the term kind of stitch me down and taped up. What can you speak to about any of that? I'm giving you all of that broadly, but what are your thoughts around that?
Harold Phillips: Yeah, I think I've seen, so I've lived in Washington DC since 1988. '88, I'll say it. And watching our queer community grow and become more inclusive and more spaces has been something that is more amazing to me. I think there's going to both, because I go to black gay pride and then I go to the general pride festival as well. For me, they serve different purposes.
Tei Pearson-Hal...: How so?
Harold Phillips: There is something that is just, I don't know, absolutely beautiful and enriching about black joy. And I get that from black pride. I get to see all of the diversity of our community. And there are times where I just sit in the lobby and I'm like, "Look at us go. Look at this-"
Malachi Stewart: [inaudible 00:21:52].
Harold Phillips: And as an older black gay man, I'm like, "Yeah, this is the stuff that I fought for. This is the stuff I marched for." I had the black boots out there-
Tei Pearson-Hal...: Yes. Thank you.
Harold Phillips: Demanding our rights. And I'm like, and look at how it's unfolded.
Tei Pearson-Hal...: You was on the front line?
Harold Phillips: I was out there.
Tei Pearson-Hal...: You said the black boots.
Malachi Stewart: [inaudible 00:22:13] black combat boots.
Tei Pearson-Hal...: [inaudible 00:22:16].
Harold Phillips: And the freedom rings. But so seeing how it has evolved and become more inclusive now that doesn't mean that there's not more work to be done because there are more and different voices that still need to be at the table to be engaged. And we need to continue to create additional spaces and places where that can flourish.
Tei Pearson-Hal...: With DC being so high on the list for the black women, black men, the White House is right here though. So what do you think could be shifted for us to change the numbers right here in the nation's capital where all of the policy and stuff has been created?
Harold Phillips: Yeah, I think DC is on the right path. We have seen some successful interventions be implemented in DC that are making a difference. So our rates are decreasing both among our youth population. I think our MSM rate, I think it may be stabilized, don't quote me, I'm still trying to figure that out. But things are moving in the right direction for DC overall. DC as a jurisdiction I think has not been afraid to be innovative when it comes to both syringe exchange programs, overdose prevention, thinking about how do these all intersect. The things that worry me about DC are our STI rates. So I know our health department has implemented Doxy PEP and is getting more information out there about medication that you can take to prevent sexually transmitted infections. I think that's great. I think that's going to be helpful. And I think also having that conversation will help connect people to both HIV prevention, HIV testing and also treatment.
I get worried sometimes about the district also. There are economic circumstances that also put people at risk. When you are sleeping with friends or relatives, sofa and all the rest of it and worried about stable housing or where are you going to get your next meal? You might engage in activities that put you at risk for HIV. That's a problem. Or if you're living with HIV and worried about the roof over your head, then you're less worried about taking your medication or making a doctor's appointment. And so how we meet the immediate needs of district residents, especially with the basics of affordable housing, income, jobs, food security, those are some of the things and the pressures that I think are on us right now. But I think overall DC has some programs in place that are moving things in the right direction. I just want our economy to play along with us and help people with overall quality of life.
Malachi Stewart: And you kind of answered this, but I want to ask more directly because when we look at the demographics of people most at risk, black MSM who are young and black women, and we look at the mapping of where we see new infections and how infection rates are. I guess in the contact tracing mapping, you kind of see the same viral kind of connectivity in ward seven, ward eight, I believe ward six, don't quote me, but we're noticing that there does seem to be a social economic piece that is involved. And these tend to be, if by proxy, if I'm born black and poor in DC, if I'm black and poor and I'm a transplant in DC and I'm therefore living in these wards, I can do literally the same thing as everyone else, but just by proxy of where I live, I'm at greater risk. Do you feel like to some degree, at least here, like socioeconomic stature and race have a play?
Harold Phillips: Oh, absolutely.
