Switch On Your HIV Smarts.

New York Times: San Francisco is a Model City of Innovative HIV Prevention & Care

, by Emily Land

In a recent New York Times article, the city of San Francisco’s collective response to the HIV epidemic is touted as a model of outstanding HIV treatment and prevention.

The article highlights the fact that San Francisco is quick to adopt effective, innovative programs ahead of the curve. For instance the city-wide initiative RAPID, which insures that newly-diagnosed people with HIV are provided with same-day HIV treatment and linkage to care, started well before the DHHS guidelines recommended immediate antiretroviral therapy to not only improve health and quality of life but also as an effective treatment as prevention strategy.

More recently, pre-exposure prophylaxis (PrEP) programs offering people at risk of HIV a once-daily medication to significantly lower risk are gaining traction in the community. Working against backlash that PrEP will decrease condom use and increase risky sex, San Francisco PrEP providers offer a realistic, non-judgmental view of how PrEP can benefit individuals at risk.

“Denying PrEP to patients because they might have unsafe sex makes about as much sense as our colleagues who treat high cholesterol denying statins to theirs because they might eat more ice cream,” Susan Buchbinder, MD, of the San Francisco Department of Public Health is quoted as saying.

Pierre-Cédric Crouch, PhD, ANP, the director of nursing at the San Francisco AIDS Foundation sexual health clinic Magnet, said in the article, “You can come in saying you just slept with 20 guys and don’t know what a condom is, and we don’t criticize you. We help you out.”

The article is excerpted below and can be read in full online.

San Francisco is Changing the Face of AIDS Treatment

By Donald G. McNeil Jr

SAN FRANCISCO — It wasn’t his first broken condom, so Rafael didn’t worry. But three weeks later, the man he’d met in a bar called to say that he had “probably been exposed” to H.I.V.

Rafael, a muscular, affable 43-year-old, went to a clinic and within 45 minutes learned he was infected. Although it was already closing time, a counselor saw him immediately and offered him a doctor’s appointment the next day.

At Ward 86, the famous H.I.V. unit at San Francisco General Hospital, the doctor handed him pills for five days and a prescription for more. Because he was between jobs, she introduced him to a counselor who helped him file for public health insurance covering his $30,000-a-year treatment.

“They were very reassuring and very helpful,” said Rafael, who, like several other men interviewed for this article, spoke on condition that only his first name be used to protect his privacy. “They gave me the beautiful opportunity to just concentrate on my health.”

Despite bad luck in sex-with-strangers roulette, Rafael did have some good fortune: He lives in San Francisco, which is turning the tide against H.I.V. and serving as a model for other cities. The city that was once the epidemic’s ground zero now has only a few hundred new cases a year, the result of a raft of creative programs that have sent infection rates plummeting…

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