The Viral Underclass: The Human Toll When Inequality and Disease Collide

by Steven W. Thrasher

From preeminent LGBTQ scholar, social critic, and journalist Steven W. Thrasher comes a powerful and crucial exploration of one of the most pressing issues of our times: how viruses expose the fault lines of society.

Having spent a ground-breaking career studying the racialization, policing, and criminalization of HIV, Dr. Thrasher has come to understand a deeper truth at the heart of our society: that there are vast inequalities in who is able to survive viruses and that the ways in which viruses spread, kill, and take their toll are much more dependent on social structures than they are on biology alone.

Told through the heart-rending stories of friends, activists, and teachers navigating the novel coronavirus, HIV, and other viruses, Dr. Thrasher brings the reader with him as he delves into the viral underclass and lays bare its inner workings. In the tradition of Isabel Wilkerson’s Caste and Michelle Alexander’s The New Jim Crow, The Viral Underclass helps us understand the world more deeply by showing the fraught relationship between privilege and survival.

Genres: Nonfiction, Science, Politics, Health, History, Audiobook, Social Justice

Audiobook

First published August 2, 2022

Reviews

[Thomas · Rating 4 out of 5]

Passionate, well-researched, and well-argued book about how viruses intersect with social oppression to disproportionately affect marginalized communities, such as Black and Brown adults and LGBTQ+ individuals. I liked how Steven Thrasher did not pull back any punches and named topics like race, capitalism, and sexual orientation head-on. He mixes research with more personalized reporting and blends things like media analysis and anecdotes from his own life. He focuses on HIV and COVID and given that these are emotional topics, it makes sense that Thrasher occasionally shares his own emotions in this book. I also appreciated the direct activism and reporting he’s done for many causes, such as Michael Johnson’s harsh and unjust imprisonment for not disclosing his HIV status.

Though I recognize this book’s great value, I did find the quality of writing a bit uneven at times. And I think for those of us who work and research topics related to the intersection of health and social justice issues, some of this book may not feel particularly new for you. Still, I liked reading The Viral Underclass, which I picked up in large part because of Dr. Thrasher’s bomb Twitter account and vocal support for Palestine.

[Nathan Shuherk · Rating 5 out of 5]

Incredible. It’s beautiful, fascinating, and resonate.

[Robert Jr. · Rating 5 out of 5]

My blurb:

"I fully expected to encounter rigorous research and a full accounting of the relevant history in Dr. Steven W. Thrasher's The Viral Underclass: The Human Toll When Inequality and Disease Collide. But what excited me and kept me rapt the entire time was the astonishing level of craft and depth of compassion with which the book was written. More than just sets of facts, Dr. Thrasher illuminates truths, all of which implore us to live by the grandest, most liberating of all principles: love. The Viral Underclass is journalism and journey, science and sermon, astute articulation of grievance and pathway to healing. It is vital reading."

—Robert Jones, Jr., New York Times bestselling author of The Prophets

[liv ❁ · Rating 4 out of 5]

Focusing primarily on HIV/AIDS and COVID-19, Thrasher uses individual stories to explain the viral underclass through an empathetic, human lens. While I do wish this was a little more technical, The Viral Underclass is an excellent introduction into how policies in America (and around the world) are enacted to create a viral underclass, or a group of vulnerable people who are on the “front line” when facing viruses. This is an important read that summarizes how so many policies that affect poor people, queer people, people of color, and more are also used to ensure that those people, who are forgotten in an array of ways by the government, are the ones most likely to die. While I went in expecting a little more explanations (and range) of the viruses themselves, Thrasher makes the excellent point that viruses themselves do not discriminate; it is the policies themselves that create this underclass and the hyper-individualism that is prevalent in Western societies is only making it worse. Thrasher does an exemplary job humanizing concepts such as the “Patient Zero” idea and has tangible solutions for how to help, even if they are a bit broad, which makes sense as this is absolutely more of an introduction for the general people, but there are many starting points offered in the book for further research into tangible action plans. The audiobook, read by Dr. Jonathan M. Metzi, was also very well done, and I would recommend listening to it.

