San Francisco isn’t just known as the American gay mecca, a place for queers of all stripes to gather and make home. It’s also focused more aggressively than any other American city on ending new HIV infections, becoming a model for others in the process.
As part of its “Getting to Zero” campaign, San Francisco health officials and other stakeholders have an ambitious goal of reducing HIV transmission, and related deaths, by 90 percent. It’s not some far-off, pie-in-the-sky rhetoric, either: Officials there plan to achieve this goal by 2020, and last year, in 2014, there were 302, down from several thousand just a few years earlier.
With a drumbeat of “zero infections, zero deaths, and zero stigma,” “Getting to Zero” is the most aggressive approach to HIV prevention and treatment ever. The initiative utilizes cutting edge HIV treatment and prevention techniques, including reducing discrimination and housing bias for people with infection.
The creative combination of testing, treatment, and prevention, including condoms and PrEP, are putting a stronghold on the virus, and creating a model for other cities worldwide.
How about we take this to the next level?
Our newsletter is like a refreshing cocktail (or mocktail) of LGBTQ+ entertainment and pop culture, served up with a side of eye-candy.
Here are five strategies being utilized…
Treatment
San Francisco has one of the best rates of access to HIV/AIDS treatment in the nation. According to the city’s Department of Public Health, 94 percent of HIV-positive residents are aware of their status and 85 are receiving antiretroviral treatment. Overall, 87 percent of HIV-positive Americans know their status and only around 40 percent are engaged in care. This has big ramifications, because antiretroviral treatment suppresses the virus, making HIV-positive folks “undetectable.” Studies demonstrate that undetectables do not to transmit HIV to their sex partners, making treatment as prevention (TasP) a winning strategy for preventing the virus.
Access to HIV Testing and Prevention Services, including PrEP
It’s easier to access sexual health services in San Francisco than any other American city. With low-cost or free sexual health centers like Magnet in the Castro, San Francisco keeps it real by educating people that sex is good, no matter what your twist, as long as its practiced in way that’s healthy for you, based on the unique circumstances for you and your partner(s).
Trans Health Outreach
America’s trans population is an acute risk of acquiring HIV, according to amFAR, and if the LGBT community wants to represent the “T” in its acronym it must address the needs of trans people. San Francisco is far ahead of the curve with widespread cultural competency of trans health education and outreach, such as TRANS: THRIVE at the Asian & Pacific Islander Wellness Center, a one-stop-shop for the social and sexual health needs of all trans San Franciscans.
Sex Positive
There’s stigma everywhere, and there’s sex negativity everywhere, too. But, in San Francisco, the idea of creating safe spaces for people to express their identities or sexuality is better than almost anywhere in the world. Where else can you go to workshops on fisting and learn how to access PrEP, the pill that prevents HIV? This creates a culture of openness and encourages gay men to talk to friends, prevention specialists, and medical professionals about their behaviors and risks.
Needle Exchange
Every $1 spent on syringe programs saves $3 in projected HIV and related care by preventing HIV’s transmission among intravenous drug users. By providing harm reducing options for users devoid of moral judgement, HIV is prevented and lives are saved.
Terry Barton
So much has changed since my diagnosis in 1987
barkomatic
It’s no coincidence that in a city where PrEP becomes widely available that new HIV infections drop dramatically. We’ve had condoms for decades and have not been able to achieve the same result. This must upset the narrow minded puritanical members of our community who think that HIV should be a punishment for guys who have sex outside of a relationship, have sex without a condom in a relationship, or sex outside of marriage.
alphacentauri
They claim PrEP works, but the fools that take it and bareback and have sex like it’s the 70s, are the ones it’s not going to work or keep working for. Condoms are far more effective, not as expensive, are not toxic medications, and do not have horrible short and long term side effects like PreP does.
People who are undetectable can and do infect other people with HIV, and they get infected with new strains of HIV if they are into barebacking.
@barkomatic: Which LGBT people actually believe that stuff you listed that “HIV is a punishment”?
Needle exchange is nice but your average IV drug user when confronted with having to share a needle to get high on their drug they’re addicted to right then and there, or go out and exchange used needles/IVs for clean ones, buy new needles, or somehow get a new unused IV is going to pick getting high, and sharing an IV over their long term health.
Michael Jakubowski
Blake Blackwell
timmm55
@alphacentauri:
Undetectable “can and do infect other people with HIV”? That’s absolutely false. Not a single case, it’s been ZERO. Some have assumed they were Undetectable by taking ART. It take 6 months or so.
passingthru
@alphacentauri: By all means, lets all listen closely to “DOCTOR” alphacentauri because he knows everything.
