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We are not all in this together. My 32-year history with the HIV/AIDS epidemic in the United States-initially as an HIV/AIDS policy analyst and now as an HIV-prevention researcher- has provided the dubitable opportunity to witness how adroitly deadly viruses spotlight fissures of structural inequality. In the late 1980s, \"changing face\" was the term often used to describe the epidemic's transition from one that affected predominantly White and class-privileged gay and bisexual men to one that exacted a disproportionate toll on people at the most marginalized demographic intersections: Black and Latinx gay and bisexual men, cisgender and transgender women, injection drug users, and poor people.The epidemic curve ofHIV/AIDS in the United States has now flattened, to use the parlance of the day, but not for people marginalized by intersections of racism, sexism, classism, and transphobia. An HIV vaccine still eludes us, but biomedical interventions such as preexposure prophylaxis effectively reduce HIV transmission. Alas, not for all. Black people are still less likely to have access to preexposure prophylaxis than are their White counterparts. Thus, COVID-19's arrival made me dread what its \"changing face\" might portend. Newspaper headlines swiftly affirmed the disproportionate impact of COVID-19 in Black and Navajo communities and issued ominous warnings about the pandemic's future in poor White rural communities.My irritation with the ubiquitous phrase \"We're all in this together\" quickly ensued. Although seemingly innocuous and often well intentioned, the phrase reflects an intersectional color and class blinding that functions to obscure the structural inequities that befall Black and other marginalized groups, who bear the harshest and most disproportionate brunt of anything negative or calamitous: HIV/AIDS, hypertension, poverty, diabetes, climate change disasters, unemployment, mass incarceration, and, now, COVID-19.

Intersectionality, an indispensable critical theoretical framework for public health,1,2 is ideally suited to address the current \"deadly confluence of health, economic, and racial crises\" (Poteat, p. 91). Aligned with my invocation of intersectionality to lambaste the \"We're all in this together\" tropes of the COVID-19 era,3 this special section affirms an essential need for \"an intersectional public health lens that . . . embrace[s] rather than obscure[s] the heterogeneity of people's lived experience\" (Elnaiem, p. 93; quote p. 94) with new public health crises such as COVID19, and ongoing ones such as police brutality and HIV/AIDS (Aguayo-Romero, p. 101; Elnaiem; Poteat). The section also ventures into uncharted terrains such as epigenetics (Zota and VanNoy, p. 104) and artificial intelligence (Bauer and Lizotte, p. 98), and highlights the conceptual and methodological challenges of intersectionality research from the perspective of a group of National Institutes of Health (NIH) extramural research administrators (Alvidrez et al., p. 95).Informed by Collins's conceptualization of intersectionality as a \"broadbased knowledge project\"-a field of study, an analytical strategy, and critical praxis4(p3)-I characterize intersectionality's inroads into public health and its potential for addressing public health crises as a series of overlapping waves. Wave 1 was and is definitional, focused on intersectionality's history, core tenets, and relevance to public health. Wave 2 reflects the mainstreaming and flattening of intersectionality as it travels through traditional research organizations such as the National Academy of Sciences (NAS) and NIH. Wave 3 is analytical, reflecting the theoretical application of intersectionality to current public health crises. In this editorial, I highlight how this special section spans these waves and preview a fourth wave essential to addressing and resolving the current spate of multiple and interlocking public health crises.

Intersectionality is a theoretical framework that posits that multiple social categories (e.g., race, ethnicity, gender, sexual orientation, socioeconomic status) intersect at the micro level of individual experience to reflect multiple interlocking systems of privilege and oppression at the macro, social-structural level (e.g., racism, sexism, heterosexism). Public health’s commitment to social justice makes it a natural fit with intersectionality’s focus on multiple historically oppressed populations. Yet despite a plethora of research focused on these populations, public health studies that reflect intersectionality in their theoretical frameworks, designs, analyses, or interpretations are rare. Accordingly, I describe the history and central tenets of intersectionality, address some theoretical and methodological challenges, and highlight the benefits of intersectionality for public health theory, research, and policy.

Audre Lorde’s provocative admonishment, “The master’s tools will never dismantle the master’s house,” is a fitting caution for Black and other scholars of color who seek to use traditional social and behavioral sciences research as a tool to achieve social justice and health equity in Black communities. Invoking Lorde, I use the “master’s tools” as a metaphor for conventional theoretical and methodological approaches and “dismantle the master’s house” as a metaphor for intersectional structures and systems of oppression that created and sustain health inequity in U.S. Black communities. Using a blend of personal narrative and insights from a 23-year career as a Black critical health equity researcher, I share 10 critical lessons for Black and other health equity researchers of color. And because the personal typically reflects the structural, I recommend system and structural-level mitigation strategies for departments, universities, extramural institutions (e.g., journals), and the government, for each critical lesson.

