Bill Keeton describes his work as chief advocacy officer at
Vivent Health as "storytelling with a purpose." Throughout his 18 years with the Milwaukee-based HIV health care provider (formerly the AIDS Resource Center of Wisconsin), Keeton has stood at the forefront of efforts to raise awareness and reduce the stigma surrounding HIV.
Vivent has made significant strides since its founding as ARCW in 1985. Now the second-largest HIV/AIDS health care provider in the country, Vivent operates 14 locations across Wisconsin and in Austin, Denver, St. Louis and Kansas City, serving around 15,000 patients a year, with about 4,500 of them in Wisconsin.
In late June, the nonprofit
relocated its downtown clinic to a $9 million, 46,200-square-foot facility at the corner of North Sixth Street and West Fond du Lac Avenue. Compared to Vivent's former home in an office building on North Plankinton Avenue, the new stand-alone clinic is about a third larger, with capacity to serve an additional 1,000 patients. It also places the organization closer to an area with the highest prevalence of people living with or at risk of contracting HIV in the state. BizTimes Milwaukee associate editor Maredithe Meyer recently spoke with Keeton about his role as an advocate for the HIV community and Vivent's impact and continued growth. The following portions of their conversation have been edited for length and clarity.
BizTimes: How did you get your start working in HIV advocacy?
Keeton: “I graduated with an undergraduate degree in biochemistry and molecular biology. When I was an undergrad student and working in a lab, I kind of got bit by the justice bug, I guess I would call it … I was working on an enzyme inhibitor for HIV, so I was doing HIV work back in the late '90s in a lab setting. I realized that what we were beginning to talk about in a scientific setting was what would become consecutive medications to help people with HIV live healthy lives, and I realized where my passion, my calling was in making sure that everyone — regardless of their socioeconomic background, where they live — had access to the medicines that were being created. And so, I kind of changed my focus, after school (I) did some food advocacy work, worked in the state capital for a number of years as a legislative assistant and then found my way to what was then ARCW. I really hadn’t been involved in HIV directly since I left college. … I got here and realized that here I was, five or six years after college, and we still weren’t making as much progress in doing what I thought was going to be something that I could be helpful in and that was increasing access to medical advances for all folks. I immediately fell in love with the organization, and the work that I started doing here was actually in fundraising.”
What does your role as chief advocacy officer entail?
Keeton: “My job is basically storytelling with a purpose. My job on a day-to-day basis is taking the experiences of the folks that we serve, taking the experiences of the folks who I work with who directly provide services to those individuals and then using those stories in a way to frankly generate understanding and appreciation and, hopefully, support for the work that we do. It’s about connecting with folks where they’re at, whether it’s someone who is very well versed in the HIV care and treatment space and being able to tell them what’s unique about what we do or talking to someone who didn’t even realize HIV was still a thing and connecting with them and helping them understand what’s going on not only in a global sense but also what’s going on here in the U.S. — and how while, yes, Magic Johnson has been living with HIV since the early '90s, the experience of Magic Johnson is not the experience of all people who are impacted by HIV, and here’s why we should care about their experiences as well.”
Who are you targeting with those messages?
Keeton: “I spend a lot of time communicating these stories to policymakers. I spend some time in Washington D.C., I’m on the board of trustees for AIDS United, which is the longest running, most influential national HIV advocacy organization. I spend a lot of time in Madison working with folks from the (Gov. Tony Evers) administration and the Legislature, working with other community groups throughout Wisconsin, primarily in the public health space but also in the primary care space. And then throughout the states that Vivent Health is located in: Denver, Colorado; St. Louis, Missouri; Austin, Texas; we recently expanded into Chicago. One of the other big constituencies I talk with — sometimes directly, sometimes in support of others who are more appropriate storytellers than me in certain spaces — is the media. I also work hand-n-hand with our chief development officer to help tell our story to private and philanthropic funders of our organization. We receive government grants and things like that; we also receive private donations.
