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What we can learn from the history of HIV surveillance during the era of COVID-19

By Abdul-Aliy Muhammad

When COVID-19 hit the US with the first reported death in Washington on February 29, 2020, I knew we were in for a hellish situation that would affect Black and brown people the most. The percolating crises of mass incarceration, nutrition apartheid and environmental racism makes the possibility of overcoming a pandemic another fight for our lives. I also knew, as someone living with a virus, that a rush to criminalization would persist. 

When HIV activists fought on the frontlines for life saving care, the response was to link statutes that criminalize HIV to access of funding streams. This is what happened when the Ryan White Care Act was enacted in August 1990. The dying and sick had to reckon with their intimacy being policed as they fought to stay alive. Some HIV-specific legislation in states labeled non-disclosure as a misdemeanor or worse, a felony, and often require those found guilty to register as sex offenders. 


It is no shock that these statutes disproportionately impact Black and brown people living with HIV. Black people bear the brunt of structural violence in the United States, this is because of the legacy of slavery. There are added vulnerabilities when you are LGBTQ and that is linked to patriarchy. These systems impede our bodily sovereignty, displace us and deny us access to adequate and affirming care.   

COVID-19 is no different in the way it starts first with race based pathology and gender, with sexuality stereotypes following. In the case of HIV, it was those perniciously oversexual homosexuals that brought the disease onto themselves, and during this epidemic it’s those Black and brown people not taking care of themselves that lead to their vulnerability. Connecticut is suggesting reopening their economy with aggressive monitoring and globally many nations are putting in place laws that allow them unprecedented access to citizen data, including sensitive health information. According to OneZero, a Medium publication,  “The most common form of surveillance implemented to battle the pandemic is the use of smartphone location data,” and this is the tip of the proverbial iceberg.

Societal surveillance, or the watching and enumerating of data; the collection of footage and photos, as well as medical surveillance, the tracking of your viral genotype; the hunt for your intimate partners; the knock on your door for not being virally suppressed—are all tools of the police state. Both forms of surveillance are conduits of a white supremacist system. The construction of the “welfare queen” archetype of the 1970s served to position Black people as reliant on and exploitive of nutrition and income subsidies, but the truth has always been that the state is reliant and exploitive of our bodies and labor. However, this trope served to gin up the surveillance of our communities and cut out critical resources.

The two pathologies of surveillance are the assumption of the axiomatic criminality of Blackness and the second is paternalism. The first, to keep an eye on the suspicious and the second, to “help” the diseased or vulnerable. These race based notions of Law & Order and the idea that taking care of the poor, the Black and forgotten, means that power structures presume they are the ultimate decision-makers about our bodies. I often think of surveillance as someone who is medically surveilled. I think about the confinement and violence of being under the watchful eye of the law. I contend that the medical system is connected to the carceral state, often trading strategies and expertise with each other, and both seek to disempower the most impacted communities  by using data and histories to make the case for behavioral modification models or interventions. 

I protested Mazzoni Center a few years ago with a med strike. They were my medical provider at the time and had been called out for anti-Blackness and covering up sexual assault allegations. About two months later, the department of public health showed up to my house to police me about not making it to my last medical appointment. I was in the living room working with a friend as they knocked at my door. Luckily, this friend was aware of my status, but what would’ve happened if I had been with someone else? They didn’t call me or send a letter before escalating to direct contact.

Here is a perplexing irony: Nation states that can’t adequately respond to the coronavirus crisis, lacking health infrastructure and logistical capacity to deliver masks and other necessary supplies to those in need, are figuring out ways to issue warrants, incarcerate and track those infected or vulnerable to infection. It seems that most of the resources are invested in the carceral state and not the well-being of the population.  This doesn’t bode well for those deeply entrenched in poverty, like many Black and Brown communities are across America. Surveillance won’t turn the tide of this epidemic, it will target and blame people for their sickness, not pointing fingers to systems that ultimately are to blame for our collective demise.


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