LAUSR

The broad strokes of the recently released data from the United States Centers for Disease Control and Prevention paint a fairly optimistic image of HIV prevention and treatment efforts during the current age of undetectable status (Centers for Disease Control and Prevention, 2019a). Although rates of pre-exposure prophylaxis uptake are still suboptimal for at-risk populations, HIV infection rates have generally dropped, and groundbreaking research at the core of the U 5 U campaign has signified a change in perception regarding HIV treatment (Centers for Disease Control and Prevention, 2019a; Rodger et al., 2016; Siegler et al., 2018). Furthermore, although the number of countries that have reached the Joint United Nations Programme on HIV/AIDS 90-90-90 goals remains limited, these targets are within grasp in the United States (Hall et al., 2019). However, to achieve these goals, it is critical that improvements in early testing and linkingpersons to care be accelerated in respect to key populations, including individuals from diverse racial and ethnic communities, sexual minority men, transgender individuals, and the identified geographic locations in the Ending the Epidemicplan forAmerica (Centers forDiseaseControl and Prevention, 2019b; Hall et al., 2019; Joint United Nations Programme on HIV/AIDS, 2017). Not altogether unrelated, before the coronavirus disease (COVID-19) pandemic upended the lives of billions across the globe, it had been more than half a century since rates of unemployment in the United States were as low as those before March 2020 (Bureau of Labor Statistics, 2020a, 2020b). The Bureau of Labor Statistics reports that 2019 saw job growth totaling 2.1 million new jobs; President Trump has frequently taken to Twitter to tout the supposed strength of the formerly booming economy in his bid for reelection this year (Bureau of Labor Statistics, 2020a; Petri & Houston, 2020). Although his grandstanding may appear to be based on fact, the Federal Reserve slashed interest rates three times in 2019 and fiscal policies before the COVID-19 pandemic led to a near $1 trillion deficit, and recent legislative responses to the COVID-19 crisis itself may contribute to a projected deficit of more than $3.8 trillion in 2020 (Committee for a Responsible Federal Budget, 2020; Golle et al., 2020; Long & Stein, 2019; Smialek, 2019; U.S. Government Publishing Office, 2020). Although an economic recession was a concern for someAmericans beforeCOVID-19 swept the nation, it certainly has become top of mind for many during and after. As this is the case, questions should rightfully be raised regarding how the recession might affect the apparent progress made in HIV prevention and treatment in the United States since the epidemic began. Looking to the Great Recession of 2008 to project the effects of a recession in the 2020s is revealing. Notably, the social and geographic scope of the epidemic in the United States has changed. In 2008,HIVwas still widely considered an urban disease, and toward the end of 2009, the rate of those living with AIDS was highest in the Northeast (Centers for Disease Control and Prevention, 2012; Huang et al., 2015). The 2008 financial crisis resulted in 8.7% of those living in the Northeast unemployed, and swathes of those living with HIV were living in fear of losing access to antiretroviral therapies because of insurance loss and cuts to HIV-related assistance programs (Bureau of Labor Statistics, 2011). Yet, 51,000 jobs in health-related services in New York, for example, were actually added—with roughly 18,000 health care and education jobs created inNewYorkCity alone (Bureau of Labor Statistics, 2011; NewYork State Department of Labor Division of Research and Statistics, 2010; Joint United Nations Programme on HIV/ AIDS, 2009). In part, because of similarly sized investments in the creation of health care jobs nationally (with emphasis on urban areas), in the years following the 2008 recession (i.e., 2012–2016), HIV diagnoses in the Sponsorships or competing interests thatmaybe relevant to content are disclosed at the end of this article.