Thrasher’s own experience as a gay black man whose journalist work in the criminalization of marginalized groups with HIV/AIDS was a valuable asset and enhanced the book’s focus on only two viruses. His direct connection to the Michael Johnson, aka “Tiger Mandingo,” case and how his coverage of the case allowed the masses to bear witness and thereby help overturn the wrestler’s 30.5-year sentence for spreading AIDS in 2013 was a quite powerful addition, helping explain just how stigmatized (and punished) having AIDS, which is a now manageable disease, still is, especially for marginalized groups who too frequently end up the scapegoat.

[Traci Thomas · Rating 4 out of 5]

This book is really very good. I loved the ways Thrasher made me think about viruses. I loved how the book is structured. The ideas in here are 10/10 phenomenal. The only critique is that the writing was a little inconsistent.

[Mare · Rating 2 out of 5]

This would have been a great book if an editor had suggested "Take yourself out of the story." I began this book with the belief that Thrasher was an MD or epidemiologist. I noticed some sweeping hyperbolic statements and realized that no, he is a journalism professor. Ultimately, I wished that I was reading Thrasher's reporting on the criminalization of HIV and the "patient zero" way of thinking about viruses. He complicates and distracts by presenting every individual and relationship as how it relates to him. There's an uncomfortable messiah-bent in his reporting on trans death. I don't know how he starts a chapter on the horrific working conditions in chicken plants during COVID and ends up with vegetarianism and animal rights as his conclusion - your cousin's organic farm is not going to end the exploitation of undocumented workers. I really can't believe he compared his experience of a nurse assuming he would be college-aged based on his student insurance to trans people attempting to access medical care.
Skip this one and read Sarah Schulman's Let the Record Show and Shira Hassan's Saving Our Own Lives for a complex understanding of the early AIDs crisis and harm reduction, respectively.

[Sarah Schulman · Rating 5 out of 5]

A page turner. An intimate view of how stigma and class inequality produce suffering at the hands of our two emblematic viruses: Covid and HIV. Thrasher tells a complex story of social stratification and injustice through very well drawn portraits of individuals in his life and in the world. Moving and compelling.

[Grapie Deltaco · Rating 5 out of 5]

Eye-opening, wonderfully written, and deeply interesting from start to finish.

This book rewired the way I view viruses and epidemics and gave so much insight to various perspective throughout American history on how disease/viruses expose greater societal issues.

It also gives a fantastic breakdown on how dangerous individualism is and how viruses expose how the concept can never truly be reasonable to believe in. For better or worse, all living things are connected and together.


CW: discussions focusing on: racism, classism, slavery, homophobia, transphobia, death & dead loved ones, grief, human experimentation, forced sterilization, xenophobia, Sinophobia, addiction & drug abuse

[laurel [the suspected bibliophile] · Rating 5 out of 5]

Thrasher brings the receipts—the grim, ghastly receipts—on how inequality and disease collide to combine in horrific consequences. The rich and affluent will be relatively safe during disaster, but those living on the margins will suffer and have little to no safety net to fall back on beside their own community.

This is the toll capitalism requires.

This book rewired my brain in the best way, and I wish I had read it when it released.

[Amy Biggart · Rating 5 out of 5]

Rounding up, but this was excellent and an important read for understanding how viral disease disproportionately affects our most vulnerable and most discriminated against populations

[Sarah Cavar · Rating 4 out of 5]

This is a smart, timely, interesting book that moves easily between historical and contemporary narratives of HIV/AIDS advocacy and contemporary COVID advocacy in a discussion of organized abandonment under neoliberal health capitalism. I do think this book could have benefitted with more sustained engagement with scholarship in critical disability, Mad, queer/trans, and animal studies, particularly re: right-wing rhetorics of toxicity and contagion.

[Faith · Rating 1 out of 5]

Promising premise but really terrible execution. A good editor could have helped this book a lot. The author would present one idea and then jump to another. I felt like the author touched on way too many points and didn't have one, overarching thesis. Also, there were times when this book felt like a memoir and times when it felt more like a sociology book. I just wish the author had chosen one or the other instead of combining the two.

[Nidhi Shrivastava · Rating 5 out of 5]

Thank you Celadon Books (@CeladonBooks) and Dr. Steven W. Thrasher (@thrasherxy) for the e-arc of The Viral Underclass and my bookish friends for the hard copy of the arc!

