Tim Barrus in the New York Times
HIV clinics, here in Appalachia, often have no doctors on the premises. Doctors are expensive and are seen as a luxury. On a good day.
These are not good days. It feels like the 1980s all over again. With HIV, your health is inherently precarious, and when the systems that are designed (badly) to keep a patient’s viral load undetectable, such as clinic labs staffed by people who cannot make it unless they have two jobs, one of those jobs now typically gone, the camel’s back is overloaded with straws, and its beginning to break.
Such lab technicians need more money. Doctors who are willing to treat fragile immune systems, should be paid more. Janitors who mop floors should be compensated at higher rates. We need to attract people in public health who have the ability to confront state public health systems designed around paradigms that leave rural people out who can’t even get to clinics, and whose communities have closed hospital systems who have all moved to treat urban populations. Health care in rural America is devastated. Health care in urban America is devastated. Health care in HIV America is a taut string that snaps in two all the time.
It’s extremely hard to not feel like America simply does not care. There is no evidence that America cares for its minorities who have been assaulted by homelessness and stigma. It is extremely hard to imagine an America that will refuse to project that stigma to people exposed to coronavirus. Stigma is our immoveable legacy.