“Those are probably our biggest three constituencies on the second tier. On the first tier, it’s people impacted by HIV. In telling the story to them that there are compassionate providers in our clinic who are here to care for them and do so in a nonjudgmental, accepting, destigmatizing way, telling people who are at risk for HIV what the steps are that they can take to prevent HIV acquisition and really trying to do that so, first and foremost, people who need us know us and that we’re reaching them with messages and information they can use to make informed choices.”
Why are human-centered stories so important in communicating the Vivent Health mission to lawmakers and other key stakeholders who may not be directly impacted by HIV but hold the power to make real change?
Keeton: “Having been a legislative assistant and having worked with lawmakers from the lobbying side for a number of years, I know that they get tons of data: There’s budget numbers, there’s program data, there’s numbers around everything and it becomes difficult to separate the numbers from the human impact and what those numbers represent in terms of people. Oftentimes, what’s most effective is helping someone else learn to tell their story in a way that’s most impactful and can reach folks and creating that intentional space to be the connector between someone directly impacted and someone who’s making policy that directly impacts their lives.
“There’s got to be a human, compassionate, personal sort of ability for folks to understand, ‘yes, this is someone living with HIV. I may not understand all the science behind it, all the background, all the epidemiology but next time someone says HIV, I’m going to be able to connect that with the person who I spoke with.’ That’s something we can always be doing better, especially as an organization in this space. What we’re really focusing on and moving into now is, how do we support and empower the folks we serve so that they can realize that power and become advocates for themselves as well? And not just advocates in terms of benefits and programs and advocating for themselves to get their Maslow's hierarchy of needs met, but also starting to have those bigger conversations on the systemic and policy level. … It’s not enough just to say we’re going to provide this medical care for you. It has to start with the question of, ‘what is it you need first?’ and asking the folks you serve, ‘what is it that you need?’ And then delivering on what they need to be successful, whether it is managing their HIV, finding secure housing, mental health services. It has to start with not just what do I think is best for that person but meeting that person where they’re at and then helping them gain access to what it is that will help them live their best life and be successful.”
HIV treatment, prevention and public perception is in a much better place now than it was when you started your career. What are some of the key inflection points over the past two decades that indicate progress and shed light on Vivent’s impact?
Keeton: “First and foremost, when I think about what the impact of this organization has been and what our successes are, if you look at the state of Wisconsin over the past 15 years or so, people with HIV by and large live longer and healthier lives here than just about anywhere else in the country. And that’s a testament to the fact that we’ve been providing the model of care that we provide here in the state to some of the most vulnerable and marginalized people living with HIV.
“When were honest and look at it, for someone of resources and means, HIV is a relatively straightforward, managed chromic disease. You take one pill once a day, you get your labs done a couple times a year. Maybe you have to tweak the medicine, maybe you have to start something new, but, by and large, for folks who are well resourced and otherwise doing well and are healthy, HIV probably isn’t their number one health concern. It might be diabetes, it might be hypertension, it might be high cholesterol, and so it really becomes a primary care delivery issue. But it’s for those folks who are struggling to have a place to call home every night, it’s the folks who face food insecurity, who can’t find meaningful and sustainable employment, struggling with mental health or substance abuse issues, the fact that we’re able to help them live longer, healthier lives is really a testament to the power of what we do. We’ve also been successful helping to reduce the number of new HIV infections in this state. There’s still a long way to go, unfortunately, but the rates of new HIV diagnoses by and large are going down.
“What I will say, however, is we still have a lot of work to do. At Vivent Health — and at partners across all of our sites as well — we’re not seeing the same outcomes and the same advancements happening equitably across all folks who are impacted. Unfortunately, communities of color are still experiencing HIV diagnosis rates that are way too high and significantly outpace the rates for white folks. So, we still have work to do, but I believe the power of our model and as we are able to reach more folks, we’ll be able to reduce those disparities for folks of color, especially African American, Latino/Hispanic, and gay men and bisexual men. Reaching those populations is really what it will take to achieve the collective goal for the country of ending HIV as an epidemic by reducing the new cases of HIV to much lower levels.”
