Thank you San Francisco

Thank you San Francisco

Some 40 years ago I emigrated from England to the Bay Area of California and witnessed the “Free Love” and “Peace” movements and the rise of San Francisco as a gay city. I was in awe at the excitement, freedom and vibrance of the area to which I owe much.

This city was once called the “Paris of the West” for its corruption and wildness but I am proud of the recent past and current history that San Francisco brings to the HIV/AIDS community and doing much in these issues to write the rules. And let’s not forget San Francisco is the birthplace of our NABWMT.

Today an HIV infected person can go to a San Francisco clinic, get tested quickly, see a doctor, get 5 pills and a prescription and, if needed, file for public health insurance. This program is called Rapid and is a great success.

The city, once the HIV epicenter has turned the tide on this dreaded epidemic like no other. Infection has plummeted and the World Health Organization has used their programs as models. So patients are encouraged to be treated with antivirals as soon as possible. Some data:1992 had 2,332 infected now it is 302. The same trend is with deaths, 1641 down to 177 (and the latter includes deaths due to natural causes).

Why is the city so successful? Factors include: wealth from the tech companies, politics, doctors with history of HIV, and a large LGBT population. San Francisco has made up for losses in federal and state funding for HIV.

San Francisco has always, for good forbad, always gone first in pilot programs and clinical trials. In 1987 it opened the first HIV hospital ward, followed by the first use of AZT anti retroviral drug and clean needle distribution.

And the latest thrust tis he PrEP (pre-exposure prophylaxis) drug program with Truvada. At once the heralded (the FDA approved) and vilified program, since it has been shown to prevent infection in HIV naive persons but evoked criticism of its use as inviting casual sex. Some gay men called others “Truvada Whores” for avoiding condoms. But San Francisco clinics, doctors and officials don’t apply blame or shame to patients.

Which brings me to the Bay Area communities at the margins. The city now is mostly well educated whites and asians as apposed to black and brown, the latter group has left because of high rent. The former group is more likely to be aware of can afford to be treated. Still, the lessons learned in the city can be applied to the nation where 63% of HIV infected people are black or brown.

The main rest of this great commitment is the loss of fear of this, one time, “dreaded” disease. In the ‘90s it crippled the gay population but now young LGBT and straight people are without fear. Let us learn lesson from this as our NABWMT brothers did and now are able to tell the tale.

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