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Special Issue of AJPH Fills Gaps in HIV Research

Date: Jun 20 2023


Contact: APHA Media Relations 

For decades, the ways in which multilevel racism, stigma and discrimination affect the health of Black Americans has been underexamined. To confront this gap in academic work, the American Journal of Public Health in collaboration with the UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP) have produced a series of qualitative studies that outline the separate links between trauma, substance use and HIV.

While systemic inequities and racial trauma are currently at the forefront of cultural scrutiny, many of the academic articles being written do not center structural racism’s effect on the health of historically oppressed people. This issue of the journal examines how structural racism and intergenerational trauma are embodied for racialized U.S. communities, resulting in disproportionate rates of HIV and substance abuse through primarily individual-level processes. The articles center the perspectives of researchers and research subjects that have been kept out of mainstream science for years in a revolutionary new capacity.

“We did not teach these researchers about this concept. We never told them that there is inequity and disparities that can have a rippling effect on the health of people of color. They came into this knowing because, as people of color, they lived it,” said HA-STTP program co-founder, Dr. Norweeta Milburn. “What we taught them was how to document it. How to study it. This is not the discovery of this information’s existence, but an acknowledgment of it within a community that has historically kept the perspectives of non-white scientists out of its mainstream.”

The studies published in the supplement show:

  • The disproportionately higher rates of sexual violence, physical assault, unemployment, housing insecurity and incarceration in Black and Brown transgender and nonbinary people have a significant health impact, leading to increased risk for depression, anxiety, suicidality, substance use disorder and HIV (Berke and Collins).
  • How some adverse childhood experiences (ACEs), which are already known to affect individuals’ health throughout their lifetimes, are rooted in structural racism and discrimination (Zhen-Duan et al.).
  • New approaches in public health teaching, training, interventions and programs to address racial disparities (Bernard).
  • How the transition to digital platforms in health care can improve continuity of care but may widen existing health disparities due to digital barriers, and how that effects people with HIV, specifically during the COVID-19 pandemic (Loeb et al.).
  • The ways that structural racism and racial trauma contribute to racial disparities in HIV-related outcomes among African Americans—including how the War on Drug’s policies disproportionately targeted people of color, directly leading to disrupted sexual networks that increased HIV risk (Burton et al.).
  • Outlines transformative solutions for improving public health that are valuable for policymakers, healthcare professionals and community organizations.

These articles showcase in-depth interviews and observations that are essential for capturing the nuanced experiences of individuals and communities affected by these intersecting issues so that new, revolutionary insights in this work can be documented.

“Science is more than just randomized control trials. We need to move beyond a cookie-cutter, one-size-fits-all approach. Our research needs to be culturally humble and congruent,” said HA-STTP program co-founder, Dr. Gail Wyatt. “This journal consists of truths, scientifically proven. This is a scientific acknowledgement that moves us closer to a society that prioritizes empathy, cultural humility and social justice.”

Public health cannot properly assist communities or the members inside of them without first dismantling structural racism and interlocking structural heterosexism, sexism and cisgenderism. The special AJPH supplement, HIV, Substance Use and Trauma: Mentoring to Dismantle Structural Racism, is uncovering suppressed narratives, exploring complex social dynamics, and developing a deeper understanding of these critical topics. It is currently available online. To request a full copy of a study or for information on scheduling interviews, contact APHA Media Relations.



Funding for the research and related work in this special issue was supported by a grant from the National Institute on Drug Abuse, R25 DA035692.


The UCLA HIV/AIDS, Substance Abuse, and Trauma Training Program (HA-STTP) is a multi-disciplinary, state-of-the-art training and mentoring program meant to better equip early career investigators to advance research on health equity and submit and receive NIH grant funding to support their efforts to disrupt racist structures and practices that undermine public health.


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