To the Surface captures a unique group of people in the AIDS epidemic. Meredyth Wilson, the photographer, interviewer, and editor of this compilation, experienced something unique, powerful, and transforming through its creation. Her gift to us is her ability capture a group of young people living with HIV or AIDS who came together during a distinct time in the epidemic. Many of the experiences articulated here transcend issues specific to youth, to people living with a life threatening disease, to people of a specific gender, sexual orientation, or race. The issues that emerge are those of human nature and the ways that we express emotions of confusion, fear, joy, and hope, the ways that we, as humans, fight to survive and to live our lives each day.
To The Surface invites you to look into the faces of nine people living with HIV and AIDS, and to listen to their voices. Some speak in whispers and others in shouts. You will witness the way HIV took over some of these lives and completely consumed their present, past, and future. With a five-year span between the first interviews and the second, there is a rare opportunity to step back into the lives of these young adults to see how they have evolved. There is also the promise of further updates in 2005.
In the 1980's AIDS affected gay men and injection drug using communities first, fast, and hard, leaving them little time to bury their dead and figure out exactly what was happening. Ten years later the AIDS epidemic continued as more communities discovered Human Immunodeficiency Virus (HIV) within them. The community of youth was one of the last to be revealed. By the mid-1990's, a disconnection existed between what young people living with HIV needed and what providers were able to give. AIDS service providers who worked with adults did not understand the specific needs of adolescents. Youth service providers, on the other hand lacked knowledge when it came to dealing with issues surrounding HIV.
Bay Area Young Positives (BAY Positives) filled the gap between youth providers and AIDS providers. Two adult providers and one positive young person started BAY Positives in late 1989 as a support group for people 26 years and younger living with HIV; it was one of the first organizations of its kind. By 1992, a core of young people from the support group worked to establish the non-profit agency of BAY Positives, committing it "to provide peer based, peer run support services for young people 26 years and under to help them live longer, healthier and more productive lives." At age 25, I had the opportunity to serve as the founding executive director of BAY Positives and worked in that capacity for over three years.
In 1995, when Meredyth came to BAY Positives as an intern, we served over 200 young people through support groups, recreational activities, peer case management, and youth development. At that time in the epidemic in San Francisco, many of those accessing services were in their later teens and early twenties. Most had homes, but lived in chaotic and transient situations. About forty-five percent of our active members were African American, Latina/o, Asian Pacific Islander, Native American, and Multi-racial. Fifty-five percent were white. Twenty-five percent were young women of whom ninety percent had sex with men. About eighty percent of the young men had sex with men. Most of these young people became infected sexually, not through needle use. At this time in San Francisco, there were other cohorts of infected youth accessing services, specifically homeless, runaway youth who often engaged in survival sex (trading sex for food, shelter, money or drugs) and injection drug use. A number of other established organizations served this population and were able to support their homelessness along with HIV issues. In the rest of the United States, the youth epidemic was shifting to a different demographic: young women of color, especially African American young women and young men who have sex with men in the African American, Latino, API communities.
When Meredyth volunteered, she became my assistant and was a godsend. She was always ready to help with whatever needed to be done whether it was conducting grant research or licking stamps. The first month or so of her coming to the agency she was very quiet and shy. Eventually we ended up talking more and more. I got to learn about her life, and she learned about mine. This same process happened in the office with the other young people working there and our members. When she asked me if she could interview me and take some pictures I was excited to work with her. I had done many other photos, interviews, and videos, but I had never worked with someone who did not have a hidden agenda. Most interviews were done by people trying to convey a prevention message to other youth. They merely looked at surface issues. The media always wanted to answer the million-dollar question: "How do we get youth to be safe?" in one sentence or less. Meredyth took her time. I think my first interview with her took three hours, and that was just the beginning. Because I knew that I could trust Meredyth to look at the whole story, the context of what I had experienced, and I knew that she was complex enough to understand some of my contradictions; I was able to open up and be myself. The authenticity of these exchanges speaks not only to the honesty of the young people involved but also reflects the time, energy, caring, and honesty that Meredyth put into her relationships with those she interviewed. She listened to hours of our stories; she never wavered. She was always there, telling us she was with us, listening to what we needed to say.
It's now over nine years later and many changes have taken place. Many of us have grown up, and some of us died before we could grow up. The HIV epidemic has also changed. More and more, those who are infected with HIV are people who are low income, undereducated, undocumented, people of color, homeless people, people who have been abused sexually and/ or physically, people facing mental illness, and transgender people. Many of these individuals and communities are invisible to our society, and young people fall into all these categories. The present time also holds much more hope for those living with HIV who have access to medical care. Fewer and fewer people are dying from AIDS because of the improvements in care and the medications now available to treat the virus. Unfortunately not all of these resources are accessible to youth. The lack of insurance, financial stability, disclosure, ability to find youth-sensitive providers, and the adherence to complicated and stringent drug regimens are just a few of the challenges young people face.
For youth at risk, what we are finding today is that many do not have hope, or feel they have the power to live a life they find fulfilling. In regard to prevention work with youth, we are in a much more difficult place than ever before. We must answer more complex and diverse questions about why people put themselves at risk, why they do or do not get tested for HIV, and how people access medical services. In order to address these questions, we must develop more effective interventions than campaigns that exhort, "Use a Condom" or "Love Yourself." These provided simplistic fixes to complicated problems. How does a young woman who has been abused her whole life turn around and begin to protect herself when no one else has?
The stories contained here do more. They explore the innermost feelings of a group of people dealing with the life threatening disease HIV/AIDS. These are our stories, our contexts, and our lives, where we were then and where we are now. This work offers us hope, strength, a way to remember our losses, an acknowledgment of our humanity, and an opportunity to look at the individual faces behind an epidemic.
To the Surface is a testament to those young people living with HIV who have reached out to other young people for support, guidance, love, and fellowship. It acknowledges those young people who were there for their peers, when they faced their own difficulties, who reached their hand towards another young person, saying, "Come walk with me, you are not alone."
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