I commence with a confession. As compelling as I find the argument that stigma is a fundamental cause of health inequities,1 and as much as I believe (obviously) that intersectionality is an indispensable critical lens for health equity research,21 am not convinced that intersectional stigma is the right concept to advance more equitable HIV treatment and prevention outcomes. The incongruity of this confession is not lost on me. In addition to my role as a guest editor of this special supplement of AJPH, I am also a principal investigator of an intersectional stigma project funded by the same National Institute of Mental Health (NIMH)3 initiative that sourced this supplement. My primary opposition is that intersectional stigma, at least as currently conceptualized, obscures interlocking oppressive social-structural systems such as structural racism, sexism, and heterosexism (to name some) that more accurately explain why, four decades into the HIV/AIDS epidemic in the United States, we can foresee the end of the epidemic for relatively more privileged groups such as White sexual minority men but not Black and Latino sexual minority men or cisgender and transgender women.

Intersectional stigma and discrimination (ISD) pose critical barriers to HIV services and drive HIV inequities. This AJPH supplement represents a combination of research, theoretical articles, and community insights to move the field toward actions to reduce ISD. This focus builds on scholarship on stigma and HIV published in AJPH. In 1987, six years afterthe start of the US HIV epidemic, Kelly et al.1 used case vignettes in which patients were described as having either AIDS or leukemia and being either heterosexual or gay to measure physicians' stigma. They concluded, \"While some attitude negativity was anticipated, the strength and consistency of the stigmatization was disquieting.\"1(p790) Also, before intersectionality was explicitly discussed in the HIV field, researchers were documenting the impact of multiple forms of stigma among sexual minority men.2,3 AJPH has since published more than 800 articles addressing HIV and stigma,4 illustrating that HIV-related stigma remains a persistent challenge to ending the HIV epidemic.

Objectives. To examine negative police encounters and police avoidance as mediators of incarceration history and depressive symptoms among US Black men and to assess the role of unemployment as a moderator of these associations. Methods. Data were derived from the quantitative phase of Menhood, a 2015–2016 study based in Washington, DC. Participants were 891 Black men, 18 to 44 years of age, who completed computer surveys. We used moderated mediation to test the study’s conceptual model. Results. The results showed significant indirect effects of incarceration history on depressive symptoms via negative police encounters and police avoidance. Unemployment moderated the indirect effect via police avoidance. Participants with a history of incarceration who were unemployed reported significantly higher police avoidance and, in turn, higher depressive symptoms. Moderation of unemployment on the indirect effect via negative police encounters was not significant. Conclusions. There is a critical need to broaden research on the health impact of mass incarceration to include other aspects of criminal justice involvement (e.g., negative police encounters and police avoidance) that negatively affect Black men’s mental health.

Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with this premise, I address four themes in this commentary. First, I criticize the ubiquitous and uncritical use of the term health disparities in U.S. public health. Next, I advocate for the increased use of qualitative methodologies—namely, photovoice and critical ethnography—that, pursuant to critical approaches, prioritize dismantling social–structural inequities as a prerequisite to health equity. Thereafter, I discuss epistemological stance and its influence on all aspects of the research process. Finally, I highlight my critical discourse analysis HIV prevention research based on individual interviews and focus groups with Black men, as an example of a critical health equity research approach.

Freedom to access federal public health data and resources, conduct federally funded research, and publish it have all been disrupted by a flurry of authoritarian and ideological executive orders. In 2019, when I assumed editorship of this laudable section, I defined critical perspectives as those that \"interrogate, expose, and challenge assumptions about policies, institutions, and practices that obscure power relations that foster inequality and oppression and conceal how dominant groups construct knowledge, facts, and problems. the new administration erase public health data and resources, particularly those relevant to gender, racial group, sexual and gender minority status, and disability; diversity, equity, and inclusion; and health equity, all underscore author Linda Tuhiwai Smith's observation that \"research exists within a system of power 226) This current torrent of abuse of power on public health science is extreme. In their quest to make novel and transformative contributions to advance public health and reduce health inequities, critical researchers engage these types of questions about power and research.

First microbicide development lagged, and then the microbicide clinical trials failed. Fast forwarding to 2025 and giving a nod to Randy Shilts's The Band Plays On\" single-axis research informs us that although РгЕР is highly effective for preventing HIV, \"women and racial/ethnic minorities\"\" are less likely to know about it, take it, or have a health care provider discuss or prescribe it compared with their White counterparts. By contrast, historically privileged groups-free of concerns about access to HIV prevention and treatment care and resources; whether their realities and needs will be prioritized in HIV research, policy, and interventions; and stigmatizing and discriminating health care providers-enjoy multiple opportunities to prevent HIV or, if diagnosed, suppress the virus. Among them are the prioritization of funding for HIV research and interventions, HIV support and care services, and PrEP education and marketing for White gay and bisexual men, but not Black women, as well as health care providers' decisions to let gendered racist stereotypes about Black women's presumed \"promiscuity\" or medication adherence govern medical decisions about who is PrEP worthy.