Alabama, The United States of America
Alabama, a largely rural state, is in poor shape — literally. Its population of about 4,900,000, 68.4% white and 26.5% black, has a poverty rate of 17% (sixth highest in the US, and far above the national rate).
With poverty and racism it has huge health problems. All important STDs are highest among blacks and Hispanics.
14,653 persons were known to have HIV in 2018, 657 newly diagnosed — 13.4 per 100,000, but 36.7 per 100,000 for blacks. These are undercounts. Alabama provided medication for only 1,156 of them. Within the black community 51% of newly Hiv infections occur among men who have sex with men (MSM). Stigma against LGBTQ persons generally is high. Many of these individuals do not identify themselves as gay or bisexual.Young black males 15 to 29 years old have been identified as a high-risk group. Black females are approximately 9 times more likely to become infected with HIV than white females. The state began a social media campaign to raise HIV awareness and lower stigma which appears to have died in 2017. Public education in Alabama is poor.
“Freddie kept a lot hidden too.”
As an 8 year old child, Katie knew she was “different.” Born as a boy, she preferred to wear her sister’s clothes. “I have tried to suppress it all my life; that feeling of actually wanting to be a woman… a bisexual woman. It was my secret that I carried with me every day.” For a long time it was unthinkable for her to burden her family with this. That was just too much, too big.
Lots of drawing helped her, as well as listening to music by role models like Freddie Mercury, who also hid so much. It was only in 2000 when she heard that she was HIV positive that she dared to be open about everything. Then everything changed. She lost her job, her marriage broke up, she didn’t see her children for a long time … The U = U message that makes clear that if your virus is low (undetectable) you cannot infect other people was enormously liberating. From that moment on she started to believe in her future again.
Photo’s by Vincent van den Hoogen