​Former Miss USA: Renew Trump's goal to end HIV by 2030

My grandmother, Mama Lola, had a saying she repeated so often it became the architecture of my life: "No matter how little you have, there is always someone who has less. Find a way to help.”

I was raised by her and my single mother, Carmen, two women who didn't have much but gave generously anyway. Community service wasn't a resume line in our house; it was simply what you did. That ethic is the thread connecting every chapter of my life, including one that, on its surface, might seem contradictory.

Twenty-three years ago, I was Miss USA and an advocate for HIV prevention and education, among other causes. During my reign, the competition was owned by Donald Trump, which technically made him my boss. I know that for many readers of this publication, his name carries real pain. I don't ask anyone to set that aside. But those threads crossed in a way I never expected.

In his 2019 State of the Union address, President Trump announced a national goal to end the HIV epidemic in the United States by 2030. Shortly after, I joined Healthvana, a technology company working to end HIV that has served nearly one million patients. It was a full-circle moment for me, and here is what I've come to believe: ending HIV is a goal that has been embraced across administrations, by people who agree on almost nothing else. On the data and moral urgency, our country can actually align.

But the uncomfortable truth is that the goal is slipping out of reach for the people who need it most.

PrEP, the medication that prevents HIV, reduces the risk of getting it from sex by about 99 percent when taken as prescribed. Testing is fast and routine. Prevention has never been more possible. Yet we still have approximately 750 new HIV diagnoses each week, and women account for nearly 20 percent of them. Black Americans account for the largest share while remaining dramatically underrepresented among those getting protection. The South carries roughly half the country's new infections.

The virus isn't spreading because we lack medicine. It's spreading through the gaps. Where insurance runs out, where a clinic is too far, where stigma makes a person too afraid to ask.

The financial cost goes unspoken too. The 750 new HIV diagnoses each week equals to over $1 billion in lifetime costs. HIV is one of the most expensive chronic conditions in our country, and it’s fully preventable.

This is where my grandmother's voice gets loudest. Because the people falling through those gaps are exactly the ones she taught me to look for, the underserved communities that we’re trying to reach at Healthvana.

Stigma is its own epidemic. People still can't say "HIV test" or "PrEP" out loud, can't have a frank conversation with a partner or a health care provider, can't shake the shame that was never theirs to carry. Silence is one of the virus's most reliable allies. Fighting it means meeting people where they are, which is why I'm energized that Healthvana is the Official Telehealth Partner of NMAC. Its CEO, Harold Phillips, and Chief Medical Officer, Dr. Leandro Mena, are among the most respected and thoughtful leaders advocating for culturally competent, judgment-free care that actually reaches the people too often left behind. We're lucky to work alongside them.

The more openly we talk about testing, prevention, and sexual health as simply health, the more we chip away at the fear that keeps people from care. Every honest conversation is a small act of prevention.

Meeting people in those gaps is the whole job. At Healthvana, what draws me in deeper is our “One-For-One to End HIV” model: for every insured person who uses our telehealth for HIV prevention, we help someone without insurance get access to free care too. It's my grandmother's philosophy turned into a system. The people who have more, helping those who have less in their own community.

But no single company ends an epidemic. That takes all of us refusing to let this goal become a casualty of our divisions.

So here's my nonpartisan ask: keep the 2030 goal alive, no matter who’s in office. Protect the funding and the programs that get prevention to those left out, like the rural, the young, and the uninsured. Talk about HIV at your dinner table, on social media, in your group chats. Get tested. Ask your provider about PrEP. Tell a friend.

I've had a strange, winding path to this work, from a pageant stage to the fight to end HIV, but the compass has always been the same one my grandmother handed me.

“There is always someone who has less. Find a way to help.”

Susie Castillo won Miss USA 2003. She has spent years advocating for HIV awareness, from her days as a title holder to her work with Healthvana to help end HIV. Visit healthvana.com to learn more about the platform's one-for-one model, where for every insured patient who uses its telehealth for PrEP, Healthvana helps an uninsured patient in their community get access to free PrEP care too.

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