“The More Things Change, the More Things Remain the Same”: It's Time to Dismantle Structural Inequalities of Racism, Discrimination, and Health Disparities

Ending the HIV epidemic for all, not just some: structural racism as a fundamental but overlooked social-structural determinant of the US HIV epidemic

“…Most of the recent editorials explicitly name ending structural racism as an essential step to ending the US HIV epidemic [54,55,56 && ,57…”

“…For example, Godley et al highlighted how targeted structural reforms within US criminal justice and healthcare systems could profoundly improve HIV outcomes for Black and other people of color [54]. Wharton and colleagues asserted that dismantling the social and structural inequities that result from racism and intersecting forms of discrimination must be prioritized if the US is to reach its EHE goals [56 ▪▪ ]. Similarly, Doshi et al , in response to a study from Khazanchi et al [59], argue that the US HIV epidemic will not end without dismantling the effects of structural racism and that researchers must prioritize structural interventions to end the HIV epidemic [55].…”

“…Most of the recent editorials explicitly name ending structural racism as an essential step to ending the US HIV epidemic [54,55,56 ▪▪ ,57 ▪▪ ,58]. For example, Godley et al highlighted how targeted structural reforms within US criminal justice and healthcare systems could profoundly improve HIV outcomes for Black and other people of color [54].…”

“…Despite their impressive targets and the NHAS's acknowledgement of social-structural determinants grounded in the historical legacy of racism, critics assert that these plans are likely to fall short of their goals for at least two key reasons: (1) they focus primarily on biomedical solutions and ignore the fundamental root causes of racialized HIV inequities [56 ▪▪ ,57 ▪▪ ,65]; and (2) they have traditionally failed to engage equitably and ethically with communities most disproportionately affected by HIV [66,67 ▪ ].…”