When we bring together trans and HIV/AIDS, what are we trying to know, and what are we trying to do with that knowledge? In this essay the author argues that antiblack racism is the nexus for critically thinking the epidemiology of trans and HIV/AIDS, not simply black trans people's disparate suffering. Antiblackness has been paradigmatic and fundamental to the structural relations of domination and violence that have organized both group vulnerability to exposure to HIV and the ecologies of human susceptibility to illness and disease through which HIV has dispersed historically. Thus, within the public-health surveillance category “transgender,” racial disparities in HIV prevalence and incidence rates point toward the true paradigm for thinking HIV/AIDS as an epidemic and the enfoldment of trans people within it.

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