PAUL KAWATA - NATIONAL MINORITY AIDS COUNCIL - INTERVIEW

When Paul Kawata agreed to serve as executive director of the
National Minority AIDS Council (NMAC) in 1989, the organization had a
staff of four and operated on an annual budget of about $700,000.
Sixteen years later, Kawata oversees a 40-person operation with a
budget of $7 million.

"This was supposed to be a four-year gig," he says with a laugh. "And
I'm still here." Advertisement . Page Continued

The reason why Kawata is still at NMAC's helm is clear to anyone who
knows him. He's committed -- devoted, really -- to fighting AIDS,
particularly in the hard-hit minority communities. But even Kawata,
whose every e-mail features the salutation "Yours in the struggle,"
recognizes there is room for improvement in NMAC's work with the
3,000 community-based AIDS organizations it serves, as it helps them
focus on prevention, care and treatment for people of color living
with AIDS. "Our mission," says Kawata, "is to develop leadership
within communities of color -- predominantly African American,
Latino, Native American and Asian -- to address the challenges of
HIV/AIDS." He points out that, in addition to serving as a resource,
NMAC is also "a kind of trade association," providing a lobbying
voice on Capitol Hill for those who might otherwise go unheard. Kawata

"This is probably the most difficult time I've ever seen for my
community," he says. "With funding flat or being cut, services are
being cut back drastically. It's a critical moment in the history of
the movement -- where it's going in terms of our ability and our
capacity to provide care for all the people living with HIV in America."

Recently, Kawata returned from a trip to Katrina-savaged New Orleans,
where the mission was to determine how to help the city cope with the
several hundred people living with HIV/AIDS who have recently
returned home. The problem, says Kawata, is that "the entire health
care infrastructure of New Orleans is gone," leaving those with AIDS
without proper medical care. NMAC is helping devise a strategy to
deal with fractured Gulf Coast AIDS-related services, including
"getting provisional government grants back up and running."

The Gulf Coast situation is high on Kawata's list of personal
missions. But most of his days are spent, as he puts it, "dialing for dollars."

"Like a lot of organizations, I spend a good portion of my time
trying to raise money to keep our doors open. I also spend a
significant amount of time on basic management issues. And then I get
to work a little tiny bit on something that nourishes me, that keeps
me in the work. Right now it's Katrina."

Another issue important to Kawata is the devastating impact of
crystal meth on the gay community, especially its complicity in the
rise of HIV infections among gay men.

"Crystal meth is an issue that cuts across ethnicity," he says. "The
problem is the pervasiveness of it -- it's an accepted part of the
gay community. And until we can figure out how to make it
unacceptable, we're going to continue to have these problems. The
truth about it is that, ultimately, if you look at people who become
addicted to crystal, their lives just go down the toilet."

Kawata is modest about his years at NMAC, acknowledging that heading
the organization has been a continual learning process.

"A lot of people, myself included, got into this work because someone
we knew got sick. I wasn't a non-profit manager -- that wasn't a
skill base I had. I had to learn while doing. And it was either learn
how to do it right, or get out of the way. I wanted to stay here, so
I learned how to do it."

METRO WEEKLY: How do you view the current state of the AIDS epidemic?

PAUL KAWATA: I think this is a telling moment in several ways. First,
for gay men, the epidemic of crystal meth and co-infection between
those addicted to crystal meth and being HIV positive is
overwhelming. And the number of new cases we're seeing in gay men --
particularly from within the African-American community -- is
startling and frightening. It's something we're very, very concerned about.

That's only one piece of the picture. The second piece is that I
think America, for a lot of reasons, has forgotten AIDS. I think
America has forgotten AIDS because [the virus has afflicted] more and
more people of color. I think America has forgotten AIDS because 25
years is a long time to fight an epidemic. I also think -- and this
isn't necessarily a bad thing -- that international AIDS has
dominated the discussion in terms of the epidemic over the last
couple of years.

MW: But hasn't the news media helped keep AIDS in the public mindset?

KAWATA: These days, things have a news cycle for about six weeks.
Then it's on to the new story, the new angle. And the media has run
every AIDS story there is, so it's hard to find that new story. The
problem is there isn't a new story. The story is the same. People
don't have medication. Funding is going down. Community organizations
are closing. And we still have new infections -- estimated at 40,000
a year in this country -- particularly within the black community right now.

MW: You mentioned the correlation between rate of infection and
crystal meth. Can you explain that a bit more?

KAWATA: There are a lot of studies that show if you are high, you are
less likely to practice safe sex. So what happens is that when you
have an epidemic of crystal meth addiction in the gay community, and
you have a lot of men who are getting high, and you have the virus in
that community, and it looks like it's a manageable disease, people
[start] having sex without condoms.

MW: So the fact that people see others living with the virus plays
into their thinking, as in "If I get it, I can at least control it."

