The Lancet Series on HIV in the USA describes the current state of the nation's HIV epidemic, including ongoing inequities and challenges for key populations and comorbidities. [1][2][3][4][5][6] Black Americans have consistently shouldered many of these HIV inequities, a pattern also seen in the COVID-19 pandemic. The overlapping racial disparities related to COVID-19 and HIV 7,8 highlight lessons that policy makers, public health practitioners, providers, and communities can leverage in their strategies to eliminate the Same script, different viruses: HIV and COVID-19 in US Black communities in subgroups of patients including SMuRF-less patients and women is mandatory.However, the success of risk stratification and treatment depends on accurate diagnosis and identification of the underlying disease mechanisms. Several different disease mechanisms have been identified in STEMI. Atherosclerotic coronary artery occlusion is the most common finding in patients with STEMI. 1 However, in myocardial infarction with non-obstructive coronary arteries, which is particularly common in women, several other disease mechanisms have been identified. These include non-obstructive coronary artery atherosclerosis and plaque rupture, coronary artery embo lism, vasospasm, and spontaneous coronary artery dissection (SCAD). 11,12 In female patients with SCAD, Figtree and colleagues observed a lower 30-day mortality rate than for female patients without SCAD; however, SCAD is particularly common among young and middle-aged women (≤50 years) and associated with underlying systemic arteriopathy with a recurrence rate of 10-30% and a reduction in quality of life. 12 A further consideration is that Takotsubo cardiomyopathy or stress cardiomyopathy might mimic STEMI. 13 Therefore, a detailed assessment is indicated in select patients with STEMI, supplementing invasive coronary angiography with cardiac MRI, to exclude myocarditis and detect myocardial necrosis, and an intravascular assessment of coronary flow and structure, possibly also including functional testing. Such a comprehensive assessment would secure correct diagnosis, risk assessment, and treatment, particularly in women with STEMI and nonobstructive coronary arteries.Without consideration of risk, there cannot be gain, and thus new sex-specific risk factors and risk markers should be implemented in clinical risk models that can identify high-risk individuals among SMuRF-less patients with STEMI. Improvement in risk stratification and accurate diagnosis would help to tailor treatment in SMuRF-less patients, reducing the excess mortality and avoiding undertreatment in this subgroup.I declare no competing interests.