Sprague Martinez Linda S, Scott Judith C, Rocco Melanie, Miranda Masill, Tucker Cynthia, Walter Angela Wangari
Linda S. Sprague Martinez and Melanie Rocco are with the Health Disparities Institute, University of Connecticut School of Medicine, UConn Health, Hartford, CT. Judith C. Scott is with the Boston University School of Social Work, Boston, MA. Masill Miranda is with AIDS United in Washington, DC. Cynthia Tucker is with the AIDS Foundation Chicago in Chicago, IL. Angela Wangari Walter is with the Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell.
Am J Public Health. 2025 Sep;115(9):1500-1507. doi: 10.2105/AJPH.2025.308138. Epub 2025 Jul 3.
In 2020, the Health Resources and Services Administration launched the first initiative focused on Black women in nearly 40 years of the HIV epidemic: the Black Women First initiative. A critical step toward advancing racial equity, the initiative addressed the health and social needs of diverse Black women in HIV care and treatment. In this essay, we posit that the disproportionate burden of HIV/AIDS experienced by Black women is rooted in racism, not race. Using critical reflexivity and the Public Health Critical Race praxis, we critically discuss the Black Women First initiative's framing and components, the factors contributing to successes and challenges, opportunities to deepen efforts, and recommendations to focus on dismantling racism in future efforts addressing care and treatment for Black women with HIV. We reflect on how racism was challenged through the involvement of Black women with lived experiences and racial justice organizations, although racism was not a focus of the initiative. Advancing the health of Black women with HIV needs a comprehensive and critical approach that addresses racism by changing intervention funding, service delivery, and the measurement of success. (. 2025;115(9):1500-1507. https://doi.org/10.2105/AJPH.2025.308138).
2020年，美国卫生资源与服务管理局发起了近40年来首个聚焦黑人女性的倡议：“黑人女性优先”倡议。这一倡议是推动种族平等的关键一步，它关注了接受艾滋病病毒护理和治疗的不同黑人女性的健康与社会需求。在本文中，我们认为黑人女性在艾滋病病毒/艾滋病方面承受的过重负担根源在于种族主义，而非种族。我们运用批判性反思和公共卫生批判种族实践，批判性地讨论了“黑人女性优先”倡议的框架与组成部分、促成成功与挑战的因素、深化努力的机会，以及在未来为感染艾滋病病毒的黑人女性提供护理和治疗的工作中专注于消除种族主义的建议。我们思考了尽管种族主义并非该倡议的重点，但通过有实际生活经历的黑人女性和种族正义组织的参与，种族主义是如何受到挑战的。促进感染艾滋病病毒的黑人女性的健康需要一种全面且批判性的方法，通过改变干预资金、服务提供和成功衡量标准来解决种族主义问题。（《美国公共卫生杂志》. 2025年；115(9):1500 - 1507. https://doi.org/10.2105/AJPH.2025.308138）
