News
Biden rounds out team to take on HIV/AIDS domestically, globally
Experts say ‘too soon’ to assess domestic efforts
With the goal of beating HIV by 2025 domestically and a pledge for a renewed effort to fight the disease globally, President Biden has put in place officials charged with making that happen.
The White House kicked off the week with the announcement that John Nkengasong, who has served as a top official on global health at the Centers for Disease Control, would be nominated as ambassador-at-large and coordinator of U.S. government activities to combat HIV/AIDS globally at the State Department.
Meanwhile, leadership within the Presidential Advisory Council on HIV/AIDS, otherwise known as PACHA, was restructured in August as the Biden administration has continued the Ending the HIV Epidemic plan health officials started in the Trump administration.
Carl Schmid, who served as co-chair of PACHA during the Trump years, no longer holds that position, and has been replaced by Marlene McNeese, a woman of color and deputy assistant director of the Houston Health Department. John Wiesman, former secretary of health for Washington State, will continue to serve as co-chair.
McNeese is among eight new members of PACHA. The others are:
- Guillermo Chacón, president of the Latino Commission on AIDS;
- Tori Cooper, director of community engagement for the Transgender Justice Initiative at the Human Rights Campaign;
- Raniyah Copeland, CEO of the Black AIDS Institute;
- Leo Moore, medical director for clinic services at the Los Angeles County Department of Public Health;
- Kayla Quimbley, national youth HIV and AIDS Awareness Day ambassador for Advocates for Youth;
- Adrian Shanker, founder and executive director of Bradbury-Sullivan LGBT Community Center; and
- Darrell Wheeler, senior vice president for academic affairs at Iona College in New Rochelle, N.Y.
The changes underscore the new approach to HIV/AIDS Biden promised during his presidential campaign. Among them is beating HIV/AIDS domestically by 2025, which is five years earlier than the plan under the Ending the HIV Epidemic initiative that began in the Trump administration. Whether or not Biden will meet that ambitious goal remains to be seen.
Winnie Byanyima, executive director of UNAIDS, hailed the nomination of Nkengasong to the global AIDS position upon news of the announcement.
“John Nkengasong’s vast experience in combatting HIV, combined with his position as Africa’s leading disease expert fighting Ebola, COVID-19 and more, position him extremely well to guide the United States’ global contribution towards ending the AIDS pandemic,” Byanyima said. “Today, the HIV and COVID-19 pandemics are colliding in communities throughout the world, and the threat of a resurgent AIDS pandemic is very real. We need the kind of bold thinking and commitment he has brought throughout his career.”
While the global AIDS appointment will have a role in international programs, such as PEPFAR and U.S. participation in the Global Fund to Fight AIDS, Tuberculosis & Malaria, the PACHA appointments will focus on both domestic and global perspectives.
Schmid, executive director of the HIV+Hepatitis Policy Institute, said despite the change in leadership he will maintain his role as head of the subcommittee on the Ending the HIV Epidemic initiative.
“It’s good,” Schmid said.”They appointed a lot of African-American community, Latino community [members] and they said they’ll rotate co-chairs,” Schmid said. “I think it’s good that they put on new blood, and new leadership.”
Schmid has been a vocal skeptic about Biden being able to meet his goal to beat HIV by 2025 — as opposed to the 2030 target set by the previous administration — but said the realignment in PACHA was “not at all” related to that.
“I think I was replaced because the Biden administration wanted the leadership of PACHA to be more representative of the current epidemic in the United States,” Schmid said.
Schmid, however, refused to back down from his prediction that Biden won’t be able to make his 2025 goal a reality.
“I think you will find wide agreement within the HIV community that it is not feasible to end HIV by 2025,” Schmid said. “There is just too much work to do and change to happen.”
The new appointments will add to the cadre of Biden appointees engaged on HIV/AIDS, including Harold Phillips, who was appointed in June to lead the White House Office of National AIDS Policy after that position remained vacant for the entirety of the Trump administration.
‘Too early’ to gauge effort to beat HIV domestically
The focus of the appointees on the domestic front will be the Ending the HIV Epidemic initiative, a plan heavily focused on PrEP as a means of preventing HIV in an effort to reduce new incidents of infections by 90 percent within 10 years. The program was launched in 2019.
Although Congress has appropriated money for the initiative, and just last week, the Department of Health & Human Services distributed $48 million to HRSA centers as part of the effort, experts say not enough data is available to tell to whether or not the program has been effective.
Jennifer Kates, senior vice president and director of global health & HIV policy at Kaiser Family Foundation, said data isn’t yet available on whether new incidents of HIV are reduced because the latest data is from fiscal year 2019.
