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  • We're Not All in This Toget...
    Bowleg, Lisa

    American journal of public health, 07/2020, Letnik: 110, Številka: 7
    Journal Article

    We are not all in this together. My 32-year history with the HIV/AIDS epidemic in the United States-initially as an HIV/AIDS policy analyst and now as an HIV-prevention researcher- has provided the dubitable opportunity to witness how adroitly deadly viruses spotlight fissures of structural inequality. In the late 1980s, "changing face" was the term often used to describe the epidemic's transition from one that affected predominantly White and class-privileged gay and bisexual men to one that exacted a disproportionate toll on people at the most marginalized demographic intersections: Black and Latinx gay and bisexual men, cisgender and transgender women, injection drug users, and poor people.The epidemic curve ofHIV/AIDS in the United States has now flattened, to use the parlance of the day, but not for people marginalized by intersections of racism, sexism, classism, and transphobia. An HIV vaccine still eludes us, but biomedical interventions such as preexposure prophylaxis effectively reduce HIV transmission. Alas, not for all. Black people are still less likely to have access to preexposure prophylaxis than are their White counterparts. Thus, COVID-19's arrival made me dread what its "changing face" might portend. Newspaper headlines swiftly affirmed the disproportionate impact of COVID-19 in Black and Navajo communities and issued ominous warnings about the pandemic's future in poor White rural communities.My irritation with the ubiquitous phrase "We're all in this together" quickly ensued. Although seemingly innocuous and often well intentioned, the phrase reflects an intersectional color and class blinding that functions to obscure the structural inequities that befall Black and other marginalized groups, who bear the harshest and most disproportionate brunt of anything negative or calamitous: HIV/AIDS, hypertension, poverty, diabetes, climate change disasters, unemployment, mass incarceration, and, now, COVID-19.