Realitycheck
@passingthru: Sarcasm? Why don’t you educate yourself? People on HIV medication that are undetectable for 6 months are non infectious, because their sperm no longer has the virus,
and saliva is the only part of the immune system that kills the HIV virus.
The only way to get infect with an undetectable individual would be a direct blood exchange such as a transfusion
or sharing needles.
That is there are so many serum assorted couples where one partner is positive and the other is negative in spite of
several years or decades of sex.
This has been discovered first in Australia and Switzerland several years ago and many countries including the USA have made the same discovery since then.
Because of possible law suits, no doctor will tell you it is impossible to get HIV with an undetectable individual or while on PreP, people that get HIV on PreP forgot to take their pill, it is that simple.
onthemark
@Realitycheck: I’m pretty sure that “passingthru” WAS being sarcastic.
But thank you for your post, which is a very good explanation of how it works.
tmewrpagn
@alphacentauri:
Where are you getting any basis for your statements? I was on PrEP and had no short term health effects that you claim occur. It’s true that it can effect your liver but my doctor monitored that monthly each time I went in for a refill. It’s also true that those on PrEP wear condoms at a lower rate, however, the groups studied were already wearing them at lower rates. PrEP reduces the rate of infection in an already at-risk group. It’s easier to get someone to take a pill daily than to change behavior.
passingthru
@Realitycheck: @onthemark: Oh gosh, sorry, total sarcasm. I am 100% with you. I don’t know why anybody would be negative about additional tools that can be used in the battle. Everybody can make their own choices but the more options the better. The more that we have educated information rather than judgmental, opinionated nonsense the better!
Stache
@alphacentauri: Unfortunately, studies and people taking it say you’re full of shit as usual.
onthemark
Reason #6 – Nobody can afford to live in SF anymore except millionaire tech nerds, who are mostly virgins anyway?
(kidding, kidding… maybe.)
sportsguy1983
Workshops on fisting?
alphacentauri
@Stache: Yeah because studies and personal claims by people are always correct. A lot of men who take PreP are going to become HIV+ but anyone with any intelligence knows this.
@tmewrpagn: Do you still take it? Do not be surprised if you eventually have liver/kidney damage, and bone density loss as that’s a long term side effect from PreP.
@timmm55: No it has not been zero. If you actually believe that and still bareback with someone that’s ‘undetectable’ you have a death wish.
passingthru
@alphacentauri: And let’s not forget, condoms BREAK. Nobody and no study can refute that absolute fact.
barkomatic
@alphacentauri: just go back and read the early articles on PrEP here on Queerty and you’ll see plenty of comments that support my statement.
Giancarlo85
@passingthru: Okay. So don’t use them at all?
That’s the logic in our community and why gay and bi men still make up 86% of new cases. PreP isn’t going to save us. Big Pharma has said to use other safe sex in conjunction with PreP. But some on here scream that condoms break and that the sensation of bareback is unmatched… again, like cocaine. Addicting and it can kill you.
passingthru
@Giancarlo85: I didn’t say that. Why would you come to that conclusion? Everybody needs to know, as well as possible, the facts which enables them to make decisions that are best for them. Nobody needs judgment. If anybody is considering condoms rather than PreP, then they must keep in mind that they are taking a risk that condoms break – which can be a VERY BAD thing. That’s all.
Giancarlo85
@passingthru: Condoms are extremely effective. And if anybody thinks Prep is going to protect you while doing bareback sex, that is a huge mistake. It is clear you have a motive and an agenda, not based on fact. You act as if condoms break all the time… Untrue. Quite rare actually.
alphacentauri
@barkomatic: So what? That proves nothing.
@Giancarlo85: Well said. It’s extremely rare for condoms to break.
passingthru
@Giancarlo85: I don’t act as anything. I’m just stating a fact. If you don’t like facts, don’t blame the messenger or make assumptions. It’s the only absolute fact in this entire stream.
@alphacentauri: It only takes one then all bets are off. One break and a person’s life is changed, unless that person has prepared for that possibility.
Everybody only has one life to live (that we know of). Everybody has to make choices for themselves. I don’t understand why folks are so ridiculously judgmental towards other people and towards options and choices. Nobody is forcing anything on anybody.
paulbear30
Giancarlo85, why are you cynical of one financial enterprise but not the other? You think condom manufactures are working for free? Give me a break. Effective? They don’t slip on by themselves. Here’s a thought – get over fucking and sucking and you won’t have to worry about loss of sensation (the hands work wonders, trust me), breaking condoms, or any pills. Truth is, the gay community is hung (no pun intended) up on fucking and sucking, just like a cocaine addict. Nice analogy.