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.
Here are five strategies being utilized…
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.
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.
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.