Even people appointed to their position by the president of the United States can feel the icy sting of imposter syndrome. When Francisco Ruiz, currently serving as the director of the White House Office of National AIDS Policy (ONAP), first learned he was being considered for the post, he felt at times like an Oscar hopeful. Despite his extensive résumé, hard-earned credentials and first-person experience, he considered it an honor just to be nominated.
“I was like, Me? Are you sure?” he says. “Often, as a member of a community that is not invited to the table—or is invited but not given a mic—I was sort of like, Am I equipped to be in this role?”
But those feelings melted away as he continued to interview for and, eventually, secure the position. The stars seemed to align. He began contending for the role just as he was finishing up his coursework for a doctorate in public health at Harvard University, meaning he would no longer need to be in a Massachusetts classroom. And now, having served in President Biden’s White House for less than a year, he has already made a visible and felt difference to the HIV community.
“I don’t know how he sleeps,” says Christopher Cuevas, senior program manager of Latino programs at AIDS United. “I have seen his name pop up on so many calls. He’s everywhere, and it shows his continued investment in our community.”
Speaking with Ruiz, you’d never guess that he could catch a case of the nerves. He speaks calmly but with authority and a disarming charm. His answers are direct, not wishy-washy. Despite his long tenure in Washington, DC, he resists speaking in bureaucratese.
Ruiz became the 11th ONAP director in April 2024, more than three years after his predecessor, Harold Phillips, first took office. He is the first Latino to occupy the role and only the second to hold it after a four-year gap in leadership, since former President Trump left the office vacant when President Obama appointee Amy Lansky departed at the end of his administration.
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Ruiz’s HIV work stretches back about two decades and includes service in the federal government. After graduating from Loyola University in Chicago in 2001, he spent two years educating children and families in Ecuador about HIV prevention as a Peace Corps volunteer. After his time in Ecuador, Ruiz continued along a path of HIV work that included a stint at DC’s Latin American Youth Center. He didn’t set out to do HIV work—in his own words, he just “fell into it”—but it ended up being an outlet for his passion around social justice issues, such as racism, homophobia, xenophobia, homelessness and substance use.
Ruiz also spent more than a decade at the Centers for Disease Control and Prevention (CDC), where he molded the agency’s messaging around HIV. He developed well-known public health campaigns, such as “Let’s Stop HIV Together,” and empowered members from diverse backgrounds to be community and clinical ambassadors for the campaigns.
Six years ago, while working on an HIV stigma campaign at the CDC, Ruiz tested HIV positive. Even as he dedicated his public life and professional energy toward eradicating stigma, he was facing the realities of it in his private life. He kept his diagnosis to himself for almost a year, not sharing it with any colleagues, friends or family. “I knew I was going to be fine,” he says. “But it still took me eight months to verbalize that I was diagnosed with HIV.”
Ruiz says he wears a red ribbon to work almost daily. Sometimes, it prompts conversation. Sometimes, folks ask him whether he has an extra one on hand. Overall, he hopes the ribbon reminds others that he is a person living with HIV who is doing the work at the federal level. “I know that visibility matters, that representation matters,” he says. “Having an office that focuses on HIV with someone who is living with HIV says a lot.”
That personal experience has given Ruiz unique insight into the power of stigma. When he was diagnosed, he had a secure job and housing but nonetheless felt shame regarding his diagnosis. That reality reinforced to him that fighting HIV will always require more than a public health or biomedical approach, a fact that informs his role at the White House, where he works across disciplines—a necessity in addressing the ongoing crisis.
“I’m trying to break down the boxes and the silos within this work,” he says. “Public health is social justice. Public health is housing rights.”
Fighting the HIV epidemic holistically has always been a strength of his, according to those who have worked with Ruiz. “He takes his life experience and his academic background and finds a really good path that allows him to speak directly to the community and to the heart of policy issues,” Cuevas says.
I know that visibility matters, that representation matters.
Ruiz relishes the opportunity to break his talk of HIV out of a health-only bubble. “I work with people who are working on diabetes, nutrition, housing, LGBTQ rights,” he says. As AIDS activists have taught us, each of these is part of a holistic approach to HIV prevention and treatment, as opposed to just focusing on the biomedical approach to treatment. “People who work in HIV know that it’s not just about the biomedical. It’s about the whole tapestry.”
