Parallel Pandemics: AIDS and COVID-19 Health Inequities and Trauma

Overview: This paper explores long-term AIDS survivor and activist perspectives on the similarities and differences of the AIDS and COVID-19 pandemics. Lessons learned about health disparities, discrimination, and trauma are presented and implications for social work education, practice and research are discussed.Proposal text: Background
COVID-19 surfaced forty years after initial reports of a virus soon known as HIV. A growing body of research examines the stark similarities of the two pandemics such as the rapid spread of both viruses killing seemingly healthy individuals, slow government response, health disparities, and stigma. Although differences between the two viruses are also apparent, several authors suggest that lessons learned from AIDS can guide public response to COVID-19 and its aftermath (Arnold, 2021; Blight, 2020; Catlin, 2021). Our paper builds upon this through sharing the perspectives of 52 long-term AIDS survivors and/or activists on pandemic similarities, differences, and lessons learned.

Methods
Non-probability sampling recruited 52 individuals who completed semi-structured interviews in real time as the pandemic was unfolding. Initial interviews were held April - November 2020 with fifteen follow-up interviews in March and April 2021, when participants were receiving vaccines. All interviews occurred over zoom, were recorded, and transcribed. Thematic analysis reveals insights on AIDS/COVID similarities, differences and lessons learned.

Results
The 52 person sample represents eight countries with 61% identifying as Male, 31% Female and 8% Transgender. Participants reflect upon pandemic similarities of stigma and ‘othering’; health disparities; slow and inconsistent government response; and crushing fear and anxiety. Participants are quick to address vital differences between the two pandemics specific to stigma surrounding disease transmission. Since HIV is spread through bodily fluids and COVID-19 through breathing, the social shaming associated with HIV is not evidenced with COVID-19. Some participants link transmission differences and discrimination against communities most at risk with government response. The role of media and social isolation from support networks are also identified as chief differences in pandemic experiences. Traumatic memories from the 1980s and 1990s were triggered for all participants during COVID-19 shelter-in-place and many expressed anger over the lessons that could and should have been learned from the past.

Conclusions/Next Steps
AIDS activists and long-term survivors offer a unique window into post pandemic life. As COVID-19 continues to destabilize communities around the world, important lessons can be learned from these voices as we consider long-term emotional consequences. These data shed light on health disparities evident in both AIDS and COVID-19. Health disparities refer to a greater occurrence of diseases, such as HIV, in certain population groups. Forty years after the beginning of the AIDS pandemic, the COVID-19 re-introduces the depths at which these health disparities exist in the United States, presenting an opportunity to analyze the fundamental causes of these inequities and build interventions to close the health gap. Devastating experiences, bereavement, and stigma are just a few reasons the AIDS pandemic left millions with lifelong emotional trauma, more specifically PTSD (Tang et al., 2020). Some of the difficult experiences faced with HIV/AIDS are being confronted again during the COVID-19 pandemic. Examining the past and present through the lens of AIDS and COVID can help social workers disintegrate the health disparities amongst marginalized populations and lessen the emotional trauma shaped by a global health crisis.