Malachi Stewart: And what do we do about that?
Harold Phillips: And what do we do about that? Absolutely. I think it does play a role in a factor. And I think some of the things that we're trying to do both include sort of increasing access to HIV prevention, increasing access to the information, because many in those wards do or don't have the access to the information as well as access to the care and prevention options that are there too. But then also, like you mentioned, being able to think about it holistically as a package. So the social economic piece, healthcare and what we call the social drivers of health. So my housing status, whether or not I have a job, whether or not I have a job that includes insurance, are all things that play a role in my own individual health outcomes.
Tei Pearson-Hal...: That's true.
Harold Phillips: And so what we've been trying to do is think about how do we create medical homes or entryways into both medical care that also have connection to social services and economic services as well. And especially for our at-risk groups, like our young people.
Tei Pearson-Hal...: So what can the youth do? Speaking of young people, what can the youth do? I love working with youth and I'm with them a lot and most of them want to get involved, but I can tell you that they're not necessarily having conversations about HIV. That is something that is so far removed from their brains, rather, I don't want to get pregnant, before, I don't want to contract HIV. So what can the youth do to help shift the conversation? Well, rephrase. What can myself and other youth workers do that work with youth to help get the conversation going so that they can see themselves at the table?
Harold Phillips: Sure. So one of the organizations that I've done some work with in the past is Advocates for Youth, and Advocates for Youth has toolkits to allow youth to learn and understand how to talk about these issues as HIV, STIs, pregnancy prevention, as well as how to also advocate. How do you talk to lawmakers about these things? That's a space and a place. I think when I have the opportunity to meet and talk with young people who are able to give that real perspective of here's what's happening in my community or here's what's happening in my school, it really and truly makes a difference to me as an older person trying to figure out policy or with the understanding of this is how I can move the policy and funding levers in a different way to address what I'm hearing real time from this youth.
So I encourage youth to not only be involved in sort of having these conversations, but program and service delivery, but also meeting with lawmakers and influence in policy and advocacy and having those conversations. Hearing, for example, from some of the youth about some of the LGBTQ laws that are happening in other states and their impact on them and their families. It has motivated individuals in the White House to really think about what can we do both in partnership with Department of Justice or the White House and the president's executive powers to really help address some of these issues of discrimination that are happening. But it's different. It lands different when it's a young person giving that message at the White House.
Tei Pearson-Hal...: Absolutely. Absolutely.
Malachi Stewart: Speaking of policy, one of the things that I believe it was last year, there was a Texas ruling that's at the precedent that it allowed for PrEP not to be ... It didn't force employers to pay for PrEP if it was sort of a conflict of their religious beliefs. And that was, for some people it seemed probably like an isolated incident or okay, that's happening. What does that have to do with the price of tea in China? For myself and other people who work in this field, we got a little shook because we didn't know, okay, how isolated is it? What are the connotations? What precedence is that setting for the future of HIV? We were shook. And so what can you speak to? What does that look like? Should we be afraid?
Harold Phillips: So yeah, let me say a couple of things about this because y'all talking about the Braidwood case, which is a case that has put at risk all of the preventative services that are part of the ACA. So not just HIV prevention, we're talking about things like cancer screenings. And so let's be clear, it is, and we have said this and our White House press secretary has said this as well, that this is another attack on trying to weaken the Affordable Care Act and access to preventive services for all Americans. PrEP is a part of that. Our HIV prevention work is wrapped up in this as well. Our Department of Justice and several others are working through the court system to see if what we can do to strike this ruling down.
It may eventually have to go to the Supreme Court, but we stand behind ... We as the White House and the Biden Harris administration stand behind our efforts to provide access to preventative services and screenings across the board for all Americans and standing behind and standing with the Affordable Care Act. Giving businesses the opportunity to sort of opt out of preventative services, there are many businesses that have stepped forward and said, "You know what? There's an economic and business case for why I should be providing access to preventive services." So think about it, your healthcare becomes more expensive when we're treating, say, stage four cancer than we could have caught earlier. So businesses are going, "This does not make a good business decision either." Court, we need the ability to provide access to preventative services for our employees. Why would we not? So many of them are coming forward and also filing briefs with the court saying, "Hold it."
