Abstract：
In the U.S., inequities by race/ethnicity in health outcomes, such as in the HIV epidemic, are long standing but have come to the forefront during the COVID-19 pandemic. There is growing recognition of the role of structural racism in racialized health inequities, yet the conceptualization and operationalization of structural racism in HIV research lags. We conducted a scoping review of existing published literature, between 1999-April 2024, conceptualizing and measuring structural racism\'s impact among people living with or at risk for HIV in the U.S. Our initial search yielded 236 unique articles, which after title and abstract screening yielded ten articles meeting full text review criteria. We then extracted key parameters, such as conceptualization, method of measurement of structural racism, study aims, design, and findings. Three of the articles were qualitative studies that conceptualized structural racism using (1) the social network model, (2) individual and structural intersectionality and (3) critical race theory. Operationalization of structural racism within the seven quantitative studies fell into three categories: (1) structural level, (2) a scale of experiences of racism, including structural racism, and (3) using explanatory demographic factors as downstream measures of the effects of structural racism. The variance in the conceptualization and operationalization of structural racism highlights the different interpretations of structural racism in its applications to the field of HIV research. Given the vast racial/ethnic inequities in HIV, we propose three overarching suggestions for next steps in improving the conduct of research on structural racism in HIV: (1) we must prioritize measuring racism past the individual and interpersonal levels to consider systemic factors at a societal level that manifest as structural racism to improve HIV outcomes in the U.S., (2) consider intergenerational effects of structural racism through the use of longitudinal data, and (3) broaden the agenda of structural racism to incorporate other systems of oppression. Additionally, broadening the scope of funding and inclusion of more researchers and individuals with lived experiences to support structural racism research to drive the scientific agenda and design of structural-level interventions will not only bolster achieving the U.S. Ending the HIV Epidemic goals but will do so by addressing inequities.
摘要：
在美国,按种族/族裔划分的健康结果不平等，比如在艾滋病毒流行中，长期存在，但在COVID-19大流行期间已经走在了前列。人们越来越认识到结构性种族主义在种族化的健康不平等中的作用，然而，艾滋病毒研究中结构性种族主义的概念化和可操作性滞后。我们对现有的已发表文献进行了范围审查，在1999年至2024年4月之间，概念化和衡量结构性种族主义对美国艾滋病毒感染者或有艾滋病毒风险者的影响我们最初的搜索产生了236篇独特的文章，经过标题和摘要筛选，产生了十篇符合全文审查标准的文章。然后我们提取关键参数，比如概念化，结构性种族主义的测量方法，研究目的,设计,和发现。其中三篇文章是定性研究，使用(1)社会网络模型将结构性种族主义概念化，(2)个体和结构的交叉性和(3)批判种族理论。七个定量研究中的结构性种族主义的可操作性分为三类：（1）结构水平，(2)种族主义经历的规模，包括结构性种族主义,(3)使用解释性人口因素作为结构性种族主义影响的下游衡量标准。结构性种族主义的概念化和操作化的差异突出了结构性种族主义在艾滋病毒研究领域的应用中的不同解释。鉴于艾滋病毒存在着巨大的种族/族裔不平等现象，我们为改善艾滋病毒结构性种族主义研究的后续步骤提出了三项总体建议：（1）我们必须优先考虑个人和人际层面的种族主义，以考虑社会层面的系统性因素，这些因素表现为结构性种族主义，以改善艾滋病毒的结果在美国，(2)通过使用纵向数据来考虑结构性种族主义的代际效应，（3）扩大结构性种族主义的议程，以纳入其他压迫制度。此外,扩大资助范围，并纳入更多有经验的研究人员和个人，以支持结构性种族主义研究，以推动科学议程和结构性干预措施的设计，不仅有助于实现美国结束艾滋病毒流行的目标，而且将通过解决不平等现象来实现。