Vivent recently relocated its downtown Milwaukee clinic to the Haymarket neighborhood, chosen for its proximity to an area with the highest prevalence of people living with or at-risk of contracting HIV in the entire state. How does the physical location and visibility of Vivent’s clinics impact the work you do?
Keeton: “Location is critical. Being accessible to folks who may need to take the bus, maybe walking, maybe relying on others for a car or ride. Geographic accessibility and location is really important to helping make the services we’re here to provide accessible. But there’s another part of that story that is really true as well. It doesn’t matter if you’re located in the community that you’re trying to serve if the people who are coming to get your services don’t feel valued, don’t feel appreciated, if they’re not treated with dignity, sensitivity, understanding of everything that they’re coming to us with. At the end of the day, the unfortunate truth is folks are not only coming to us with their HIV: We know that racism still exists and plays a role in the lives of African American and Hispanic folks we’re serving, we know that sexism still exists and plays a role in the lives of the women who we’re serving, and we know that homophobia and transphobia are playing really significant roles in the lives of folks from those communities who we’re serving. The location is critical, but it’s got to be coupled with a team of service providers and clinicians who are incredibly sympathetic, empathetic and are able to help people not just with managing their HIV but understanding and creating a space where those folks can come, they bring their whole selves to their appointment, because when they do this, we can be a part of solving some of those challenges that folks are experiencing.”
Tell me more about Vivent's approach to DEI.
Keeton: "We're really proud of the work we're doing in this space. As an organization, when you are intentional about existing and serving in this space, you really need to make sure that you're talking the talk and walking the walk, and so if we have a commitment to diversity, equity and inclusion here that it's really designed to make sure that the folks who directly provide those services that they're in a spot that is allowing them to bring their whole self to work. It's a journey, it's process and we're really excited to be engaging in it with the folks who work here."
Is there a story or an experience you can share that helps illustrate the impact Vivent has had on the HIV community?
Keeton: "Back in 2019, we were then the AIDS Resource Center. We knew we needed to change our name for a number of reasons: We weren't just in Wisconsin anymore, AIDS was something that we were trying to prevent and actually an indicator of a systems-level failure in terms of the folks we provide care to, so we wanted to move away from the term AIDS and we're not just a resource center, we're a health care provider. So one day in 2019, our director of marketing and communications and I were meeting with our rebranding partners at a restaurant here in Milwaukee. We were sitting down, having a couple of cocktails and just brainstorming, just talking about what is our unique value proposition? What is it that is so meaningful about us? Who is it that we're trying to reach?
"One of the people who was working in the restaurant overheard our conversation and walked up to us and asked, 'Are you guys from ARCW?' I said yes, and he said, 'I get my care from you guys. I've been all over the country — California to the East Coast — and what you guys do here in Milwaukee is unlike anything I've seen anywhere else in the country. It has been so meaningful to me. It's been so impactful on my health and wellbeing and just need you guys to know that.' And I think what's telling to me about that is HIV is still stigmatized, people are still discriminated against because of their HIV status. There's still a belief in some circles that the activities that may put one at heightened risk for HIV are behaviors that are eligible to be judged and judged harshly and negatively. Yet here was someone in their place of business, with co-workers and other patrons around, and was so moved by what we do and felt so safe in it to come and talk to us about it in a public setting.
"It's one of those stories that tells me we're doing the right thing and that we're having an impact. It continues to stick in my mind because it wasn't about the politician coming up and saying, 'Hey, I'm happy to make sure we get this grant to you.' It wasn't a donor saying, 'I'm so happy to donate to you guys.' It was someone who we serve who is so grateful for what we do."
