Addressing Racism’s Role in the US HIV Epidemic: Qualitative Findings from Three Ending the HIV Epidemic Prevention Projects

Citation

Harrison, Sayward E.; Muessig, Kathryn E.; Poteat, Tonia; Koester, Kimberly; Vecchio, Alyssa; Paton, Mariajosé; Miller, Sarah J.; Pereira, Nastacia; Harris, Orlando; & Myers, Janet, et al. (2022). Addressing Racism's Role in the US HIV Epidemic: Qualitative Findings from Three Ending the HIV Epidemic Prevention Projects. Journal of Acquired Immune Deficiency Syndrome, 90(S1), S46-55. PMCID: PMC9204779

Abstract

BACKGROUND: Racist socio-political and economic systems in the United States are root causes of HIV disparities among minoritized individuals. However, within HIV implementation science literature, there is scarce empirical research on how to effectively counter racism. This article names racism and White supremacy as key challenges to the success of the Ending the HIV Epidemic (EHE) initiative and delineates opportunities to integrate anti-racism into HIV interventions.
METHODS: Formative data were synthesized from 3 EHE studies in California, North Carolina, and South Carolina. Each study engaged with community stakeholders to inform pre-exposure prophylaxis interventions. Key informant interviews and focus groups were used to query individuals-including Black individuals-about implementation challenges. Although racism was not an a priori focus of included studies, discourse on race and racism emerged as key study findings from all projects.
RESULTS: Across diverse stakeholder groups and EHE locales, participants described racism as a threat to the success of the EHE initiative. Institutional and structural racism, intersectional stigma, and maltreatment of minoritized individuals within healthcare systems were cited as challenges to pre-exposure prophylaxis scale-up. Some recommendations for addressing racism were given-yet these primarily focused on the individual level (eg, enhanced training, outreach).
CONCLUSIONS: EHE implementation scientists should commit to measurable anti-racist actions. To this end, we present a series of recommendations to help investigators evaluate the extent to which they are taking actionable steps to counter racism to improve the adoption, implementation, and real-world impact of EHE interventions for people of color.

URL

http://dx.doi.org/10.1097/QAI.0000000000002965

Reference Type

Journal Article

Year Published

2022

Journal Title

Journal of Acquired Immune Deficiency Syndrome

Author(s)

Harrison, Sayward E.
Muessig, Kathryn E.
Poteat, Tonia
Koester, Kimberly
Vecchio, Alyssa
Paton, Mariajosé
Miller, Sarah J.
Pereira, Nastacia
Harris, Orlando
Myers, Janet
Campbell, Chadwick
Hightow-Weidman, Lisa B.

Article Type

Regular

PMCID

PMC9204779

Data Set/Study

Ending the HIV Epidemic (EHE) Program

Continent/Country

United States of America

State

California
North Carolina
South Carolina

ORCiD

Poteat - 0000-0001-6541-3787