Thoughts 💭: Pre-eminent LGBTQ scholar, social critic, and journalist Dr. Steven W. Thrasher explores the structural, racial, and classist inequalities as we continue to cope with the repercussions of Covid-19, the AIDS crisis, and death of George Flyod, which brought these issues to the forefront. Thrasher’s storytelling throughout this study is accessible, and asks us to reflect on how lives have transformed in the aftermath of the current times. The book is divided into 4 Acts: Blame, Law and Order, Social Death, and Reckoning. Thrasher weaves the narratives of friends, activist, and teachers navigating their intersectional identities as he argues the concept called “the viral underclass” as he contextualizes his own subjectivity within this conversation. He defines the term as the acknowledgment that viruses affect people as a whole and interact with power structures that exist within our society.

As the narrative unfolds, he presents the case of Michael Johnson, a man who was charged with spreading HIV and was later sentenced to 30 years to present the case for criminalization of AIDS. Moreover, he also links the exploration of these cases with capitalism and racism, and how they further perpetuate these inequalities. As a writer, it is clear that Thrasher has a wealth of knowledge that he imparts on the reader. This book should be required reading to get insights into the lives of people who have precarious identities, and is an eye-opening and thought provoking narrative that would make us aware of who we are and how we are privileged in many ways.

[Michelle Belmont · Rating 1 out of 5]

1.5/5

This book would be better as a collection of personal, memoir-style essays. Was way too personal (in my opinion) for a nonfiction book, and it only focused on a few stories. It was not at all what I was expecting based on the summary.

The viral underclass is an interesting topic in general. A lot of good points were brought up. However, it was more complaining than facts, and no real solutions were offered. Everything not involving the author’s (and his acquaintances) personal experiences was incredibly superficial.

If that’s what he wanted the book to be, that’s fine; the book should have been advertised as such.

[Alicia Kozak · Rating 2 out of 5]

Should have looked at this more closely. I thought this would be a technical, science-based book, focusing on the details of various viruses. Instead it's a social and political opinion on race and gender/sexuality, discussing only HIV and COVID. The book condemns generalizations and stereotypes, but I feel the author included some of his own assumptions. A lot is also based around New York, Chicago, and other large cities, disregarding the differences in small, rural areas, leaving it feeling unrelatable to me. A few interesting parts but overall not the book for me.

[Harold · Rating 1 out of 5]

This is a pure polemic. Written by a gay black man, his own life experience, and that of his friends is the only information or analysis he needs to describe the viral underclass — basically black and gay. Not the poor of South Africa or India. He does pay passing reference to the essential workers in America who have no real choice but to work in extremely dangerous conditions throughout Covid, but even that comes without data or much more background than you can find in a quick Google search.

And what is this book really about — to the extent it is more than a book long rant. The summary of one chapter says it all: “People who live with and die from viruses are not the parasites. The parasite is capitalism.” Yet capitalism is not the only boogeyman here. What he objects to are certain policies, which are not necessarily limited to capitalism. He wants to see a more egalitarian state — a worthwhile goal to be sure — without examining any of the costs or implications of the policies he tosses out like confetti.

This one isn’t worth reading.

[Dona's Books · Rating 5 out of 5]

Such an excellent read.

Review to come.

[Glenda Nelms · Rating 4 out of 5]

The Viral Underclass is about how stigma and class inequality create suffering at the hands of Covid and HIV. The book discusses social stratification and injustice. Dr Thrasher weaves his personal experiences and the stories of friends, teachers, activists into his research with humanity, compassion and optimism. Moving, timely and compelling book that everyone in the world should read.

[Jung · Rating 5 out of 5]

[5 stars] An investigative analysis of the social conditions that fueled the HIV and COVID-19 pandemics, through the lenses of race, gender, sexuality, disability, capitalism, criminalization, media literacy, and global austerity. There were a couple of books I read this year that made me think "I wish everyone could read this" and The Viral Underclass is definitely one of them. Dr. Steven Thrasher writes with a narrative journalistic style that drew me in to and broke down complex and layered ideas. The result is a compelling and sharp thesis that pushes readers to consider the lessons and legacies of the HIV and COVID-19 pandemics with a collective and population level approach that centers the needs and lives of the most marginalized and criminalized. I was challenged to reconsider my own understanding of global public health solutions in both pandemics, and really wish this book has existed when I was trying to articulate many of the book's foundational ideas as an anti-capitalist MPH student frustrated at the neoliberalism of the academy. Highly recommended to anyone still COVIDing wanting to feel less isolated in your frustrations, those in search of interdisciplinary root cause analyses, and disabled trans and queer kin everywhere who have lived the reality of we are the reason that we survive.

