Researchers from the Institute for Global Health and Infectious Diseases, the Gillings School of Global Public Health, and Center for Health Equity Research reviewed qualitative data from three “Ending the HIV Epidemic” (EHE) projects, published in the July issue of Journal of Acquired Immune Deficiency Syndrome (JAIDS). In the article, Kate Muessig, PhD, associate professor in the department of health behavior, Tonia Poteat, PhD, associate professor of social medicine, and Lisa Hightow-Weidman, MD, MPH, professor of medicine in infectious diseases, name racism and White supremacy as key challenges to the success of the EHE.
Researchers synthesized formative data from three 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 a priority focus of included studies, discourse on race and racism emerged as key study findings from all projects.
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).
The authors conclude EHE implementation scientists should commit to measurable anti-racist actions. They also 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.