The Positive Community/PLWA

ZEKE Magazine, Fall 2017

Social Documentary Network

John Rae has spent the last 15 years documenting the HIV/AIDS pandemic in developing countries throughout the world. He started his career as a commercial industrial photographer in NYC but found the work vacuous.

“I began to understand how photos and stories change the world,” Rae says. “I wanted in.”

For a decade and a half, Rae has been partnering with both NGOs and global partnerships such as The Global Fund to Fight AIDS, Tuberculosis, and Malaria to promote their messages and raise funds for the fight against HIV/AIDS. He has seen “big strides” in efforts to combat stigma and discrimination, and has watched HIV evolve from a death sentence to a manageable disease. He is inspired by the sacrifices of the people he has met through this work, and he calls these people his heroes. Says Rae: “My heroes do not assault mighty castles, or slay evil enemies. They do not amass mighty fortunes. They work on the front lines of health, education, and poverty to make each day a little better.”

Today, Rae is based in Montague, Massachusetts. However, his assignments often find him working in international locations with local activists and NGOs. While Rae claims that he is “not a photojournalist,” he does consider himself incredibly fortunate to do the work that he loves.

“I am an advocate for the causes I believe in,” he says. “It has been one of the greatest privileges of my life to walk among some of the bravest people who work on the front lines of the HIV/AIDS pandemic.”

Rae is the winner of ZEKE’s recent Call for Entries. He has received prizes in over 55 international photography contests.

—Emma Brown

Today, with access to proper healthcare, an HIV-positive diagnosis is no longer a death sentence.

There are approximately 37 million people living with HIV/AIDS worldwide (PLWA). That number has been steadily increasing over the past decade due to successful life-saving treatment for those affected. Today, with access to proper healthcare, an HIV-positive diagnosis is no longer a death sentence. Antiretroviral treatment (ART) can prevent the onset of AIDS and the transmission of HIV. When taken daily, HIV-positive individuals can expect to live just as long as their HIV-negative counterparts.

In the United States, ART is covered by most health insurance policies. But, around the world, access to these drugs can be limited and the cost can be prohibitive. Fortunately, there are many global organizations working tirelessly to provide communities with the resources they need to treat HIV/AIDS. Eleven of the 19.5 million people currently receiving treatment for HIV are doing so through programs supported by The Global Fund to Fight AIDS, Tuberculosis, and Malaria. And, in 2003, the United States Agency for International Development (USAID) began implementing PEPFAR, the United States President’s Emergency Plan for AIDS Relief.

“PEPFAR is the largest commitment by any nation to address a single disease in history,” says Irene Koek, USAID’s Acting Assistant Administrator for Global Health. Its efforts are primarily focused on saving lives and preventing the spread of the disease on the African continent. According to the World Health Organization, nearly one in every 25 adults in sub-Saharan Africa is living with HIV. This population alone accounts for two-thirds of the world’s PLWA.

In Mozambique, 13.2% of people aged 15-49 are HIV-positive. Rute Dos Santos, the Health and HIV Program Manager for Voluntary Service Overseas (VSO), works with PLWA in Manica and Maputo. Her organization helps equip communities with the knowledge and skills they need to lead healthy and productive lives. Part of this work is ensuring that their clients always have access to ART. “The drugs are free,” says Dos Santos, “and rarely out of stock.” However, the real challenge is keeping HIV-positive individuals on the medication. About a third of Mozambique’s infected population quits ART within the first year. Poverty is often to blame; Dos Santos explains that to challenge ART’s side effects, one has to have at least three meals a day and some patients need to travel more than 10 kilometers on foot to reach the nearest health facility.

The international response to the HIV/AIDS pandemic has been successful in saving lives and improving the quality of life for those affected. However, prevention efforts have yet to achieve similar progress. In 2016, there were more than two million new HIV infections around the globe. To curb the spread of the disease, scientists have developed new drugs to target HIV-negative individuals who may be at high risk of becoming infected. One such preventative medication is Truvada for PrEP, which has been shown to reduce transmission rates when used in combination with safe sex practices. Rodney Lofton, Deputy Director of Diversity Richmond, an organization that provides services and programming for the local LGBTQ community in Richmond, Virginia, has spent the past two decades educating communities about HIV. “As much as we talk about how many people are on PrEP, we need to increase accessibility to it. If we know that this is a drug that is going to dramatically decrease transmission rates, we need to make it more affordable and accessible to communities who may not be able to access it.”

