At New York City’s Pride parade this summer, tucked between the rainbow-dyed dogs and the thousands of hairy legs in tiny shorts, was the head of the city’s HIV/Aids bureau, Demetre Daskalakis, wearing a mesh T-shirt and DJing the health department’s float.
The parade’s party atmosphere echoed the sex clubs where Daskalakis still occasionally offers consultations and the spin classes he teaches each week. And that atmosphere remained as health department staff handed out New York City-branded condoms and kits filled with HIV prevention drugs to the cheering crowd. This might be because the health commissioner, Mary Bassett, was voguing next to the DJ table.
The health department in New York City, once the center of the country’s HIV/Aids epidemic, has made a point of directing funds to small, on-the-ground initiatives like the program that emerged from Daskalakis’s nights providing care in sex clubs.
Daskalakis, now the assistant health commissioner in charge of the Bureau of HIV/Aids Prevention and Control, achieved widespread acclaim while testing people in city sex clubs in 2013 to successfully combat a meningitis outbreak among gay and bisexual men. There the man known as “Dr Demetre” would offer HIV and hepatitis-C screenings and provide consultations while clubbers waited for the results of their tests.
But now he is funding the same programs he helped create. The bureau has contracts with 375 local and national groups. And money from the state’s Ending the Epidemic fund is being directed towards small transgender rights groups who do not yet have the resources to offer the sort of interventions provided by much more powerful HIV/Aids groups.
“That money is being used to actually teach these organizations how to get bigger and thrive and be organizations,” Daskalakis said. “In fact, at the beginning of this, we don’t care what service they do, we just care that they grow.”
The comment might seem flippant, but Daskalakis surges with energy when he’s detailing HIV policies on a humid Monday afternoon at the health department headquarters or tweeting about Israeli singer Ofra Haza at 8am.
“HIV allows us to leverage the healthcare system to support the health of people who weren’t always getting that support,” Daskalakis said.
While the nature of government means a person with this much energy and experience may have to lower their ambitions – Daskalakis said he “tortured” his staff with ideas when he first started at the department – the bureau is the largest of its kind in the country with 413 staff members, and its initiatives are closely watched by other agencies. “We’re also bossing the feds around a little bit,” Daskalakis said.
One example of that is the city’s push to provide grants to groups that offer “status neutral” care to people whether they are HIV positive or negative – instead of focusing on people who already have the lifelong disease, this gives more flexibility in providing resources to at-risk communities.
Daskalakis said the city’s “status neutral” plan is part of a demonstration project the department is running for two federal health agencies – the Centers for Disease Control and Prevention and the Health Resources and Services Administration. “Obviously we have to see if this going to work,” he said. He barely took a breath before continuing: “But it’s going to work, it’s a great idea.”
Some of the LGBT groups who have not worked as closely with the health department, like the Services & Advocacy for GLBT Elders (Sage), said they’ve noticed a more aggressive response to the epidemic in recent years.
“The whole orientation around ending the epidemic has been an important step forward – that if we take a more aggressive and more proactive and more energetic approach, that we can really turn the corner on HIV,” said Michael Adams, SageUSA CEO. “It has been encouraging to watch that orientation, and that’s coming from leadership at both the city level and the state level.”
Sage gets money from the city, mostly through the Department of Aging, but said elder health in the HIV crisis is often overlooked – even though 50% of the people living with Aids in the city are over 50 years old. His group is still working to get the city to respond to that population more strongly, but in general, he has been encouraged by the energy emanating from the department.
And when it comes to the bureau chief of HIV/Aids, Adams said advocacy is essential to the role. “It has always been and remains the case that in order to advance an effective response to HIV activism, advocacy is required and a willingness to challenge the status quo and challenge assumptions that are often really wrong-headed,” he said.
Challenging the status quo has been a driving force during Daskalakis more than 30 years in the field. When medical schools were keeping students away from hospital Aids wards in the 1990s, Daskalakis, trained as an infectious disease doctor,was skipping classesto follow rounds and listen to doctors treating those patients.
Now, he’s “a kid in the candy store” with the extensive collection of data the city has on HIV/Aids in its health department headquarters. And though he jokingly whispered in his office that the department’s role is “secretly an advocacy group in government”, it is no secret to any visitor who sees the small rainbow flags flying above the 22nd floor cubicles.
But his work in the department has even pushed Daskalakis to an even more activist bent.
He was “the gay health warrior” before he took over the HIV/Aids bureau in September 2014, but his time in office has ramped up his activist bent. Recently, he changed his title to “queer health warrior” to encompass sexual and gender identities beyond gay.
“I was dubbed gay health warrior and kind of realized that with all the work we’re doing in the transgender space, the gender nonconforming space, it’s a lie, that it’s not really accurate to what I’m doing anymore,” he said. “So I kind of thought though at least it has a little political overlay to it, I feel like it captures a lot of what we’re doing, which is sort of for all of that universe trying to sort of advocate for a population that in some way hasn’t had that.”
New York"s "queer health warrior": city official funds grassroots fight against HIV