“From the perspective of the timeline of the goals of the initiative, it’s too early, we wouldn’t know that anyway, but just even given the context and what’s happened since it started, I just don’t know how you’d evaluate it,” Kates said. “What I do believe is important though, is the idea of dedicated new funding. It was the first new funding provided to HIV for years that’s been channeled to local jurisdictions [and] has the potential to catalyze new and better responses, but we don’t know yet that’s happened.”
The coronavirus pandemic, which has been the top priority for health officials around the world, is also obfuscating any potential assessment of the Ending the HIV Epidemic initiative.
Daniel Bruner, senior director of policy at the D.C.-based Whitman-Walker Institute, said the coronavirus has “dramatically impacted medical care,” including HIV/AIDS efforts.
“The pandemic has also necessitated substantial shifts in federal, state, and local resources into COVID prevention, diagnosis and treatment,” Bruner said. “Therefore, it is premature to draw any conclusions about the EHE initiative’s effectiveness. The federal government has emphasized its continuing commitment to the EHE initiative, and Whitman-Walker also remains committed to that work.”
News
An effort to increase the number of psychiatrists of color
After 35 years in law and advocacy, Rawle Andrews Jr. returns to his roots
Rawle Andrews Jr. took an indirect path to become executive director of the American Psychiatric Association Foundation (APAF).
From a psychology major in college to becoming a lawyer, the passion for equity and inclusion that fueled him during his years at AARP and as a professor at Howard and Georgetown universities serves as the foundation for his career in mental health.
Andrews has made it his mission at APAF to prioritize youth mental health — including in schools in D.C. and across the country — and to reduce stigma around mental illness and increase the number of psychiatrists of color practicing in the U.S.
Andrews, who began his educational career studying psychology, said he felt out of place in college when his classmates were pursuing medical careers and he was more interested in law.
“I was the only person in my cohort who was going to law school,” he said. “Everybody else wanted to be a doctor and go to medical school.”
Everything changed for Andrews during the COVID-19 pandemic and after George Floyd was killed by police in Missouri: Those pivotal moments reshaped national conversations about health, race, and inequality, and pushed Andrews to rethink his career.
“I saw people deathly afraid of some disease, but also mortified by the fact that they witnessed somebody die on TV,” he said.
After nearly 16 years working as a lawyer in private practice and 15 years at AARP, Andrews found himself pulled back to mental and “whole body” health.
“My goal in law school was to be a courtroom lawyer all the time. If you had told me in 1990 that I would be a practicing lawyer going to court every day, I would have laughed you out of this room. If you had told me in 2010 that I wouldn’t be an in-house lawyer every day … I would have laughed you out of this room,” he said. “Everybody thinks you’re going to go straight from A to B. Life doesn’t work A to B.”
Now, Andrews says, he has the “ability to serve the whole house.” He can help “the eight-year-old who’s struggling in middle school … the parent who’s trying to get that child through, but also caring for an older loved one … who might have some cognitive decline or mobility challenges.”
Building a pipeline of Black mental health professionals
In his role at APAF, Andrews has his sights set on increasing the number of psychiatrists nationwide by reducing barriers to study and success, particularly for practitioners of color, who are vastly underrepresented.
Only about 5% of physicians are Black, and the number for Black psychiatrists is even lower at just 2%, according to the American Psychiatric Association. Widespread stigma around mental illness in communities of color, combined with “systemic barriers that keep persons of color from getting into medical school and matching for residency with teaching hospitals after graduating,” have contributed to the low numbers, Andrews says.
Financial pressures, limited residency slots, and a lack of exposure to psychiatry as a viable career all play important roles in limiting Black representation in the field. At the same time, stigma surrounding mental health — especially in Black communities — can discourage both patients and future physicians, according to Andrews.
He explains that this stigma is rooted in underlying fear, shame, and historic discrimination, and the only way to deal with those issues is directly. If you break those down, Andrews said, you can actually address them.
There are signs of change, though. “In the digital world, more and more people are seeing and talking about mental health all the time,” Andrews said. “And I believe more and more young doctors of all colors are deciding, ‘we need more psychiatrists, and I want to be a part of that solution.’”
Not having enough psychiatrists of color has far-reaching consequences. If you are a “non-diverse” physician or a physician practicing without humility or cultural competency, you may over-diagnose or misdiagnose a patient, said Andrews. You might assume a patient has symptoms due to your own cognitive biases.
A 2024 study in the Journal of General Internal Medicine revealed that mistrust and suspicion were high among dozens of Black patients with serious mental illness, who said they felt doctors did not take their concerns seriously or took a condescending tone with them during appointments.