Goodreads Challenge 2023: 38/52
Book Riot Read Harder Challenge: QT and/or POC history
Nonfiction Challenge: history

[Leigh Kramer · Rating 5 out of 5]

“When we follow the virus—any virus, really—we follow the fault lines of our culture.” p. 5

An incredible undertaking. If you overlay a map of those most affected by COVID-19 and those most affected by HIV/AIDS, you’ll find a striking connection. Journalist and professor Steven Thrasher explores why marginalized communities are at a greater risk of being diagnosed and then surviving various viruses. The answer comes down to systemic issues like racism, capitalism, ableism, and the carceral state. With stories from past investigations and from his own life, Thrasher offers an empathetic holistic account of those hit the hardest. No one gets off scot-free, including politicians on both sides. Each chapter could have been expanded into a whole book and I hope we’ll get more examinations along these lines, perhaps with practical steps. We have so much more work to do.


Content notes: HIV/AIDS, COVID-19, disability, ableism, suicide, HBV, HCV, West Nile, influenza, smallpox, death of loved ones, death of author’s sister (cancer), anti-vaxers, STI stigma, victims of child survival sex, sex work, unsafe sex practices, racism, racial slur, xenophobia, homophobia, transphobia, officer-involved shootings and killing, police violence, police corruption, lynching, opioid epidemic, substance abuse, overdoses, incarceration, forced sterilization, medical abuse, enslavement, slaughterhouses, ageism, eugenics, homelessness, unstable childhood, poverty, capitalism, classism, casual acephobia (“sex is a necessary part of life”), anti-fat bias, ableist language

[Kristen · Rating 1 out of 5]

DNF. Stopped listening to the audiobook at 30%. The topic interests me, but the author wasn’t making his case, going off on tangents about personal stuff (his longtime crush that committed suicide) that he tried to relate to the topic at hand but was only speculation not supported by evidence.

Disappointing because I was looking forward to reading this, but I found it too annoying to finish.

[Kayli · Rating 4 out of 5]

A phenomenal and timely read about how systemic inequalities are blown wide open and exacerbated by viruses. Steven Thrasher uses real-life stories of those impacted by HIV stigma and draws the parallels with COVID-19. A large strength of this book is the accessibility of the text: the way it is structured and not laden with heavy jargon for a wide audience wanting to understand the intersections of societal inequalities (i.e.: over-criminalization, marginalization, racism, ableism). At the same time, he has incorporated many studies and references to scholars. As someone whose life has changed forever under Long Covid, this book was something I very much needed as I'm hyper-focused on studying ableism's persistence in society especially at this present moment.

Thrasher's overarching point throughout the book is how viruses are a "magnifier of the divisions already present in our world", showing us where the "cracks in our society are", disproportionately affecting a group termed "the viral underclass". Bodies belonging to the viral underclass are placed in disproportionate proximity to dangers of infection due to the structural design of society and its institutions.

"In other words, viruses interact with the power structures already at play in our society so that those who are already marginalized are left even more susceptible to danger, exacerbating existing social divides. But more important, of the variables in this equation, it is social structures that are the drivers, while viruses merely amplify."

(HIV) [or (SARS-CoV-2) or (HBV) or (HCV) or (H1N1)] + racism [or ableism, or sexism, or heterosexism, or capitalism] = a viral underclass

Through 12 chapters, Thrasher explores how the following social vectors "enable the relationship between viruses and marginalization": racism, individualized shame, capitalism, the law, austerity, borders, the liberal carceral state, unequal prophylaxis, ableism, speciesism, the myth of white immunity, and collective punishment. All of these are interconnected and exist outside of viruses, but with the addition of infectious diseases--create and sustain the viral underclass.

An important read for everyone.

