A fever has spread throughout Pose. As the last episode ends with a heartwarming feeling of love and hope, episode four gives viewers a dosage of a harsh reality. Sunday night’s (June 24) premiere presents three poignant issues that still affect the world and the LGBT community. There’s HIV, dangerous plastic surgery procedures and the fetishizing of a group of people for their bodies and/or ascribed sexual prowess. Now, the stakes are higher. As the AIDS plague ravished through the 80s, naïve young men like Damon often drown in their deadly ignorance.

And transgender women (who are referred to as transsexual) still continue to fight for a place in their world. Here's how these three conundrums are highlighted in this week's episode.

Curves, body image issues, and silicone injections: In the episode’s opener, Candy Abundance (Angelica Ross), is seen strutting her stuff at a ball, but is quickly ridiculed because of her thin frame. In her eyes, beauty is defined by possessing hip hugging curves paired with a small waist and thick attributes in all the right places. If she naturally had a voluptuous body, she feels she would pass more as a biological woman. It’s a battle most transgender women grapple with considering the way their gender identity is perceived can be lethal or lifesaving.

Ultimately, Candy resorts to getting silicone injections to make her backside grow and her curves outline her figure. The scene takes place in a grimy basement with a botched looking woman who claims she received the substance from a  black market in Honduras. The dangerous procedure has grown in popularity since the 80s. Pop-culture icons like Cardi B have openly admitted to getting butt injections in random houses before the fame; others have died from these surgeries, a fate that seems to knock on  Candy’s door.

HIV/AIDS scare and its harsh reality: At The New School For Dance, Damon randomly starts feeling dizzy and a fever coming on strong. Once home, Blanca questions him heavily about his recent sexual experiences with Ricky. He sheepishly admits that once a condom slipped during intercourse, but they’ve been using protection. The panic jumps at you from the television screen as Blanca assesses Damon’s symptoms: high fever, swollen glands, and nausea—all signs that could potentially mean anyone is HIV positive.

Blanca gets together with ball MC Pray Tell (Billy Porter) and discusses how naïve Damon and Ricky are to the virus that’s plaguing their world. A nostalgic image of the Twin Towers serves as their backdrop when the two meet up at the Christopher Street Pier. To put an end to the suspense, and serve as an educational opportunity for Damon, Pray Tell takes all the boys in Blanca’s house to get an HIV test. They all test negative—except for Pray Tell. He’s devastated, but unlike Blanca, he is not forthcoming about his diagnosis and tells the boys he also tested negative.

For Porter, being emotionally present in Pray Tell’s feelings came second nature because he lived through the harsh epidemic of that time period. “I lived it, so that part of the preparation is already done,” he told Variety. “There will be roles in my life that come later, that I have to dig deeper for things. But everything that I’m doing in this show is completely and totally in my wheelhouse.”

“I feel like I’m standing [up] for all of my friends who didn’t make it and whose stories were buried for so long,” he continued. “Their stories are getting told [now] and I’m one of the people who’s getting to tell them, and that means everything to me.”

The fetishizing of transgender women: Both Angel and Elektra Abundance have relationships with men who are fixated on their trans identity. Stan reveals to Angel that he once got an erection while flipping through a dirty magazine that featured transgender women and admitted his attraction because they still have a penis.

Angel is appalled and disgusted because she feels like an experiment; more so a subject of objectification instead of genuinely loved. Then in a heated bedroom scene, Elektra’s lover and financial support system brings up the action of oral sex and that he is not in favor of her gender reassignment surgery. Elektra’s battle comes in two ways: she wants the freedom of having the full anatomy of how she identifies sexually but also wants the financial power that comes with her relationship. Despite possibly missing out on her lavish lifestyle, she chooses to move forward and complete her transition.