So that's kind of where we are. Should we be shook? Absolutely. Because there continue to be attacks on our overall healthcare and the people that are going to be most impacted by this are black and brown individuals are women. So think about it, women couldn't giving employers an option not to screen women for cervical cancer as an example. Who is that going to impact? So again, that's another one of those attacks, but we're watching it and the administration is doing what it can, and we're also working with the Department of Justice is the bottom line.
Malachi Stewart: So we right to be shook, but you got our back.
Harold Phillips: We're trying.
Malachi Stewart: Okay.
Tei Pearson-Hal...: He said he got us. So you started the conversation with you having a positive status. And so I can just imagine every day is a journey of you, like you said, a remembrance of when you was out in the streets with your pin on and your Nike boots. Right?
Harold Phillips: Right.
Tei Pearson-Hal...: And here we are at the White House. So what does it feel like for you every day to wake up knowing that you are still impacting so much policy that is making the new generation of us gay folks to come up behind you and hopefully have a better pathway?
Harold Phillips: I think there are those days in the White House where it's easy to forget or get bogged down in the every day or just for lack of a better word, just the grind of the White House. I think when I sort of realize, oh, I am making a difference is usually when I'm out in the community and I will see or hear or learn the stories of people. People send letters to the president and there is an official office of White House correspondence, and every now and then they will send the, bundle the letters up, or some of them and send them to White House staff. Somebody figured we are in the grind, and sometimes I take a look at them, sometimes I don't.
I took a look at one because Spirit moved me, like, look, read these. And it was from a guy in Kentucky who had been living with HIV who had found out he was positive five years ago, and he heard about everything that the administration was doing to help people with HIV. And he had, as a result of his status, he had come out to his family and he had fallen in love, had a partner who was negative and on PrEP, and he wanted to thank the president for what he had done.
Tei Pearson-Hal...: Wow.
Harold Phillips: That letter was in the bundle. And I read it and I was like, "Okay, yep, I'm glad. I'm glad he thanked the president." Because the president has been in line with everything that we've wanted to do as an administration, but it was like that was me and my work.
Tei Pearson-Hal...: Yeah. Hello.
Harold Phillips: And so if those reminders that we get from the community, that's what sort of keeps me going. Knowing that I can have an impact, I am making a difference and that we are helping people.
Tei Pearson-Hal...: Well, we thank you. We thank you and your staff and the whole administration for just everything that you guys are doing every day. Yes. Thank you.
Malachi Stewart: For sure. And before we wrap up, we met at a gala. We both award recipients. I didn't know who you was when I ran into you. So we had the opportunity to talk as people, as two black gay men who were just keying who were from two different generations. And it was such a beautiful moment. And then I remember thinking when you went on stage that they sort of did what we did and started this interview and we just kind of went into who you are and your official title and getting all these government questions.
And I feel like I never really see you on platforms get to talk about what it was like just for Harold, the person who was diagnosed with HIV and who had to probably navigate some of the things that we all living with HIV had to navigate. So no pressure, but whatever you want to speak to, whatever that human experience was, because I felt like when I met you, I knew why you were in the room before I knew what your title was. We were talking about experiences where I knew, okay, I know why this person's sharing a stage with me.
Harold Phillips: So I would say when I got diagnosed in 2005, it was hard. It was not easy. And to be quite frank about it, I was angry because this was not part of the plan. I was one of those people that I had a plan, my life had a trajectory. I was supposed to be doing X, Y and Z and I had been doing X, Y, and Z. So I was mad. I was angry. I knew enough to know that my life was not over. Because I worked in the field, so I knew mean when the doctor came in and said, "We've run every test to try to figure out why you are sick, why you were in the hospital and you've gotten HIV, you're HIV positive." And I was like, "Really? Huh? This must be an acute infection. What is my viral load and what am I seeing?"
