Seven months after his arrest, loved ones of Cuban dissident artist Luis Manuel Otero Alcantara worry for his health, locked away mostly incommunicado in a high-security prison.

Named one of Time magazine's most influential people of 2021, the government in Havana considers the 34-year-old a mercenary in the service of the United States, which is calling for his release.

The last time his girlfriend Claudia Genlui could speak to Alcantara, by telephone, was on January 18. Since then, he has started a hunger strike. It's not his first.

Then earlier this month, Genlui got a telephone call from a family member of a fellow inmate who reported that Alcantara "was not doing well, that he has lost a lot of weight, that he has almost no strength left to walk and that he hardly speaks," she told AFP.

Alcantara is the leader of the San Isidro protest movement (MSI) of artists and intellectuals pressing for free speech and other rights in the communist island nation.

The Cuban government accuses him of political revolt funded by the United States, which has had sanctions in place against Cuba for six decades.

On July 11 last year, when thousands of Cubans spilled onto the streets in a spontaneous outburst of anger against economic hardship and repression, Alcantara set out to join them.

But, already in the government's sights, he was arrested shortly after leaving Genlui's home, before he could even participate in the protest.

Since then, he has been held at the Guanajay maximum security jail 40 kilometers (25 miles) west of Havana.

Cuban dissident artist Luis Manuel Otero Alcantara has been held at a high security prison for seven months
Cuban dissident artist Luis Manuel Otero Alcantara has been held at a high security prison for seven months AFPTV

The charges against him include incitement to commit an offense, aggravated contempt and public disorder -- all allegedly committed before last year's mass protests.

Last week, US Secretary of State Antony Blinken tweeted: "Seven months after peacefully standing up for human rights and fundamental freedoms, @LMOAlcantara awaits a trial that never seems to come."

And the State Department said in a statement to AFP: "We are extremely concerned that Cuban authorities have unjustly made an example of Otero Alcantara."

Alcantara, who defines himself as an "artivist," has for years been a thorn in the side of the Cuban government with his provocative displays.

To protest a decree governing the work of artists in 2018, he sought to cover himself in human excrement outside parliament, but was arrested before the work was complete.

Once, he wore the Cuban flag over his shoulders for a month and was sued for insulting state symbols.

Last year, he spent almost a month in hospital following an eight-day hunger strike after authorities seized several of his works when he was arrested during a demonstration.

He was freed but rearrested several times for trying to leave his home, which had been surrounded by police who cut off his internet service and kept visitors away.

The entry in Time magazine calling Alcantara one of the most influential people of 2021 was written by Chinese dissident artist Ai Weiwei, who said Alcantara's "art, his unignorable fight for freedom of expression and his uncompromising stance against autocracy reveal the power of resistance."

According to Genlui, the Cuban authorities have repeatedly offered Alcantara his freedom in exchange for exile, but he refuses.

"What motivates him, his goal, which is all of ours, is the freedom of Cuba," she said.

Amnesty International has declared Alcantara a prisoner of conscience.