KAWATA: Yes. And that sounds good until you talk to people who have
been living for 20 to 25 years with this disease. I have many, many
friends who have lived for years with this disease and many of them
are doing very well. But they are doing well because they're taking a
lot of medication, and because they go to the doctor frequently to
monitor it. It is not easy -- it is a very, very challenging process.
And it's getting more challenging as we may or may not be spreading a
drug resistant virus from person to person.

What happens is this: Let's suppose that you have unsafe sex with
somebody who's had the virus for a long time, and they've gone
through all these different drugs and have become resistant. Well,
the virus they're carrying is also resistant. So when you get
infected with their virus, you have the same resistance profile of
the person who infected you.

MW: Twenty-five years ago, there would be a dozen or more
AIDS-related obituaries in the paper every week. It was overwhelming.
You don't see that anymore. Does that make it harder for you to get
your message across?

KAWATA: Yes. People are dying -- but the papers don't always list
AIDS [as a cause] anymore because it might be one of the side effects
[of certain AIDS-therapy drugs]. Have you noticed how a lot of people
are dying of heart attacks right now? The drug gets into their blood
system that causes these heart attacks. So it's a side effect, but
it's not always reported that way.

MW: Are there any positive trends in fighting the epidemic?

KAWATA: There are a lot of positive trends. We are continually
finding new drugs -- and that's a good thing, because as people
become more resistant to existing drugs, we need to keep filling the
pipeline so there will be drugs available for those who either become
resistant or get resistant viruses.

Another good thing is the fact that we are providing anti-retrovirals
to developing countries. We're not providing enough and we're not
covering enough territory, but we've started. There was a time when I
thought we would never, ever do this, so the fact that we are making
incremental progress amazes me. We're going to Mexico next week to do
a treatment conference for Mexicans living with AIDS. Last year
Mexico decided to provide universal access to anti-retroviral drugs
for all Mexicans living with HIV. That's a wonderful thing. Now they
need to train these folks on how to use the drugs. So we're going in
to have a conference at the invitation of the Mexican government. I
do think that countries are now understanding that they have a
responsibility to their citizens.

MW: Any news on the vaccine front?

KAWATA: In terms of vaccines, we've not come very far. I think we are
decades away. There's been so much promise and so much hope, but all
the early results from all the vaccine trials have not panned out.

MW: There has been criticism of other national groups for not
focusing enough on the problem of HIV infection among gay men. What
are your thoughts on that?

KAWATA: It's true. Gay men often get left out of the discussion. And
as a gay man, I totally understand what's happening. It is one of the
most difficult times I've ever seen in America for gay men. Between
what the administration is trying to do and what the radical right is
trying to do, it's extraordinarily difficult to be a gay man in
America in the year 2005. I don't think that we're speaking up
enough, and I don't think that we are fighting back enough. It's
hard. You feel very isolated out there as you speak up and as you fight.

The truth is that anyone who meets me knows that I'm a gay man. It's
not a big stretch for people to understand that. So I get to be who I
am wherever I go. But that's real different from the need for all of
us as a community to look at what's happening internally as well as
externally. The fact that there are so many new infections among
black gay men is outrageous and unacceptable -- and who do you blame?
Do you blame African-American gay men? Do you blame the
administration for not providing enough prevention dollars? I think a
lot of fingers can be pointed in a lot of different directions,
including to me. I feel awful about it. I feel like we failed.

MW: What steps are you taking to turn that failure around?

KAWATA: Several things. And do I think it's enough? No. The first
thing is that we have to get funding for prevention for [AIDS
service] organizations. If they don't have the money, no matter how
well-intentioned their services are, they're never going to work. So
we've been advocating very hard for increases for prevention. The
reality is that prevention is not getting any new money given the
politics of Congress right now. They just don't want to talk about
sex the way it needs to be talked about.

The second thing is that we are working with our constituents to
begin to have dialogues about this issue and to begin to figure out
what works. Because the reality is that what works in 2005 is very
different from what worked in 1995 and is very different from what
worked in 1985. The prevention message has to change. NMAC is a big
believer in the proponent of science-based prevention so we can make
sure that what we're doing is the right thing. We're past the days
where we can just put condoms out in bars and say that we're doing
prevention. We have to really look from a scientific perspective in
terms of what's effective. And we have to build relationships with
behavior scientists and behavior researchers to ask them to be able
to scientifically verify that what we're doing is what's necessary
and what's needed.

MW: You would think the gay community wouldn't even need the
prevention message by this point, that it would be deeply ingrained
into our collective psyches after 25 years.

KAWATA: I'm an old queen. My experience is that most gay men,
regardless of their ethnicity, understand how safe sex is or isn't
practiced. And so it's not a knowledge issue. It is in that moment,
when you're about to have sex with someone and are high [on crystal
meth], will you use a condom? It's about the value you feel as a
human being, your ability to be in control of everything.

