Health Equity

COVID-19-Related Xenophobia, Racism, and Stigma

NASTAD recognizes and condemns the recent uptick in xenophobic and racist attacks towards Asian American communities that has arisen as a result of this pandemic. We echo Jeffrey Caballero, the Executive Director of the Association of Asian Pacific Community Health Organizations, in the Joint Statement of Asian American and Pacific Islander Leaders and Over 260 Civil Rights Organizations Call on Congress to Denounce Anti-Asian Racism around COVID-19 in strongly condemning incidents of anti-Asian racism:

This is a global emergency that should be met with both urgency and also cultural awareness that COVID-19 is not isolated to a single ethnic population. Xenophobic attacks and discrimination towards Asian American communities are unacceptable and will not make our families safer or healthier.

NASTAD acknowledges that pandemics further exacerbate social prejudices, such as xenophobia, racism, and stigma, which target historically marginalized groups. This rhetoric further perpetuates the health inequities and disparities faced by people placed at risk, including people living with HIV and/or viral hepatitis, and people who use drugs, therefore NASTAD will continue to disseminate accurate and culturally responsive information.

Incarcerated Individuals and COVID-19

Correctional and detention facilities present unique challenges for control of COVID-19 transmission among incarcerated/detained persons, staff, and visitors. Consistent application of specific preparation, prevention, and management measures can help reduce the risk of transmission and severe disease from COVID-19. The following resources are available regarding COVID-19 prevention and control in correctional facilities and prisons:

Nondiscrimination in Access to Ventilators and other Medical Interventions

NASTAD encourages health departments and public health systems to ensure nondiscrimination in access to critical medical care, services, and equipment, particularly for people living with HIV, viral hepatitis, and those who use drugs.

In response to concerns that people living with HIV may not receive the same COVID-19 care as those in the general population, notably denial of access to a ventilator if a hospital needs to ration critical care, IDSA and HIVMA have updated their COVID-19: Special Considerations for People Living with HIV resource stressing that people living with HIV have a normal life expectancy and:

  • HIV status should not be a factor in medical decision-making regarding lifesaving intervention decisions (for example, ventilation) or enrollment into clinical trials, and
  • care and treatment for COVID-19 in people living with HIV should follow the same protocols advised for patients without HIV.

Additionally, the HHS Interim Guidance on COVID-19 and Persons with HIV emphasizes the following in its introduction:

People with HIV who have COVID-19 have an excellent prognosis, and they should be clinically managed the same as persons in the general population with COVID-19, including when making medical care triage determinations.

Many jurisdictions have adopted guidelines on the ethical allocations of health care resources during pandemics. These include the New York State Department of Health Ventilator Allocation Guidelines, which call for the use of a triage officer or triage committee, the application of evidence-based exclusion criteria, and assessments of mortality risk using the Sequential Organ Failure Assessment (SOFA) score, to determine priority for initiating ventilation.