Magnet serves 10,000 PrEP clients

In October, SFAF’s Magnet clinic served its 10,000th client with the HIV prevention tool PrEP. This momentous goal would have been nearly inconceivable when the PrEP pilot program began–enrolling its first 20 clients–more than a decade ago at the small Magnet storefront on 18th Street in the Castro.

“Although I wasn’t here at the initiation of the program, and so can’t take credit for the work of starting the Magnet PrEP program, I’m proud of how Magnet PrEP’s program is a model for how to provide and maintain people on PrEP,” said Jorge Roman, RN, MSN, FNP-BC, AAHIVS. “It’s extremely gratifying to see where we are now, as a pioneer of PrEP programs, and know that we’ve reached 10,000 people with PrEP services.”

On July 16, 2012, the FDA approved Truvada for PrEP in combination with other safer sex practices for the prevention of HIV. 

At that time, Magnet clinic leaders didn’t anticipate needing to open a PrEP program. 

“We didn’t think we’d be prescribing the medication,” said Steve Gibson, the founder of Magnet who is now the Director of HIV Prevention at the Alameda Public Health Department. “We thought we’d provide patient education and refer people back to their primary care docs so they could do the necessary lab work and monitor their patients. But guys started coming to us and said they weren’t comfortable talking to their doctors and they trusted us. We even had some guys tell us that their doctors said they wouldn’t prescribe it to them.” 

Gibson remembers the moment he realized that Magnet would need to step up and find a way to provide PrEP to the community. It was while he listened to an interview with Dr. Anthony Fauci who spoke about  the results of the iPrEx study, the first study to provide concrete evidence that PrEP was effective in preventing HIV infection. 

“There weren’t many places at that time in the U.S. when PrEP was being rolled out on a large scale,” said Gibson. “Tony said in his interview that someone in SF needed to figure out how to make PrEP scalable for gay men and that others would follow. That’s when I knew we had to do it.” 

The medical team worked with the lead nurse at the time and SFAF’s medical director to develop the protocols to do everything from completing lab work, to storing and dispensing medications, to navigating the many patient assistance programs that would cover costs of PrEP medication. 

In mid-November 2014, San Francisco AIDS Foundation was able to open its pilot-phase PrEP program to a small group of 20 clients. This “buffer group,” meant to ease the clinic into the provision of PrEP care, filled up immediately. 

“We had no idea how big the program would get,” remembers Gibson. “We started out calling it a pilot because we didn’t have an electronic medical record (EMR) system yet and tracking clients on PrEP without an EMR wouldn’t be practical, but we did it anyway.”  

As the city’s earliest community PrEP provider, Magnet realized they’d have to ramp up their PrEP provision in order to keep up with the overwhelming community demand. The stand-out services, efficient benefits navigation, and Queer-centric care brought people from across the Bay Area and beyond. In the first nine months, the clinic enrolled more than 350 people on PrEP; by the spring of 2016 the program saw its 1,000th client–and the clinic staff gifted him a big hot cookie decorated as a Truvada capsule in icing.  

Although the PrEP program began at Magnet’s original location–a three-room clinic space on 18th and Castro–clinic leaders were eager to expand. The opportunity came in 2016 when Magnet moved into SFAF’s newly built health and wellness center Strut, just down the street from the original Magnet clinic. Over the years, the new clinic location has enabled the team to open up services beyond gay and bisexual men. Now, the clinic serves people of all gender identities and sexual orientations, and includes a robust trans care program tailored to the needs of transgender and non-binary clients. 

“I am very proud to have been on the team that figured out how to make PrEP widely available in the Bay Area. We didn’t know then that what we were doing was setting such a high standard of getting the medication to people the day they came in,” said Gibson.  

Over the years, the clinic has responded to community needs–expanding but also strengthening the care provided. 

“We have a very strong and integrated model of care,” said Roman. “At the beginning, we were offering only a small subset of clients PrEP. And now, it’s part of every single visit for people who may benefit from PrEP. We have a discussion with someone and even make it an option to start it on the very same day.”

Roman shared other advances the clinic has made, including making injectable PrEP available (first with Apretude and now with Yeztugo), opening up a trans care program and providing PrEP along with gender affirming care, and expanding access to Black, Indigenous, and people of color–particularly the Latine community. 

“Magnet has been through a lot of changes, and we’re proud of the ways we are able to serve our community,” said Roman. “This clinic really was based and founded in community–and it’s humbling but also not a surprise that we’ve served so many people. The community recognized a need for sexual health and HIV prevention, and it’s a testament to our community that we are still here today.” 

“We are proud that San Francisco AIDS Foundation has been a leading PrEP provider in San Francisco, and significantly contributing to the steady decline in new HIV diagnoses in our city,” said Tyler TerMeer, PhD, CEO of SFAF. “For more than 40 years, our organization has stood at the forefront of the HIV response–advancing innovative HIV prevention, advocating for communities most impacted, and finding impactful ways to support everyone living with HIV. Although there is still much more we must do to end the epidemic, including ensuring PrEP access in Black, Brown and TGNC communities, we recognize and celebrate the incredible gains we have made thus far.”