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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

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Joseph R. Barndt


Persons with far more expertise about HIV/AIDS than this writer have documented the ways in which national and global efforts to understand, prevent, treat, and find a cure for HIV/AIDS are persistently affected by racism. We know, for example, that information about HIV/AIDS is more readily accessible in white communities than 'in communities of color; that treatment is less available to Persons of Color with HIV than white males; that within the AIDS activism movement, voice, access and power is in the hands of white activists while the voices and concerns of Persons of Color with HIV and AIDS have gone virtually unheard and unheeded.

From the perspective of this writer, it requires serious denial to avoid the conclusion that racism and AIDS are intimately interrelated- However, it is not nearly as easy to comprehend how or why this reality exists and will not easily disappear. I believe the problem is not due to our failure to understand H1V/AIDS so much as our failure to understand racism. Thus, any attempts to understand how and why racism profoundly affects efforts to understand, prevent, treat, and find a cure for HIV/AIDS must begin with some basic presuppositions about racism.


Following are three brief statements of presuppositions about racism that need to be explored before applying them to the issue of HIV/AIDS. The brevity of these statements do not include in-depth explanations, nor assume agreement of disagreement by the reader, but are intended to suggest premises for exploring the interrelationship between racism and HIV/AIDS.

I) Racism is a systemic issue, more than personal and relational. Contrary to the assumptions of most white people, racism is not simply an individual, relational, or attitudinal issue, perpetuated by intentionally prejudiced or bigoted persons. Rather, racism is a systemic, institutional issue and is not even necessarily correlated to conscious intentionally. People of Color (African Americans, Native Americans, Latinos/as Asian Americans, Pacific Islanders, Arab Americans) are not hurt by white individuals as much as they are hurt by white institutions.

Thus, the exploration of the interrelationship of racism and AIDS should not just pursue individual and purposeful acts of discrimination, but the underlying systemic reality of institutionalized racism.

2) The end goal of racism is white power and privilege. Systemic racism can not be understood simply by measuring its detriments, effects on People of Color, but rather how much it helps, benefits and empowers the white society. Hurting People of Color is not the end goal, bit is rather a consequence of racism. This is the "Big Secret" about racism that the white community pretends not to know: that racism's essential purpose is white power and privilege. By focusing on the how racism hurts of People of Color, we cover up the real reason that racism exists and persists.

Thus, to explore and understand the interrelationship of racism and AIDS requires not only measuring how People of Color are systemically excluded, but also measuring haw the preferential inclusion of white people as a racial group is systemically preserved and maintained.

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3) Racism is preserved in the roots of every US institution. Racism is like a weed that thrives in its roots even after the visible plant is tom from the ground. Systemic racism continues because of institutionalized infrastructures rooted in the past. Every system and institution in the United States was intentionally created and structured to serve the white society exclusively. Eradicating the visible evidence of discrimination without dealing with its underlying causes only guarantees that racism will reinvent itself in forms that are more subtle, sophisticated and destructive than ever.

Thus, the exploration of the interrelationship of race and AIDS requires not only analyzing more recently developed systemic efforts to understand, prevent, treat and cure HIV/AIDS, but the historic roots of racism in the healthcare system of which HIV/AIDS care is apart. The problem is not simply the interrelationship of racism and AIDS, but that People of Color are now and have always been disproportionately without access to, resources from, and control over every aspect related to a just and affordable health care system.


Of course, tile above premises must be more deeply explored and tested, which is unfortunately not within the purview of this brief article. However, to the degree these promises are valid, it is possible to conclude that if we are to effectively address racism while simultaneously addressing MV/AIDS, there must be an approach on two fronts.

The first is to continue and increase efforts to confront and eliminate discriminatory practices at every opportunity. While struggling on a daily basis to transform the way AIDS work is carried out, it is imperative that we do so with an understanding and analysis of racism. We must work in ways which understand and challenge the ways treatment, research, education and activism are designed to serve white privilege and result in detrimental effects on Communities of Color in general, and *in particular Persons of Color with HIV and AIDS. We need to work on a daily basis to correct daily discrimination in the policies, practices, and programs 'in the cure and prevention of HIV/AIDS. However, to do this alone is to continue pulling up weeds without getting at their roots. Systemic racism must also be addressed at its foundations. Fundamental change in the cure and treatment of HIV/AIDS is interdependent with - and cannot be separated from - the struggle to transform the racism of the entire health care system and the white power and privilege which is embedded in its origins, its Mission and purpose and its historic structures.

If those who are addressing HIV/AIDS do not adopt an anti-racist understanding and strategies in all of their work, including toward the entire health care system, then it is inevitable that efforts to understand, prevent, treat and discover a cure for HIV/AIDS will continue to be racist. This statement is, in fact, applicable to all struggles for justice that seek to cross racial lines: if they are not addressed from an anti-racist perspective, the results will inevitable be racist.

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The Civil Rights Movement created a revolution of expectations in the United States. However, many of us live with the daily frustration that forty years later these expectations have yet not been implemented. The cause of this frustration is, to a great extent, due to our failure to eliminate systemic racism. Our institutions have not yet been equipped to carry out these expectations; they have not yet been enabled to transform structures that were designed for the benefit of white society.

The late nineties and beginning years of the next century are a special moment in time of both crisis and opportunity. The crisis is evident in the frustration and the realization of our failure to implement the expectations of the Civil Rights Movement. The opportunity is the realization of the possibility of fundamental systemic and institutional transformation by equipping our systems and institutions to be anti-racist at the very core of their being.

Can we begin to realize that this time of crisis and opportunity is fertile for the shaping of anti-racist HIV/AIDS work?