Lessons we can—and can’t—apply from HIV/AIDS to COVID-19

Countless headlines of late have compared the novel coronavirus (COVID-19) to HIV/AIDS. When are these comparisons useful and when are they misleading? And what can both pandemics teach us about marginalized populations and racism? Northwestern Medill School of Journalism professor Dr. Steven Thrasher joined a Northwestern Buffett Institute on Global Affairs webinar this week for a discussion on these questions and more. Here are four key takeaways: 

The HIV/AIDS pandemic provides a useful but imperfect antecedent to COVID-19: There are some now obvious differences between the HIV/AIDS and COVID-19 pandemics. Transmission of HIV/AIDS is difficult and inefficient, while COVID-19 spreads much more casually and efficiently, Tihrasher noted, “and the rapid-fire spread of the COVID-19 virus has sparked faster political responses and swifter necropolitics—the power and capacity to dictate who may live and who must die— that can more quickly harm marginalized populations.” Black and LGTBQ+ communities as well as individuals with disabilities are especially vulnerable, he added

While the rate at which each virus spreads may differ, the “othering” of those who contract them has not. The “patient zero” myth persists: in the late 80s and early 90s, many believed one flight attendant brought HIV to North America. Likewise, officials at the highest levels of government have referred to COVID-19 as “the Wuhan virus,” but “this is not the way viruses bloom,” Thrasher said.  “Viruses don’t exist within national borders.”

We must remove structural barriers and improve quality of life for the global “viral underclass”: Thrasher talked about the disproportionately harmful impacts of both HIV/AIDS and COVID-19 on the “viral underclass—a class of people who are systematically put in harm’s way”—pointing to the racial disparity in the incidence of AIDS among black versus white individuals, which has grown significantly over the past three decades, according to data from the CDC. “In 2015, the incidence of AIDS cases per 100,000 people was as high for black people living in America than it ever was for white people,” Thrasher said. “Medications for HIV have been around since the 1990s, but have not been economically accessible to all,” he added. “The availability of drugs doesn’t change racism. We need antiracist interventions.”

Thrasher also talked about the “cartographies of environmental racism,” pointing to the disproportionate number of LGBTQ+ people in the U.S. who are incarcerated and therefore at greater risk of contracting COVID-19; prisons are now among the largest reported sites of COVID-19 infections in the United States.  He urged people to think about the “structural reasons for the disproportionate incarceration of LGBTQ+ people,” and structural barriers to health care for marginalized and vulnerable populations.

“Universal healthcare is a prophylaxis.” Health and government officials talked about preventing HIV/AIDS by promoting the use of condoms and refraining from needle sharing, and now they talk about preventing COVID-19 through physical distancing. But housing, health care, freedom from incarceration, and economic stability—the things people need to lead safe and fulfilling lives—are also critical antidotes, Thrasher said. “We need to think about the viral underclass and what’s going to bring them into wholeness and health. Those things and universal health care, in particular, are going to benefit us all,” he added, casting light on how we might rethink our existing capacity to produce them: “We have a society based on militarism and consumption,” he said. “We have enormous capacity to produce things people don’t need. We need to think long-term about how to produce wellness and safety versus defensiveness—how to get people into safe housing and provide access to health care.”

“We owe a lot to AIDS activism.” Advocating for universal health care should be a top priority in the fight against COVID-19, Thrasher said, pointing to the AIDS Coalition to Unleash Power (ACT UP) as an example of an advocacy group that has succeeded in engaging people in “mutual aid networks focused on doing right for everyone.” ACT UP was an extremely collective group, Thrasher said. “It was about reciprocity versus rewarding individual stars.” ACT UP’s model, however, was built on very physical forms of protest—people staging their own deaths and engaging in other forms of physical activism with a certain shock value, Thrasher acknowledged. “We should look at the way activists with disabilities have been able to create effective campaigns without people needed to congregate in physical places."
 

Thrasher concluded his talk with some suggested readings on race and racism as it relates to the HIV/AIDS pandemic: Remaking a Life by Celeste Watkins-Hayes, The Boundaries of Blackness by Cathy J. Cohen, America’s Hidden HIV Epidemic by Linda Villarosa, and The Marshall Project’s reporting on race. “The AIDS pandemic is not in the past,” he said. Globally, 74 million people have been infected with and 32 million people have died of HIV/AIDS. “We can learn a lot from the AIDS pandemic and the policies and tools used to address it.”