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Yuexuan Chen

Yuexuan Chen

Chen Chen is studying Public Policy and Biology with a Journalism Certificate. She is a science/environmental journalist with articles published in outlets such as Medscape Medical News, The Plain Dealer and the Third Polc. She is an Associate with Oxpeckers Investigative Environmental Journalism Network and the former Health/Science Editor at the Duke Chronicle through the spring Covid-19 outbreak. Her career interests lie in public health, infectious disease and communications. She plans on pursuing a Master of Public Health after graduating from Duke.

Honors Thesis:

Strategies for Infectious Disease Containment Based on Testing Fail High-Risk Subpopulations: Cultural Practices of Testing in TB, HIV and Covid-19 in the United States

Faculty Advisor: Professor Christopher Sims

Abstract: By looking at the tuberculosis (TB) and HIV epidemics in America in the 20th century, we find that containment strategies based on and built around testing fail to protect high-risk groups and stem transmission. Testing is culturally portrayed as a way to “behave” or be responsible during these infectious outbreaks. While necessary and important, testing rhetoric often places blame, empowerment and responsibility on individuals, neglecting the structural inequities and violence that put high-risk individuals at greater exposure. Works better for the privileged, mostly because they already have far more access to preventative measures and avoid those who are positive. In various socioeconomic and cultural ways, many people can’t afford to test positive. Groups that are at disproportionate risk for acquiring an infection often have barriers to equitable testing measures. Even when testing itself is equitable, outcomes for the burden of disease aren’t corrected as a result. Positive tests are already too late as those patients who already contracted the virus or bacteria, failing as a preventative measure. By comparing the rates of TB and HIV testing and infections rates in high-risk versus low risk groups from 1955 (for TB) and 1990 (for HIV) to 2019, we can analyze whether the burden of disease has shifted due to more equitable and available testing. Successful epidemic containment strategies in the US have taken into account cultural and socioeconomic differences for preventative measures along with provision and adherence to treatment. Not only does testing need to be implemented equitably, but also the results from testing must be used to improve upon those inequities.