Since its first diagnosis in 1981 in the United States, and having escalated into public consciousness by the ‘4H’ moniker – Homosexuals, Heroin addicts, Hemophiliacs, and Haitians, those considered the most at-risk groups – HIV/AIDS emerged as a new urban mode that overflowed and reinvented the limits of buildings, cities, frontiers, and communities. HIV/AIDS carriers embodied the regulations on borders and international mobility agreements through their treatments and through the epidemic itself. Both ideas affected, in particular, Haitians. Access for Haitians to the American healthcare system was predominantly difficult since they could not obtain legal immigration status in the early 1980s. Bellevue Hospital in New York City was one of the few medical facilities that attended this transnational community during the HIV/AIDS crisis. Known as “Biohazard Architecture”, the architectural configuration of Bellevue Hospital is particularly important, as it closely relates to the definition of HIV/AIDS carriers’ identity, in particular the Haitian diaspora in New York.
Bellevue improvised spatial solutions to confine HIV/AIDS patients. These policies stated that HIV/AIDS patients could not be admitted to shared rooms, and that they had to be held in the ER when the limited number of isolation rooms filled up. The containment policy was approved in part because applications for residencies from top medical schools had lagged. The result was the building of different entrances for med applicants and for patients, with the latter architecture organised through other regimes of circulation – all of which created an urbanism based on epidemiology, and infection as a state-making practice.