Malachi Stewart: [inaudible 00:38:49].
Harold Phillips: She was like, "Who are you? Nobody asks me those kinds of questions." And so I had to, knowing that my life was not over, knowing that, okay, there are medications out there that are going to keep me alive and healthy. This is really going to change how I operate and who I am. I had to also realize this doesn't define me, but at the same time, because I have this diagnosis, I need to do something even greater than I was doing before in the field of HIV. I didn't know what that was. And a friend of mine told my mother that as well. And she said, "And I'm going to hold you to that." As she had to deal with this news too, my friend had said, with this diagnosis, I expect that he is going to do something great with this. And my mother said, "I'm going to hold you to that." And so HIV, a part of my life, but not defining my life had to be one of those things that I sort of worked through and got to
Malachi Stewart: And look at you now.
Tei Pearson-Hal...: Hello?
Harold Phillips: I know. This was not part of the plan, but I think it has worked out [inaudible 00:40:16].
Tei Pearson-Hal...: Or was it?
Harold Phillips: The White House was not part of it-
Tei Pearson-Hal...: Was not your plan.
Harold Phillips: It was not my plan. Right. It was not my plan.
Tei Pearson-Hal...: Yeah.
Harold Phillips: Definitely there was a greater power that I also had to learn to get out of the greater powers way.
Malachi Stewart: How about now?
Harold Phillips: That whole thing about me being angry, I was like, this was not what I thought was supposed to happen. And I had learned you have to get out of the higher powers way and believe that there is a path and a trajectory.
Malachi Stewart: I want to ask because I feel like I just know so many black gay men who work in the field and we never could dream of being in a position that feels as influential as yours. Having had this career and been in this position, what would you say is the highest point for you or the most accomplishment that you're the most proud of? And maybe something that you kind of felt like I didn't really get to do what I wanted to do or that was a low moment or a powerless moment?
Harold Phillips: I think my high moment was World AIDS Day 2021, which was President Biden's first World AIDS Day as president. And I had started in June of that year. And the task was President Biden wanted a national HIV AIDS strategy. President Obama had one. As vice president, he was used to that to guide the nation and the federal response. And I said, "I think we can do this. Wouldn't it be great if we did it for your first World AIDS Day as president?" So that only gave me six months to coordinate all of the federal agencies, get community input, get this thing document written, cleared through all the departments released, and then a World AIDS Day event. And then after I did that, they were like, "Well then now you have to work with the speech writing team to develop President Biden's speech for World AIDS Day." So I was like, "Oh my God, I can't believe I'm doing this."
Tei Pearson-Hal...: Right? Speechwriter?
Harold Phillips: Wow. And so working with the speech team, I had President Biden talk about HIV criminal laws and policies, because we have about 30 states that criminalize HIV transmission. There are laws are on the books that criminalize HIV, sometimes not even focusing on transmission. It's a problem. And I wanted President Biden to speak to that problem. And so I didn't care what else he said in the speech or what else the speech writers took out. But President Biden did talk about HIV criminal laws and policy in his World AIDS Day speech. He even went off script and was like, "These laws and policies don't even follow the science of HIV transmission."
Tei Pearson-Hal...: Wow.
Harold Phillips: It's 2021, we need to follow the science. Come on, let's get with it. And I was like-
Malachi Stewart: Good talk.
Harold Phillips: Drop the mic. I'm done. He said the thing that I wanted to say.
Malachi Stewart: That would be my high point too.
Harold Phillips: That was the high point. And then as if that wasn't enough, at an event of the Elizabeth Taylor AIDS Foundation, I met a guy from Detroit who's been a victim of HIV criminal laws. And he said he saw on YouTube President Biden's speech that day and he said, and he cried. He said, "For the first time I felt like somebody in Washington saw me and understood what I was going through."
