How Rural Kentucky HIV Care Saved Nathan Wilson
He was an HIV patient in Rural Kentucky. Now he helps run the nonprofit that saved his life. Nathan Wilson is on a mission to fight against the stigma of living with HIV in Kentucky and beyond.
Before Nathan Wilson worked at HIV health nonprofit Matthew25, he was a patient. He was a convicted felon and was in active addiction for more than a decade. Now, Wilson oversees patient experiences as the facilities and project manager for the organization. He serves the same rural Kentucky communities where he once struggled to find care himself.
Matthew25, which celebrates its 30th anniversary this year, works with those living with, at risk of, or affected by HIV and other sexually transmitted infections. With four clinics across Southern Indiana and Western Kentucky, the organization serves 25 counties in Kentucky and 12 in Indiana.
Wilson became a patient with Matthew25 in 2019. He found out he was living with HIV while at a Suboxone clinic. He recalls being told: “Hey, your blood test shows this. You should probably reach out to these people.”
He admits that he wasn’t the best patient at Matthew25 in the first year, but the workers at the organization were patient with him. He made up for it, and four years later, he began working at the nonprofit, first as a driver, transporting patients to appointments and then working the group’s food pantry. He now oversees facilities operations for all four of Matthew25’s clinics.
“Matthew 25 has changed my life since day one — not only changed it, but saved it,” Wilson says. He said the organization fought for him to get his HIV medications when he was incarcerated. While the group didn’t succeed, the fact that they worked hard to help him had an effect on Wilson.
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When he first started working at Matthew25, he wasn’t sure he was “a healthcare facility would hire somebody” like him.
But now he sees his various roles with the group as a full-circle moment.
“I spent every day on the road with patients — young, old, different ethnicities, different backgrounds — and it changed my view of how broadly HIV affects people,” Wilson says. “It also broke down a lot of barriers between me and patients, because I am one of them.”
He says many people he’s met also living with HIV don’t have such robust support systems.
“A lot of times, you’re just there to listen. People don’t necessarily want advice; they just need somebody to hear them,” Wilson says. “Matthew25 has recognized that from the beginning: that we support system. Sometimes they just need to get something off their chest.”
Wilson believes his work is a part of a greater impact on their patients.
“I work to make sure we have the best possible experience for both clients and employees. That’s the van someone rides in, the exam room they sit in, the quality of our medical equipment. I want people to feel welcomed and cared for in every detail of their environment.”
He says it’s that care that he was shown at Matthew25 that still stays with him.
“Everywhere else I went, I was treated like an addict or a criminal. I never felt that way here. They strive so hard to meet people where they’re at — without judgment, just focused on providing the medical care you need and whatever support you want,” Wilson says.
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Matthew25 is one of a few providers supporting Western Kentucky, offering services in locations outside large urban centers. Geography, Wilson says, plays a large role in obstacles to care for HIV-positive Kentuckians. The organization itself travels about a 200-mile radius to pick a patient up to get them to their HIV care, but also any other medical care they need.
Another obstacle, Wilson says, is fear. He remembers thinking it was a death sentence when he was told he had HIV.
“I think a lot of people avoid getting tested because they’re scared of what they’ll find, and worried about cost. What they don’t always know is how many resources exist specifically to help with treatment and suppressing viral load,” he explains. “If we can suppress viral loads in people already living with HIV to the point where there’s no transmission risk, then eventually this ends.”
Wilson says there’s still stigma surrounding living in the area and a misconception that HIV is only a virus gay men get. He said that while he is a gay man, he also was an IV drug user. Male-on-male sexual intercourse is not the only way a person can contract HIV.
“I think transmission is still deeply misunderstood, and that misunderstanding costs lives.”
The stigma from the gay community also comes to Wilson’s mind.
“There’s still so much shame and secrecy around it. I’ve been undetectable for years, but people still treat HIV-positive individuals as if we’re diseased,” Wilson says. “You would think that people who have experienced so much oppression themselves would be more willing to accept others.”
He adds that it’s that specific stigma that makes him want to be open about his status and history: “to show that life doesn’t end with an HIV diagnosis.”
Wilson believes the only way to overcome this stigma and to work to stop the transmission of HIV is to recognize each other’s humanity.
“People with diabetes aren’t stigmatized for their condition. People with cancer are treated with compassion. People living with HIV deserve the same. And the most important thing to hold onto is this: We could actually see the end of this disease, in my lifetime, or the next,” he says, explaining the need to support HIV medications and PrEP. “Transmission can be stopped. Why would we not want to do everything in our power to make that happen?”
