This article originally appeared on The Positive Women’s Network.

September 8, United States Conference on AIDS, 2017. Washington, D.C.: A study in Portland, Oregon, found that Black men wait 32% longer to cross the street than white men. Males in their 20s, identically dressed, had very distinct experiences: While the white men waited only 7.4 seconds to cross, Black men waited an average of 9.79 seconds for a driver to yield after signaling their intention to cross. Such an anecdote, at first glance, seems to have little to do with health care. Yet—as Dr. David Williams of Harvard University, the keynote speaker at the opening plenary of the 2017 U.S. Conference on AIDS (USCA), illustrated with diverse statistics—the overlap between structural racism that people of color, particularly Black people, face every day and significantly lower health outcomes is impossible to ignore. Even Black people with a college degree have a shorter life expectancy than white people without a high school diploma. When it comes to health disparities, there are systemic problems that run even deeper than the already very real and widely acknowledged problem of lack of access to poor and working class people.

Despite addressing different topics, the first two plenaries of the conference, as well as a number of panels and workshops, have been underpinned by a recurring theme: Access to health care alone is not the only cause of disparities in health outcomes, and increasing access will not eliminate the disparities in the absence of other interventions. If we truly hope to end the HIV epidemic in the U.S., we must address all the barriers to care—we must indeed make access to affordable, comprehensive health care available to all people, but we also must ensure that providers treat and support their patients in an affirming manner and spirit of cultural humility, that people living with and vulnerable to HIV see people who look like and can relate to them when they seek or are offered services, and we must make sure that interventions are appropriate to the populations they are hoping to reach.

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