Surviving two pandemics

“This pandemic takes me back to when I was diagnosed with HIV. What I went through trying to stay alive—and now all of a sudden COVID-19 comes.”

Nadine Ruff, a 34-year survivor of HIV, in this issue

As we move further into 2021, we catalogue the innumerable losses of this past year. As these words were being written, the U.S. surpassed 500,000 deaths from COVID-19—another new disease caused by another previously unknown virus, causing another pandemic that starkly reveals this society’s oldest ingrained disparities.

There has rightly been some recent focus in mainstream media on lessons embedded in the HIV response that can now inform a world upended by COVID-19. Particularly for those who witnessed the HIV epidemic unfold— including young long-term survivors who acquired HIV in infancy and have never known life without it—these are lessons wrought by trauma: Taking care of one another when the government abandons your community. Navigating intimacy, identity, and stigma. Learning everything about medications and prevention methods to potentially save your own life. Taking these actions amid a fog of unremitting loss and grief.

In the COVID-19 landscape there are numerous frontlines—spaces where the high impact of the disease and profound disregard for those affected often intersect. These spaces are hidden from popular view not just by the forced isolation of COVID-19, but by systemic bias and neglect by society at large. For example, COVID-19 has rampaged through incarcerated populations. Some social-distancing approaches have rendered people of trans experience more vulnerable to violence. Substance misuse has skyrocketed in self-isolation. The weathering effects of systemic racism and discrimination pave the way for health conditions like hypertension and other high-risk underlying conditions when paired with COVID-19. And our health care and social service systems still have yet to come up with innovative, creative, widely accessible programs to holistically support people aging with HIV.

In all these spaces we find long-term HIV survivors and older adults with HIV, enduring trauma and bringing hard-won resilience to bear in response to this new threat. While research shows that treated HIV by itself does not appear to equal heightened COVID-19 vulnerability, it is rare to find a person aging with HIV who is not also managing co-existing conditions, social determinants of health, systemic bias, or a combination of these. Part of our charge in the following pages is to bring some of those frontlines into clearer view.

This special issue is an offering from two aspiring allies/accomplices to long-term survivors and older adults living with HIV—a Black queer woman whose adult life has been shaped in connection with people surviving HIV over the long term, and a young person living with HIV who credits our community’s elders with having the privilege to think 20 years down the line to his 50th birthday. We are thankful to the visionary editors, writers, visual storytellers, and truth-tellers whose skills and insights made this project possible. We hope this collection contributes to ongoing conversations around how our people survive, thrive, and fight.

Yours with gratitude,

Giuli and Olivia

Giuli Alvarenga (he or they) is an award-winning writer who spends much of his time at the border in Tijuana working with asylum-seekers. This fall they are starting a graduate program in anthropology while finalizing their legal studies.

Olivia G. Ford (she or they) has worked in HIV-related media since 2007. She is a freelance editor/writer and editorial director for The Well Project, an online information and support resource serving a global audience of cis and trans women living with and affected by HIV.