On assignment from CDC from 1992 to 1994, Gayle was the AIDS coordinator and chief of the HIV/AIDS Division at the United States Agency for International Development (USAID).

Under her leadership, CARE strengthened its focus on advocacy efforts and policy work to have a long-term impact on reducing poverty across the globe.

Under her leadership, Gayle introduced signature programs that focused on financial inclusion, maternal health and improving girls' access to quality primary education.

The three-part strategy to close this gap centers around growing household wealth, catalyzing neighborhood investment and building collective power.

"[6] She been featured by media outlets like The New York Times, The Washington Post, ForbesWoman, Glamour, O magazine, National Public Radio, and CNN.

[7] On April 25, 2022, it was announced that Gayle was a candidate to succeed Mary Schmidt Campbell as the 11th president of liberal arts HBCU Spelman College.