With recent results from vaccine and microbicide trials, revisions to global surveillance data and newly approved antiretroviral drugs, HIV research is back in the headlines.  As we endeavor to understand, translate, and disseminate emerging HIV/AIDS research, the San Francisco AIDS Foundation occupies a unique nexus among our clients, the San Francisco community, researchers, and policymakers.
   
Occasionally, the Foundation must not only interpret research data, but protect the public from hasty conclusions.  For example, The New York Times recently reported on a study conducted at the University of California, San Francisco, which found a higher-than-average rate of the drug-resistant staff infection MRSA (methicillin-resistant Staphyloccus aureus) among men who have sex with men in and around San Francisco's Castro district, even implying that MRSA was sexually transmitted.
   
Almost immediately, other media sensationalized "a new gay disease." Not surprisingly, the news coverage caused fear and even anger in San Francisco, and raised anxiety for many of our clients.  
   
The Foundation issued a press release explaining that MRSA has been present in the population for 15 years. A serious infection, MRSA does cause 19,000 deaths annually, but these are primarily among elderly hospital patients.  The bottom line?  MRSA transmission can normally be prevented with simple soap and water.   Two days later, the Foundation hosted a public conversation about MRSA at Magnet, the Foundation's health and community center in the Castro; and joined with other local organizations to sponsor a follow-up forum two weeks later.  By then, the University had apologized for its misleading report, and the Times went so far as retracting its article.
   
Sometimes the Foundation needs to remind the government of the importance of research, too.   Through our federal policy efforts, we have consistently challenged the Congressional ban on federal funding for needle exchange.  Until just last December, even dollars raised locally in Washington, D.C., were prohibited from going towards providing clean needles there, despite the city's alarming rate of HIV prevalence, 5% of the city's total population, the highest by far of any city in the nation. Like a stinging gadfly, the San Francisco AIDS Foundation reminds lawmakers that scientific evidence, not ideology, should guide their legislation.
   
More recently, the Foundation has focused on the role of evidence in evaluating programs, and how valid and reliable that evidence might be for replicating our strategies in other organizations and communities.  Several of our community programs, including Magnet, Black Brothers Esteem, the Speed Project, and Stonewall, compliment their focus on HIV prevention and treatment with an emphasis on promoting health.  If we enable individuals to connect with their desires for a hopeful, meaningful future shared with friends, partners, neighbors and families, we know they are far more likely to make smarter choices surrounding drug use and HIV risk behaviors. 
   
Of course, interventions like these are most useful when we can confirm their validity through research; evidence of their effectiveness helps us document our progress against HIV and work to replicate the programs elsewhere. But because of their focus on community wellness, such programs don't lend themselves to randomized controlled trials, the current gold-standard of HIV/AIDS research. Our innovative programs require new means of evaluation.
   
That's why the Foundation has spearheaded a series of national discussions about the various types and quality of research that may be used as valid evidence for replication of programs and services.  We hope to identify criteria that, while still rigorous, incorporate the lived experiences of individuals and communities affected by HIV/AIDS.  Simultaneously, we're partnering with San Francisco State University to collect from our programs precisely that kind of meaningful evidence, specifically in 13 broad domains including social support networks, substance abuse, life stability, and spirituality. 
   
At the San Francisco AIDS Foundation, we believe the effort to use research to establish a solid base of evidence is necessary to develop robust strategies and programs to eliminate new HIV infections.  We will call for more targeted HIV/AIDS research, interpret it, share it, sometimes argue with it, other times defend it, and now even shape it. We'll continue to do so until the only researchers interested in HIV are historians.