Ruiz continues, “We can’t forget about the human aspect of this work. When we talk about education [and] economic mobility, we need to talk about what it means for José or María down the street to be successful, to know their HIV status, get on PrEP [pre-exposure prophylaxis] or get into care.”
That ability to think holistically about the HIV epidemic and how it affects marginalized people will be an asset to Ruiz during his tenure. His appointment comes at a dire time for queer Latinos facing the ongoing HIV and AIDS crisis. In June, a KFF analysis of CDC data found that queer Latinos are experiencing an increase in new diagnoses.
While overall HIV rates declined 23% in the decade between 2012 and 2022, Latinos have experienced a much smaller decline and, in certain areas, have even seen a rise in new infections. Public health officials in some municipalities—such as counties in North Carolina and Tennessee as well as in San Francisco—have recorded an increase in infections among Latinos, especially queer Latinos.
In the face of such data, Latino advocates have called for the federal government to declare a public health emergency in the hope that more money will be directed to Latino communities. “Our invisibility is no longer tolerable,” Vincent Guilamo-Ramos, PhD, MPH, cochair of the Presidential Advisory Council on HIV/AIDS, tells The Associated Press (AP).
Cuevas echoes that sentiment and underscores that specific efforts are needed to reach Latinos. “Resources are not really reaching queer Latinx people,” they say. “We are not getting to the heart of the challenges that Latinx communities are having to navigate.”
While Black Americans continue to have the highest rates of HIV overall, Latinos had the largest share of new HIV diagnoses among gay and bisexual men in 2022. Though Latinos make up 19% of the U.S. population, they accounted for about one third of new HIV diagnoses.
“My goal is that we see the numbers going down,” Ruiz says of the latest data. “We haven’t seen that much investment in the Latino community.”
Ruiz sees his appointment as a signal from the Biden administration that it takes the needs of Latino people living in the United States seriously. “The Latino community has been yearning for visible leadership,” he says. “I don’t take my appointment lightly.”
And while it’s certainly helpful to have an out queer Latino person living with HIV in this specific role at this time and though Ruiz may have momentarily hesitated when handed the mic, he knows that it’s important to pass the mic to others in his communities so that they may tell their stories.
“My focus has been making sure we do a better job of telling our story,” he says. “There’s an obligation for our leadership to bring folks who maybe haven’t been to the table and not just bring them to the table but give them the pen to write policies and inform decisions versus just tokenism.”
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Ruiz also knows that an important part of his job is identifying new lawmakers on Capitol Hill who will champion HIV causes and funding. Although HIV funding has long been a bipartisan issue, as anti-LGBTQ sentiment within the Republican party grows, dollars meant to fight the AIDS crisis are now in danger of disappearing.
A 2025 spending bill put forward by Congressional Republicans suggested gutting HIV funding by up to $767 million, according to GMHC. Funding for HIV prevention and treatment is under attack from all sides of the political spectrum. For example, in New York City, Mayor Eric Adams proposed a cut to a program meant to help people stay undetectable. However, public outcry led to a reversal of that proposal.
“We’ve always had advocates like Maxine Waters, Barbara Lee and Nancy Pelosi,” Ruiz says of the longtime congresswomen. “They’re still there, and they’re still strong, but one of my priorities is to identify new champions on the Hill to carry that message.”
To that end, Ruiz will set out to do what he loves most about his work: forging connections and telling stories. While early announcements about his selection touted him as the first Latino person to take on the role, perhaps it’s even more important that he has a deep network within the Latino community. He is not a spotlight hog; he is a connector, someone who wants to play matchmaker between the right voices and the right people in power.
Ruiz hopes he can bring a level of complexity to the way Latinos are discussed, represented and catered to in government. Although some marginalized communities have received big investments because of the disproportionate burden of the epidemic they shoulder, the Latino community hasn’t, he says.
His plan includes convening multiple groups that focus on Latinos, both inside and outside of the public health sphere, to ensure that they are addressing the specific needs of subsets of the Latino community.
“What newly arrived Mexicans need differs from third-generation Mexican Americans,” Ruiz says. “It’s very nuanced and complex.”
Making inroads for a community as multifaceted as Latinos might seem a daunting challenge to some. But for Ruiz, caring for people he knows, people who are part of his many communities, grounds him and helps make the enormous task ahead of him tenable.
“I’ve been trying to bring the fusion of public health with policy,” he says, “which is always bringing it back to humanity.”
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