Plus, you have now a whole generation who came up in a time where
they didn't see the type of devastation we saw in the late '80s and
early '90s. They don't have the same cultural reference point for HIV
that men my age do. Their reference point is that people take these
drugs and they survive and they do well. It's a very different
reference point. They see the world from a very different place.

MW: They haven't had to go through the behavior modification that we did.

KAWATA: Part of what modified our behavior was the fact that our
friends were dying in front of us. We were going to hospital beds
every day to see different people and we were going to funerals once
a week. In that process, we saw firsthand the implications of this
epidemic, versus today where what people see is other people's little
beepers going off so they know it's time to take their drug.

MW: You mentioned the administration. What types of obstacles do you encounter?

KAWATA: This is probably politically the most difficult time I've
ever had in Washington -- absolutely no question. We now meet with
the radical right at many of the meetings we attend, so the CDC
[Centers for Disease Control and Prevention] had a kind of
state-of-HIV prevention summit. And a man from Concerned Women for
America said to me, "I think you're sick and demented, but I guess
you think I'm sick and demented so I guess we're even." Andrea
Lafferty, from the Traditional Values Coalition, said to me, "I just
don't understand, Paul, why do you have to have more than one sexual
partner in your lifetime?" At those moments you want to say, "Because
it's fun." But then you realize you probably shouldn't say that.
[Laughs.] Anyway, at the end of this meeting they made a
recommendation that we take all of the HIV prevention money targeted
towards gay men and rechannel it to reparative therapy. That's what
we're fighting.

MW: There must be a silver lining somewhere -- not all Americans
agree with that viewpoint. In fact, you could argue that many are
more tolerant now than a quarter-century ago.

KAWATA: I saw Ellen [Degeneres] today on some TV show and she's
talking about her relationship with Portia [de Rossi]. There was
nothing salacious about it, nothing scandalous. It was just a very
natural thing. And I think that's where we're going to win. We're
going to win because it no longer is going to be salacious [to be
gay]. It's just going to be the way it is. And we're going to win
because people like you and me don't have a choice. We are who we
are. Our only choice is whether we tell the world about it. And it
takes great courage to stand up and come out. It takes great courage
to say your truth. I'm on the board of the Colin Higgins Foundation,
where we give out the Courage Awards to young people. These kids are
coming out at age 14, 15 and 16. They're taking same sex partners to
their senior proms. They're doing things that were unheard of in my
time -- things that I think are wonderful, amazing and courageous.
So, I think the dam is broken, and I don't think you can ever push it
back. But it's still going to take some time to get to the finish.

MW: Why has it been such a struggle to focus on the black gay
community as a target audience for both prevention and treatment?

KAWATA: Because of homophobia and racism combined. You've got these
two things that already bring you down -- and when you put them
together, it makes it doubly bad and doubly difficult. People don't
like to talk about gay men and they don't like to talk about racism
- -- but that's what you've got to talk about if you're going to be
able to address this issue. Part of our challenge is that we haven't
put the money to build an infrastructure within the black gay male
community so that they can have effective organizations that lobby on
their behalf. There are some starting, like the National Black
Justice Coalition, but we really have to make sure that they're
well-funded and that they can build a voice for their community.

MW: Are there areas in the country that skew better on AIDS
prevention for gay men than others?

KAWATA: It's such a mixed bag. And what I mean by that is that I
think it's probably easier to be gay in New York City than it is to
be gay in Omaha. No question in my mind. But I also think it is
probably easier to get crystal in New York City than in Omaha --
although you can easily get crystal in Omaha now, let's not kid ourselves.

MW: What is the rate of infection like in the Latino and Asian communities?

KAWATA: The Latino community is disproportionately impacted, but it
isn't as bad as the African-American community. The Asian community
is proportionately impacted. There are a lot of factors as to why
that happens, why there is that differential. There are some studies,
but there is nothing definitive about it.

MW: This interview will be published on World AIDS Day. But really,
shouldn't every day be World AIDS Day until we've found a cure?

KAWATA: Absolutely. Every day should be. But the reality is that
every day isn't. And every day should be, if you look at the number
of people who die every day of AIDS. But it isn't. I just appreciate
the fact that there is this annual moment that we all stop as a
planet and take the time to remember, take the time to think, take
the time to look at where we need to go from here.

MW: Do you see any hope on the horizon?

KAWATA: Oh, God, I always see hope. If I didn't I couldn't stand this
work. At the end of the day, with all the loss I've seen, all of the
sadness and heartbreak, I'm a basic believer in the human spirit. We
will overcome all of this. We will succeed.

For more information on NMAC and its programs visit www.nmac.org or
call 202-483-6622.