Q&A: Gregorio Millett, Senior Policy Adviser, Office of National AIDS Policy

Q&A: Gregorio Millett, Senior Policy Adviser, Office of National AIDS Policy

Longtime HIV researcher and activist Gregorio Millett, M.P.H., formerly with the Centers for Disease Control and Prevention (CDC) and now working at the White House's Office of National AIDS Policy, is helping to lead the Obama administration's effort to develop our country's first National HIV/AIDS Strategy. We caught up with Millett to find out what motivates him and how the Black community figures into the plan.

What inspired you to take up the cause of addressing HIV/AIDS?

I grew up in New York City in the 1980s and 1990s. My father worked as a microbiologist at St. Vincent's Hospital in Greenwich Village, which at the time was ground zero for the AIDS epidemic on the East Coast. People everywhere were visibly sick. I had just graduated from college and was contemplating law school to pursue a career in civil rights. I watched Black men whom I admired deeply--like Craig Harris, Donald Woods, Essex Hemphill--pass away. I decided that I needed to do my part. I started attending ACT UP meetings and volunteered to lead workshops for GMHC [Gay Men's Health Crisis], teaching Black and Latino men who have sex with men [MSMs] about HIV prevention. Eventually I realized that I could make a greater impact in public health rather than law school.

What personally motivates your HIV work?
I have always hated gross generalization to explain complex problems. I used to bristle at the stigmatization of Black gay men--that HIV prevalence was likely higher in our community because of promiscuous sex and rampant drug abuse. It compelled me to conduct a series of research studies while at the Centers for Disease Control and Prevention that proved that Black men who have sex with men, and African Americans generally, do not engage in higher-risk behaviors that place us at greater risk for HIV infection. In fact, I found that existing community prevalence, density of sexual networks and less access to care likely explained the racial disparities in infection rates.

Another gross generalization that I tried to shed light on through research was the "down low" and its relationship to HIV infection among African Americans. My colleagues and I were among the first to scientifically prove with quantitative data that identifying as "down low" was not associated with greater sexual-risk behaviors with male or female partners; nor was it associated with a greater likelihood of HIV infection. Dr. Kevin Fenton at the CDC recently used the data to dispute the role of the "down low" in HIV-infection rates among African Americans. Here at the White House, I hope to inform HIV policy--and particularly the National HIV/AIDS Strategy--by bringing my knowledge of scientific data in HIV-prevention research, HIV epidemiological studies and behavioral/biomedical interventions.

Why is a national AIDS strategy important to the well-being of Black people?
A: African Americans make up 12 percent of the population but 46 percent of new HIV infections each year in the United States. We also make up about half of the more than one million people living with HIV in the U.S. We are more likely to be HIV-positive and not be aware of our diagnosis than other communities, more likely to be diagnosed with AIDS rather than HIV, less likely to access HIV care after being diagnosed and more likely to die from HIV, even in the era post antiretroviral therapy.

What is the timeline for creating the strategy and for the community to get involved?
We are balancing competing pressures: moving quickly in light of the urgent need, and being deliberate and thorough. In terms of community input, [since August 2009] we convened 14 community discussions with nearly 5,000 people nationally, and we received more than 500 comments from our online Call to Action. There will be additional opportunities for community members to comment on the strategy through Presidential Advisory Council on HIV/AIDS meetings.

What surprised you most or was most unexpected at the town hall meetings?
The persistence of HIV stigma and discrimination. We heard stories of HIV-positive individuals in urban coastal cities having difficulty accessing dental care. We heard about providers in rural America who were afraid to touch or to go near people living with HIV. I have been involved in HIV work since the early '90s--HIV stigma was a major stumbling block then and remains a stumbling block two decades later.

Sheryl Huggins Salomon is a Brooklyn, N.Y.-based writer and editor who can be found @sherylhugg on Twitter.