René Esparza on AIDS and Health Inequality in Urban History

Residential segregation based on racial and economic inequality is a pre-existing condition that exacerbates any transmissible health threat – from tuberculosis to COVID-19 to AIDS, the latter of which Faculty Fellow René Esparza is taking up in his new book project, “From Vice to Nice: Race, Sex, and the Gentrification of AIDS.” Weaving methodologies from medicine, geography and history to construct a case study in Minnesota’s Twin Cities of Minneapolis and St. Paul, Esparza, an assistant professor in the Department of Women, Gender and Sexuality Studies, exposes the enabling conditions of injustice and impoverishment that continue to catalyze ill health and disease — as well as collective remedies against them. Below, he gives us a preview of his book in progress.

Briefly, what is your book about?

“From Vice to Nice” rethinks the history of the U.S. AIDS epidemic in relation to the gentrification of central cities and its attendant system of residential segregation. It focuses on the spatial determinants of health to insist that the driving force behind the racial disparities of the U.S. AIDS epidemic have not been the deviant behaviors of LGBT people or people of color but rather the unequal living conditions in which these populations have been historically confined, conditions that become embodied as ill health and vulnerability to disease. 

I argue that real estate is crucial to understanding the story of the U.S. AIDS epidemic — on the one hand, how some LGBT leaders mobilized the private housing market as a protective shield against HIV, but only for those whose intimate relations upheld the monogamous, couple-centered household; on the other hand, how residential segregation created a welcoming set of socio-biological conditions for HIV to feely disperse among immunosuppressed communities. 

In a climate of structured impoverishment and compromised health, a viral infection like HIV found (and continues to find with COVID-19) the perfect host in racially segregated and economically divested neighborhoods. Through a case study of the Twin Cities of Minneapolis and St. Paul that widens our primarily bicoastal and metropolitan understanding of the U.S. AIDS epidemic, I uncover how access to the private housing market for certain gay men came to provide immunological safeguards at the expense of racialized others. These home-based LGBT responses to AIDS, I show, operated in the service of private development, helping to physically distance and, thus, spatially inoculate some gay men — those with racial and class mobility — from the racialized ecologies of urban abandonment through which the virus traveled.