Malachi Stewart: Wow.
Tei Pearson-Hal...: Wow.
Harold Phillips: So yeah, that would be my high point.
Malachi Stewart: Double high point.
Harold Phillips: Double high point.
Malachi Stewart: Double high point.
Harold Phillips: Yes, he did it. He said it and people saw it and really got moving behind it. We still need to address those 30 states where this is a problem and issue. Luckily, DC has in its statute laws that protect HIV surveillance data from use in criminal prosecution. So really applaud DC as a model for other states and jurisdictions. I think my low point in not ... Wow, that's a tough one. But I think low points in not being able to get something done. I'm trying to think what that could be. I mean, well, I would say I'm having some low points in terms of right now where we are with Congress and a lack of understanding of HIV and the needs. But I think that's the thing that really is bothering me right now is the thing that is a struggle is that the investment in HIV and the amount of money that we need, we need Congress to be on board. And we've been working to get them on board more and that's been a struggle.
Malachi Stewart: Yeah. Thank you for sharing that.
Harold Phillips: I would say that there are a couple of call to actions here. One, we need to continue to have the conversations about HIV within our community to erase the stigma and the discrimination. Two, get an HIV test, ask for an HIV test. If you haven't had an HIV test in the last year, two, three because I did one and two, three-
Tei Pearson-Hal...: Or F.
Harold Phillips: Or F.
Tei Pearson-Hal...: [inaudible 00:45:29].
Harold Phillips: Three would be, if you are HIV negative, find out information about PrEP. It can save, it can extend your life and that of your sexual partners. If you are HIV positive, get into care and stay into care. Live a long, healthy life. I'm planning to live 'til 90 plus.
Tei Pearson-Hal...: Hello.
Harold Phillips: Hello. And so I want all of you all to be there too. And it's possible. Easy, effective, safe treatment is available.
Tei Pearson-Hal...: There you have it folks. Another great episode of Positive Voices. I'm your girl, Tei Pearson-Hall.
Malachi Stewart: I'm Malachi Stewart.
Tei Pearson-Hal...: And we had our wonderful guest with us, Harold here. He was the director of-
Harold Phillips: White House Office of National AIDS policy.
Tei Pearson-Hal...: Big timer. Y'all heard him. He went from combat boots to Oxfords in this journey of EHE, eradicating the HIV epidemic. And we want you to join in with us. So head on over to DCEndsHIV.org, take a survey, learn some things. If you want to watch more of season one or if you want to catch up on what we have going on for season two, click podcast and you'll be linked to us. We want to hear from you though. When you watch the episodes, we want you to share, subscribe, tell a friend to tell a friend, pull up on us so we can hear your thoughts as well.
Also, you are like, "We might need some services, I might need some resources. I may not know where things are around me and I want to get plugged in." So we want you to head on over to linkU, the letter U, as Chi likes to say, dot dmv.org. Put in your zip code, put in your friend's zip code. A list of resources will populate based on your area and you'll be able to get connected to the folks that can keep you going and your journey of healing and life. Once again, this is Positive Voices season two. We'll catch you guys on the next episode.
Malachi Stewart: Bye bye.

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Harold Phillips
(HE/HIM/HIS)

Harold J. Phillips, MRP, Director of the White House Office of National AIDS Policy (ONAP).  In this position, he leads the effort to set the Administration’s domestic HIV/AIDS priorities.  This includes monitoring and implementing the National HIV/AIDS Strategy (NHAS), consulting with the Office of Management and Budget, coordinating with others on the Domestic Policy Council, the National Security Council, and the Office of the Global AIDS Coordinator to ensure America’s response to the HIV epidemic is accelerated, comprehensive and reflective of the lived experiences of those at risk of and living with HIV. This work is done to reduce the number of new HIV transmissions, improve the quality of life for people living with HIV, and end the HIV epidemic.

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