San Francisco, CA – Starting September 1, 2011, San Francisco will roll out changes to its HIV prevention plan, eliminating targeted resources and programs serving the Asian and Pacific Islander (A&PI) community. The plan, developed by San Francisco Department of Public Health (SFDPH), directs HIV prevention resources to address the epidemic among Caucasian, African American, and Latino gay men, transgender women, and intravenous drug users. The plan fails to make provisions for San Francisco’s significant A&PI community, whose numbers of HIV diagnoses continue to rise at alarming rates.
“A&PIs represent over one third of San Francisco’s total population and nearly 20% of the gay community, yet the City’s public health officials are refusing to specifically include A&PIs, despite doing so for other groups who need culturally sensitive programs,” says Samer Danfoura, San Francisco Attorney and LGBT Advocate. “This seems discriminatory and neglectful.”
Christopher Punongbayan, deputy director of Asian Law Caucus, says that SFDPH’s plan “could inflict significant harm on the A&PI community in San Francisco. ”
San Francisco seeks to eliminate new HIV infections by suppressing the overall “community viral load” in part through increased testing and treatment activities targeting prioritized populations in the gay community. To be sure, advances in the science of HIV treatment have altered the way in which we care for people living with HIV, with important implications for prevention. It is now possible to limit the likelihood of transmitting the HIV virus if viral loads are kept at undetectable levels, which can be done if people know they are infected and are being adequately treated. Unfortunately, the City’s plan will only effectively serve the needs of Caucasian, African American and Latino gay men.
“Community viral load reductions won’t have as strong an impact as the City would like because a large proportion of new cases are spread amongst people who don’t know their status, aren’t in care, and aren’t on medications,” says Dr. Tri Do, an HIV physician and researcher in San Francisco.
A&PIs are the least likely racial or ethnic group to get tested for HIV–less than 1% of A&PIs have been tested at public health sites in San Francisco–and one in three A&PIs living with HIV are unaware they are infected, according to US Centers for Disease Control and Prevention estimates. SFDPH data indicate more than half of all A&PIs with AIDS were diagnosed during their first HIV test. Late testing and low HIV status awareness increase the likelihood of transmission, illness and death. Yet the City’s plan excludes A&PIs from targeted prevention activities. It’s clear the City expects A&PIs to access the same one-size-fits-all services that already fail to meet their needs.
“The City’s own data show an increasing number of new infections among A&PIs who account for 10% of new HIV cases. Why are they ignoring their own data? Where is the accountability for our tax dollars and the public trust?” asks Dr. Do.
SFDPH’s plan marks an effort to align the City’s HIV prevention strategies with the priorities outlined in the National HIV/AIDS Strategy (NHAS). However, the NHAS makes provisions for states and local jurisdictions like San Francisco with large concentrations of A&PIs and A&PI gay men, recommending improved surveillance activities and prevention approaches for this hard-to-reach population. Despite this, SFDPH has opted to omit HIV prevention activities specifically targeting the A&PI community.
A&PI Wellness Center has been in negotiations with SFDPH since March 2011 to address the issue, but to date, nothing has been done by the City. “SFDPH continues to assure us that the needs of A&PIs will be met, but we have seen no evidence to support this,” says Lance Toma , executive director of A&PI Wellness Center . “It’s been four months and we have yet to see a concrete plan for reaching A&PIs. A&PIs are affected by HIV, and we need to be included, just like other high-risk communities in the City.”
A&PI Wellness Center is currently in talks with SFDPH, the Office of the Mayor, the Board of Supervisors and the LGBT Advisory Committee of the Human Rights Commission. On August 11th, they will present their concerns to the Human Rights Commission.
Having HIV is not the end of the world. Because of it, I have met so many wonderful people here in Michigan and around the country (even a few abroad) through HarmonyHIV.com. My life has become richer because of it. To all of us who test positive stay strong and don’t let anyone put you down. life goes on and we can continue to live a full and happy life.