“My Biggest Fear Isn’t AIDS, It’s Being Evicted From My Rent-Controlled Unit”
With the median rent for a one-bedroom apartment hovering around $3500 per month by latest estimates, housing is a top concern for many San Francisco residents, but especially so for those whose long personal histories tie them to the city—such as long-term survivors living with HIV.
“My biggest fear isn’t dying of AIDS, although that worry never goes away,” said Jonathan1, a San Francisco resident who’s lived in the city through the worst of the epidemic. “I have been living with HIV for more than 20 years and have been diagnosed with KS [Kaposi’s sarcoma], but my biggest fear is being evicted from my rent-controlled apartment.”
The San Francisco homeless point-in-time count and survey by Applied Survey Research counted 6,686 homeless people in San Francisco in 2015, with 7% reporting having AIDS or an HIV-related illness (about 486 people). The AIDS Housing Alliance of San Francisco reports that people with HIV are disproportionately affected by homelessness, with 14% of people with HIV/AIDS homeless at any given time. Housing is critical for people with HIV since stable housing facilitates retention in medical care and continuity of HIV treatment—both which improve health and prevent further HIV transmission.
Jonathan is a California native. Growing up in L.A., he first remembers visiting San Francisco when he was seven years old. By the time he was nine, he knew he was gay and already recognized San Francisco as a place where he could belong. Plus, he saw the city as “magical.”
He moved to San Francisco when he was in his early-20s in the early nineties to work for a non-profit. He paid around $500 for an apartment in Hayes Valley. “It was almost a three-bedroom apartment. Some of the closets were big enough to be bedrooms,” he said.
Around that time, he tested positive for HIV. He delayed being tested for years; already sure he had been infected in the early eighties—before he knew or had heard anything about HIV or AIDS. “I wanted to wait until I turned 30 before I got tested, because I had this romantic vision of not living with that burden while I was in my 20s.” But at age 26, he started feeling fatigued for unknown reasons, and decided it was time to find out if HIV was the culprit.
It was. His primary care physician delivered the positive test result, along with a prescription for the anxiety medication Xanax. “The anxiety medication was helpful. But I was without hope for my life—I absolutely thought that I was going to die.”
Soon after, he was prescribed early HIV medications including AZT (azidothymidine) and d4T (stavudine). He developed oral thrush, a fungal infection that can happen in people with weakened immune systems. He got sick, and felt tired a lot.
But he stayed alive.
“I went about what I thought would be my short life by going to a lot of Grateful Dead shows and working for nonprofits and trying to save the world,” he said. Soon after being diagnosed, he started participating in HIV clinical studies, something he continues to do to this day. He wanted, in some way, to help advance HIV treatment and cure research—hopeful that even if he himself didn’t see any direct benefit, that his participation might benefit future generations.
“I felt obligated to do my part. There were people who came before me who risked their lives to test AZT and earlier HIV medications, something which I benefited from. Participating in HIV research feels significant and important. I’m not reckless about it, nor am I utterly fearless. But if I can, in small ways, help, I want to.”
In his early days in San Francisco, Jonathan also fell in love, with his partner of more than two decades. They moved into a beautiful, rent-controlled flat in the heart of the Castro. He loves the hardwood floors, the views of the bay and the classic Victorian style of his apartment.
His rent controlled unit, which is in a highly desirable neighborhood, makes him feel “like there’s a huge target on [his] back.”
“I’m terrified that an eviction notice will come. I’ve seen it happen to many people. And oftentimes, the people who get evicted are elderly or disabled, and that includes people with HIV. I don’t think the property owner owes me anything. But I think this city does. There needs to be political will to make sure that the history of our city—and that includes people—doesn’t get lost or pushed out. This city protects inanimate historical landmarks—and I think that it should also protect its living historical landmarks.”
Jonathan isn’t against change, and he isn’t offended by the newer generations of young gay men who move to the Castro without the fear and heavy burden of AIDS that so many in his generation carry. He doesn’t pine for “the good old days,” because frankly, he says, “the good old days were terrifying.”
“I’m thrilled that newer generations of gay men don’t have the same terror of HIV that I had as a young person. It’s amazing that there’s a pill you can take every day to prevent HIV now. If that existed when I was younger, I absolutely would have wanted to take it.”
In reference to the drug Truvada that is approved for PrEP, Jonathan says, “I take it too. But I take it to stay alive. I want people to go out there, and have a great time and lots of great sex. Lots of smart, great sex. And embrace their sexuality, while remembering that everything comes at a price. Truvada was developed for the HIV-positive community—and many of us have been taking this drug for years and years. Truvada as HIV treatment has absolutely informed its use as HIV prevention.”
After attending a recent HIV cure symposium at the new UCSF campus in Mission Bay, Jonathan said he looked around in surprise at some of the housing going up in the neighborhood. It was surprising, he said, how expensive some of the luxury condos seemed to be, and it made him wonder, ‘who can afford to live here?’
“Probably not the people who are participating in the HIV research at the new medical campus,” he said. “What’s going to happen when so many of us lose our housing and have to move out of the city? These studies are going to lose all of their participants.”
He says, more than anything, he just wants people to know that AIDS isn’t over—that it’s part of the fabric of our city. Although it may be less visible, it’s still here, and it’s part of the lives of our residents.
“My health, and the health of our community, is tied to housing. This eviction and affordability crisis is permeating every discussion. I came to this city to be gay—but I stay here now to be healthy. The topical and intravenous chemo[therapy] I take to treat my Kaposi’s sarcoma leaves me fatigued and doesn’t allow me to work much, but my viral load is undetectable and my CD4 count is high. This is possible because I have access to talented, caring HIV specialists in San Francisco and a pharmacy I can walk to. I’m able to participate in HIV research because I live near to cutting-edge medical research centers. This dynamic, vibrant city—which attracts some of the brightest, most passionate people—can’t settle for complacency when it comes to this issue.”
1Not his real name
Learn about the housing services San Francisco AIDS Foundation provides and read about the work housing case manager Jesus Moreno does to connect clients with housing support.
Do you see how health and housing are linked? Share your thoughts in the comments below.