Ending the HIV epidemic for all, not just some: structural racism as a fundamental but overlooked social-structural determinant of the US HIV epidemic.
Ending the HIV epidemic for all, not just some: structural racism as a fundamental but overlooked social-structural determinant of the US HIV epidemic.
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DOI：
10.1097/coh.0000000000000724
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发表时间：
2022-03-01
影响因子：
4.1
通讯作者：
Boone, Cheriko A.
中科院分区：
文献类型：
--
作者：
Bowleg, Lisa;Malekzadeh, Arianne N.;Mbaba, Mary;Boone, Cheriko A.
我们回顾了最近的理论和实证文献结构性种族主义，艾滋病预防和治疗的背景下，健康框架的社会决定因素，以及对美国疫情的国家反应的批评。随着主流社会越来越关注结构性种族主义和健康不平等的作用，最近的社论和研究认为结束结构性种族主义是结束美国艾滋病毒流行的重要一步。最近的研究表明，根植于结构性种族主义的障碍，如监禁、住房不稳定、警察歧视、邻里不利、卫生服务利用和社区暴力，以及难以获得或无法获得社会服务、交通和儿童保育，都是预防艾滋病毒的障碍。最近的文章还批评国家对艾滋病毒的反应，如结束艾滋病毒流行病（EHE）和国家艾滋病毒/艾滋病战略（NHAS）计划未能解决结构性种族主义问题，并优先考虑社区参与EHE工作。总的来说，本文中的文章强调了一个日益增长的共识，即美国没有真实的机会为所有人结束艾滋病毒流行病，缺乏有意义和可衡量的承诺，以解决结构性种族主义和交叉歧视作为艾滋病毒的核心决定因素，没有更公平地参与社区组织和社区不成比例地受到艾滋病毒的影响。
We review recent theoretical and empirical literature on structural racism, social determinants of health frameworks within the context of HIV prevention and treatment, and criticism of the national responses to the U.S. epidemic. In line with growing mainstream attention to the role of structural racism and health inequities, recent editorials and studies cite ending structural racism as an essential step to ending the U.S. HIV epidemic. Recent studies demonstrate that barriers rooted in structural racism such as incarceration, housing instability, police discrimination, neighborhood disadvantage, health service utilization and community violence, and poor or no access to social services, transportation and childcare, are barriers to HIV prevention. Recent articles also criticize national responses to HIV such as the Ending the HIV Epidemic (EHE) and National HIV/AIDS Strategy (NHAS) plans for failing to address structural racism and prioritize community-engagement in EHE efforts. Collectively, the articles in this review highlight a growing consensus that the U.S. has no real chance of ending the HIV epidemic for all, absent a meaningful and measurable commitment to addressing structural racism and intersectional discrimination as core determinants of HIV, and without more equitable engagement with community-based organizations and communities disproportionately affected by HIV.