San Francisco AIDS Foundation's Prevention Efforts Evolve and Expand

It is estimated that up to 1,000 people become newly infected with HIV each year in San Francisco. While there are indications that the rate of new infections in some high-risk populations may be leveling off or possibly even dropping-- particularly among gay men--the number of HIV infections occurring in San Francisco still remains too high.

In an ongoing effort to bring down infection rates, the San Francisco AIDS Foundation has recently expanded and re-tooled its prevention and community mobilization efforts. The agency has worked to ensure that its programs continue to be as responsive as possible to the needs of those at greatest risk for HIV infection.

"We carefully analyzed data on the epidemic in San Francisco and assessed the impact of our existing programs," explains William Bland, Community Programs Director at the San Francisco AIDS Foundation. "We discovered that some of our efforts were right on target while other services required changes to reach those at greatest risk."

As a result of this analysis, the Foundation's Black Brothers Esteem (BBE) program will be expanded and refined. This program promotes the sexual health and well-being of African American same-gender loving men and has a proven track record of building community and improving health among African American gay and bisexual men in the Tenderloin neighborhood in San Francisco.

"This program is a real success and more men are participating every month," said Tony Bradford, BBE's Program Manager. "An added feature of the program will be the training of peer health educators who will disseminate accurate and useful information on ways to improve and maintain good health while living in the Tenderloin," added Dr. Micah Lubensky, Community Development Manager. In addition, BBE will implement two federally evaluated models: Many Men, Many Voices, a multiple session workshop series developed for gay men of color to improve their sexual negotiation skills; and Healthy Relationships, which assists HIV-positive men in developing healthy relationships.

Meanwhile, the San Francisco AIDS Foundation's Gay Life program has refocused efforts on methamphetamine use among gay men. Studies show that gay men who use methamphetamines (also known as "crystal" or "speed") are up to three to four times more likely to become infected with HIV than men who do not.

"Based on this research, Gay Life is working to broaden community-wide efforts to address this growing problem," explains Mark Rumpler, the Manager of Gay Life. "We are developing a new peer-based outreach and risk-reduction program that focuses on gay men who are active speed users and men who are at high risk for using speed. We believe these innovative services will play a critical role in minimizing the number of new infections among gay men in San Francisco."

Through this new program--based on a CDC model called Community PROMISE (Peers Reaching Out and Modeling Intervention Strategies)--outreach workers will actively recruit men who are using methamphetamines and encourage them to distribute materials and information to their friends, offering a variety of strategies to reduce sexual risk-taking that may occur when crystal is used. "The strength of this program is that crystal users will work closely with us to develop risk reduction messages and distribute them throughout the community," continues Rumpler.

In addition to these programs targeting gay and bisexual men who are at high risk for HIV infection, the AIDS Foundation's needle exchange program -- the HIV Prevention Project (HPP) -- helps thousands of injection drug users and their sexual partners avoid HIV and Hepatitis C infection. This year, the program will exchange approximately 2.6 million syringes at ten sites throughout the City. In an effort to expand the reach of the program, HPP has also embarked on a process of training secondary exchangers (those who exchange needles for others in their social networks) as peer advocates, helping to get clean syringes and information to those who do not visit the exchange sites.

"The San Francisco AIDS Foundation's prevention programs are critical to the City's efforts to stem the spread of the epidemic," said Steven Tierney, Director of HIV Prevention for the San Francisco Department of Public Health. "The AIDS Foundation continues to be a leader in ending the epidemic in our community."