[Emma Ann · Rating 3 out of 5]

For some reason, I was expecting a technical book heavy on numbers, but The Viral Underclass is very readable and human-focused—to the extent that sometimes I wished the book was written in a more objective style (but that’s probably a personal preference).

Dr. Thrasher’s main argument is that viruses and marginalized groups are locked together in a kind of cycle, which creates the “viral underclass”: Marginalized groups have less access to preventative measures, so they contract viruses more often and more severely, which in turn causes members of these groups to be labeled “dirty” and “unclean” and so on. As the back of the book puts it, “There are vast inequalities in who is able to survive viruses, and the ways in which viruses spread, kill, and take their toll are much more dependent on social structures than they are in biology alone.”

I don’t always agree with Thrasher’s suggestions for how we should fix the presence of the viral underclass, and sometimes I wished for additional citations for assumptions made in the text, but I find Thrasher’s arguments compelling and engaging nonetheless.

Thank you to Celadon for providing an ARC!

[Rickie Poole · Rating 5 out of 5]

Thrasher has dedicated years to studying viruses and how they interact within the societal and capitalistic structures in the US and across the world. While his main focus is on the HIV/AIDS crisis and COVID 19, the core of community and mutual aid that Thrasher advocates for is applicable to all viruses. This is not solely a book on theory, Thrasher writes about personal experiences and people in his life who were affected by these viruses and lived in the viral underclass. He breaks down the ideas of interconnectedness and how viruses move between people and societal structures by making this book about the humans who lives are the reality of the oppression of the viral underclass.
At its core this is was social justice theory is, it is the critique of current systems and the advocation of better systems to protect and nurture the flourishing of ALL lives.
Thrasher writes with such tender compassion that I found myself mourning the loss of the people he writes about, even though I had never met them and it had been years since their passing. I highly encourage everyone to pick up this book and spend some time with Thrasher’s words.


“Viruses offer us the chance to be interdependent rather than having to think we’re all independent, and that interdependence gives me hope.”

[Maddie · Rating 5 out of 5]

What an eye opening, deeply personal, and call to action this book was. The author invites you to learn about the systemic othering of the viral underclass through his lived experiences, research, and scientific fact. I’ve made notes to continue my learning on a number of things Guano, treatment of slaughterhouse employees, and the myth of white immunity.

[Tara · Rating 5 out of 5]

I think this might be might top nonfiction read of the year. It is so thorough, yet so personal and engaging, I highly recommend it. The audiobook is read by the author and though I would have preferred to have the physical book with me to highlight, it was a good audio listen- not too dense so it was easy to stay engaged and not get lost in the info.
The author ends the introduction of this by saying to get a box of tissues before continuing to read. And while this did make me very emotional, I was much more filled with rage throughout. Thrasher is a Black queer man and brings a unique perspective and I really appreciated how he shared his personal experiences throughout this book. Along with looking at virus' and stigma regarding COVID and AIDS in particular- the connection between the two is something queer folks have recognized, but not nearly enough- this book really drives home how the most marginalized with continue to bear the brunt of our failing public health system, AND how it so easily does not have to be this way- we have the means and often it would actually cost LESS. This is a political and social choice that people in power continue to make and we continue to support in order to maintain power and privileges. Drastic change is long overdue. Even if recognizing the connection between inequality and public health isn't a new concept to you, this is well worth your time. I look forward to reading more from the author.

[Cherry Anne · Rating 4 out of 5]

Yes yes yes yes so important

[Kelsey Baguinat · Rating 4 out of 5]

4.25

[Halye · Rating 2 out of 5]

The book wants to be a social, scientific nonfiction about inequality, poverty, racism and disease....but ends up just being a personal memoir about people the author knows who has died of disease who are part of one 'underclass' or another. It is heavily anectdotal, with little to no actual science or studies involved. Maybe if it had been honest about the kind of book it was I would have enjoyed it more, but as it is, I feel let down and disappointed. It was as hard hitting as a basic self help book, and as eye openeing as a buzzfeed article.

[Holly · Rating 5 out of 5]

Highly recommended read if you were affected by the COVID-19 pandemic, have ever been sick, interact with other people, or live in a broken capitalist system (read: everyone). A phenomenal look on who is actually most harmed by viruses and what living in a viral world looks like from our socioeconomic, cultural, & political landscape.