This type of treatment does not promote trust or disclosure, Andrews said. “What is my advantage to be vulnerable with people who don’t think much of me, because you already thought I was broken?”
To combat medical racism and bias, APAF runs one of the largest psychiatry pipeline programs in the world. It provides more than 1,000 medical students from underrepresented and marginalized communities with training and professional development. Programs like the Diversity Leadership Fellowship emphasize cultural competency and evidence-based practices to better serve diverse groups and at-risk populations.
These programs have had tangible success in producing leadership in the field of psychiatry: APA’s CEO Dr. Marketa Wills, the first CEO of color and first female CEO in the APA organization’s 180-year history, was a trainee with the APAF nearly three decades ago.
Despite efforts to make healthcare more equitable for patients of color and members of the LGBTQ+ community, many experts believe that racism and biases are more deeply ingrained in the system than many realize. For example, a 2019 study found that Black patients suffering from depression are often misdiagnosed with schizophrenia, and a 2016 study revealed that many doctors wrongly believe that Black patients have higher thresholds for pain tolerance.
“If you don’t have cultural humility or cultural competency, you could over-diagnose somebody because you’re looking for them to be ADHD, you’re looking for them to be bipolar, you’re looking for them to be schizophrenic,” said Andrews. “And then, because of the fears, the stigmas, the shame, people don’t want to go and get tested either.”
Youth mental health focus
Andrews says many fear that telling someone else about their struggles will cause that person to look down on them. That unwillingness to share about mental health challenges can start at a young age.
That’s why the APAF has partnered with local organizations in the Washington, D.C., area to help young people address mental health concerns. One of the programs, Our Minds Matter, operates in D.C.-area schools and other states to educate students on signs of emotional distress and how to address it. APAF also runs the Notice.Talk.Act. at School program, which helps train school staff to recognize and address student mental health issues and connect them to resources. The program was recently adopted at Jefferson Middle School Academy.
The program is “the ‘stop, drop and roll’ of mental health,” Andrews said. “How do I notice signs and symptoms of distress in a student? How do I create an open space to talk and be a better active listener with a student who wants to share their mental health concerns and then act?”
APAF’s program, funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and free to schools, trained about 890 school staff members across the country in 2024, and boasts a 70% reduction in truancy and 89% reduction in disciplinary referrals, according to the foundation.
Notice.Talk.Act. is not just in schools — there are versions for home, for college, for the workplace.
Andrews hopes that this work with the APAF will reduce the stigma surrounding mental health struggles and improve access to culturally competent care. But he acknowledges there’s still a long way to go.
“We are planting and sowing seeds now and fertilizing the soil and tilling the soil,” he said. “We know that the next generation of doctors is going to look closer to the way the population looks. But ultimately, we still haven’t done enough.”
(This work is part of a partnership between the Washington Blade Foundation and Youthcast Media Group, funded through the FY26 Community Development Grant from the Office of D.C. Mayor Muriel Bowser. Jebeh Pajibo is a senior at Bard High School Early College DC, one of Youthcast Media Group’s journalism class partners. Sarah Gandluri, a UNC-Chapel Hill sophomore, is an intern and former high school participant with YMG. YMG founder, former USA Today health policy reporter Jayne O’Donnell, contributed to this report.)
Rehoboth Beach
BLUF leather social set for April 10 in Rehoboth
Attendees encouraged to wear appropriate gear
Diego’s in Rehoboth Beach hosts a monthly leather happy hour. April’s edition is scheduled for Friday, April 10, 5-7 p.m. Attendees are encouraged to wear appropriate gear. The event is billed as an official event of BLUF, the free community group for men interested in leather. After happy hour, the attendees are encouraged to reconvene at Local Bootlegging Company for dinner, which allows cigar smoking. There’s no cover charge for either event.
District of Columbia
Celebrations of life planned for Sean Bartel
Two memorial events scheduled in D.C.
Two celebrations of life are planned for Sean Christopher Bartel, 48, who was found deceased on a hiking trail in Argentina on or around March 15. Bartel began his career as a television news reporter and news anchor at stations in Louisville, Ky., and Evansville, Ind., before serving as Senior Video Producer for the D.C.-based International Brotherhood of Electrical Workers union from 2013 to 2024.
A memorial gathering is planned for Friday, April 10, 11:30 a.m.-1:30 p.m. at the IBEW International Office (900 7th St., N.W.), according to a statement by the DC Gay Flag Football League, where Bartel was a longtime member. A celebration of life is planned that same evening, 6-8 p.m. at Trade (1410 14th St., N.W.).