In addition to poverty, stigma plays a major role in hindering prevention efforts and continues to influence who is more likely to become infected. Although HIV/AIDS affects people of all races, genders, sexualities, socioeconomic statuses, and geographic locations, it has been proven that disease risk does discriminate, and those at highest risk of becoming infected with HIV are often society’s most marginalized — the LGBTQ community, people of color, sex workers, and intravenous drug users. In 2015, the Centers for Disease Control and Prevention (CDC) reported that of the 32,000 new HIV diagnoses in the United States, 26,375 of them were acquired from male-to-male sexual contact. The CDC also estimates that one out of every two gay black men will become HIV-positive over the course of his lifetime.

In contrast, on a global scale, the face of HIV/AIDS is female. The majority (51%) of PLWA around the world are women. In low and middle-income countries, AIDS is the leading cause of death for women of childbearing age. Limited access to proper reproductive healthcare and a lack of education about safe sex practices are directly correlated to increased transmission rates.

In the global fight against HIV/AIDS, there are disparities in access to preventative care, education, and treatment, and the burden of the disease and its effects falls most heavily on the marginalized. Koek understands that to fight HIV/AIDS, it is imperative for agencies like USAID “to keep those who are most vulnerable at the center of our work.” To address these disparities, VSO in Mozambique often focuses its programming on young women and girls, encouraging youth to make healthy choices that will reduce their risk of early marriage, teen pregnancy, HIV, and STIs.

Dos Santos from VSO believes that education is imperative in preventing the spread and combating the stigmas of HIV/AIDS.

“We need to change our way of thinking and addressing PLWA and be able to explain to the communities what this disease is, what causes it, how it is transmitted, and prove that we can live positively with HIV.”

Much of this educational work is done by volunteers, activists, and PLWA themselves. Those who are affected or infected with HIV partner with local organizations to raise awareness and spread messages of prevention. They also participate in other important activities like peer support groups, where they can share experiences, improve self-esteem and coping skills, and support one another’s medication adherence and plans of care. Despite the challenges brought on by poverty and discrimination, Dos Santos is hopeful about the future of PLWA in Mozambique and around the world.

“PLWA in Mozambique are resilient to the challenges,” she says, and she trusts that those who are well-informed will continue to support others by providing information about HIV and improving access to necessary services.

For more information

The Global Fund to Fight AIDS, Tuberculosis, and Malaria

Diversity Richmond

United States President’s Emergency Plan for AIDS Relief

Voluntary Service Overseas

ZEKE is published by Social Documentary Network (SDN), an organization promoting visual storytelling about global themes. Started as a website in 2008, today SDN works with thousands of photographers around the world to tell important stories through the visual medium of photography and multimedia. Since 2008, SDN has featured more than 2,800 exhibits on its website and has had gallery exhibitions in major cities around the world. All the work featured in ZEKE first appeared on the SDN website,www.socialdocumentary.net.

Fall 2017 Vol. 3/No. 2

ZEKE

Executive Editor: Glenn Ruga
Editor: Barbara Ayotte

Social Documentary Network Advisory Committee

Barbara Ayotte, Medford, MA
Senior Director of Strategic
Communications
Management Sciences for Health

Lori Grinker, New York, NY
Independent Photographer and Educator

Catherine Karnow, San Francisco, CA
Independent Photographer and Educator

Ed Kashi, Montclair, NJ
Member of VII photo agency
Photographer, Filmmaker, Educator

Reza, Paris, France
Photographer and Humanist

Molly Roberts, Washington, DC
Senior Photography Editor, National Geographic

Jeffrey D. Smith, New York NY
Director, Contact Press Images

Jamey Stillings, Sante Fe, NM
Independent Photographer

Steve Walker, Danbury, CT
Consultant and Educator

Frank Ward, Williamsburg, MA
Photographer and Educator

Amy Yenkin, New York, NY
Independent Producer and Editor

ZEKE does not accept unsolicited submissions. To be considered for publication in ZEKE, submit your work to the SDN website either as a standard exhibit or a submission to a Call for Entries. Contributing photographers can choose to pay a fee for their work to be exhibited on SDN for a year or they can choose a free trial. Free trials have the same opportunity to be published in ZEKE as paid exhibits.

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Photographers and writers featured in this issue of ZEKE

Barbara Ayotte, U.S.
Emma Brown, U.S.
Caterina Clerici, U.S. and Italy
Catherine Karnow, U.S.
Monia Lippi, U.S.
Younes Mohammad, Iraq
John Rae, U.S.
Sascha Richter, Germany
Gabriel Romero, U.S.
Anne Sahler, Germany and Japan
Astrid Schulz, England
Mick Stetson, Japan
William Thatcher Dowell, U.S.
Quan Tran, U.S.
Frank Ward, U.S.

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Cover photo by Gabriel Romero from Liberation and Longing: The Battle for Mosul. A Peshmerga soldier in the Yazidi town of Bashiqa, Iraq.