Steven W. Thrasher’s book review of “The Virus Underclass: Casualties When Inequality and Disease Collide”

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When Michael Johnson went on trial in Missouri in 2015, accused of “recklessly” infecting several other men with HIV, he embodied what the journalist Steven W. Thrasher described as “Virus Underclass”.

The young man has only one ally — his public defender — writes in a major new book, “The Viral Underclass: Human Casualties When Inequality and Disease Collide.” That lone backer was an overwhelmed and ill-prepared lawyer who falsely called Johnson a “guilty” charge in his address to potential jurors that could cost the 23-year-old for life jail.

For his part, prosecutors aggressively portrayed Johnson, one of a handful of black students at the suburban University in St. Louis where he and some of his accusers attended, as a public health threat. A jury found Johnson guilty under a 1988 state law that allows people with HIV who fail to disclose their identities to their sexual partners to face felony charges. The judge ultimately sentenced the young man to 30 years in prison — longer than the state’s average for second-degree murder.

As a reporter for outlets such as BuzzFeed, Thrasher has delved into Johnson’s case for years. In “The Viral Underclass,” the story provides a narrative for Thrasher’s argument through clues: The “isms” that define American life — racism, ableism, capitalism — not only cause some to suffer disproportionately and unnecessarily suffering, but has also led society to blame individual “bad guys” for the devastating toll of the virus. In other words, members of the viral underclass are not only most at risk of contracting diseases like HIV and covid-19, but are also disproportionately punished for doing so, a process that largely exempts the country from classist and racist policies and system.

Thrasher borrowed the term “viral underclass” from a 2011 statement by longtime pro-LGBTQ equality activist Sean Strub, which he coined as a way of acknowledging the discriminatory impact of legal sanctions and other HIV-related policies. The practice “leads to a viral underclass that is less empowered than others, especially when it comes to sexual expression,” Stroub wrote.

In expanding the scope of the concept, Thrasher shows that this logic can be self-reinforcing. For example, instead of fighting for a more affordable and equitable health care system that expands access to HIV medicines and significantly reduces the risk of transmission, we target lonely people like Johnson who face a variety of challenges, including in his case , dyslexia and financial hardship. In Thrasher’s account, Johnson becomes a scapegoat for society’s sins.

Stories of some brave, virus-stricken people living — and sometimes dying — on the fringes of society are at the heart of Thrasher’s book. It also includes Lorena Borjas, a leader of the transgender immigrant community in Queens, who has helped countless people, most of them transgender, deal with police harassment, sexual violence, homelessness, HIV infection and other health issues. Borjas, who was hit by the coronavirus early in the pandemic, refused to receive medical care from a system she knew posed a clear stigma and risk to trans people and Spanish speakers like her . Ultimately, she became so ill that she had no choice but to seek medical help. Her story tragically demonstrates how cruelty and injustice in our society can exacerbate individual vulnerability to disease over time – as we concentrate all the different forms of prevention or protection in the hands of some and others almost complete loss of life.

Thrasher, a professor of journalism at Northwestern University who focuses on LGBTQ research, noted that the U.S. response to the pandemic has been defined by the uneven acquisition of some of the best-known forms of protection: masks, drugs and vaccines. However, he points out, other forms are more diffuse and entrenched — and potentially more powerful. These include quality healthcare, stable housing, flexible work-from-home jobs, literacy and computer proficiency. “If they’re already considered a one-time thing, people in the U.S. don’t typically get preventive treatment,” he said. “Then when they’re infected with the virus, their diagnosis can marginalize them even more, if not. Untouchable words.” For example, the incidence of AIDS among the black population is alarmingly high.20 years after effective drugs became available, blacks had higher HIV per capita rates in 2015 than in the past once Thrasher points out that this is for white people. This is not only a direct consequence of unequal access to treatments, but also of all other factors, large and small, that prevent people from needing these treatments in the first place.

Thrasher builds most of the chapters around a theme—for example, the catastrophic effects of when white people think they are immune to disease, or have unequal access to protection—with anecdotes or personal stories. At times, the book feels like a pause between a memoir and a public health book. Still, the sometimes sprawling nature of storytelling, and Thrasher’s free acknowledgment and inclusion of many of his friends and colleagues (as well as his past journalism and relationships), ultimately serve one of his main points: that we are all More interconnected and interdependent than we usually realize.

However, I still want to go deeper in some places and take less detours in others to stay focused on what is freshest and most inspiring. For example, I can skip the plot of the 2019 Korean movie Parasite, which occupies most of his chapters on capitalism.

At the end of the day, the book is most popular when Thrasher shows, through numbers and people, how America’s various public health crises have exacerbated the viral underclass — and then, often blaming them for their own pain. To that end, Thrasher’s account of Johnson and Borjas’ story is particularly powerful. His example also illustrates how inequalities and public health issues often overlap during the Covid-19 pandemic — with devastating results. For example, he pointed to a report that found that, as of November 2020, 80 percent of those who died from COVID-19 at Texas correctional facilities were in pretrial detention and had not been convicted of the crime for which they were held. is convicted. I am eager for more of this original reporting and analysis.

Michael Johnson was released in 2019 after an appeals court found his preliminary trial unfair. However, real victories on behalf of the viral underclass are rare. Thrasher hints at how fast the lower classes are expanding — and indeed, how fast viruses can spread, especially as climate change increases the likelihood that new (or old) viruses will find homes in the human species. We are all more vulnerable and intertwined than we realize, he writes in an eloquent epilogue — that the line between the exposed underclass and those who think they are “immune” is as unstable as quicksand.

Casualties when inequality and disease collide

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