Few Castro Clinics Treat Women for HIV
In San Francisco HIV has long been a male dominated disease. Men, particularly gays and bisexuals, account for the bulk of the city’s HIV and AIDS cases.
As such, there are not as many services available for women who are living with HIV and AIDS. While women can get tested for HIV at various clinics run by nonprofits in the city’s Castro district, they have fewer options for accessing treatment and care than their male counterparts.
The reason is a matter of money and numbers.
The majority of HIV/AIDS cases new and old in San Francisco are among gay white men and men who have sex with men who inject drugs intravenously, according to the city’s Department of Public Health.
By the end of 2011 there were 15,489 San Franciscans diagnosed and living with HIV/AIDS, according to the San Francisco Department of Public Health’s annual HIV/AIDS epidemiology report. In 2011 men accounted for 92 percent of living HIV/AIDS cases, while 6 percent were women. Transgender people comprised the remaining 2 percent of cases.
"Among women with AIDS, the most frequent exposure category for whites, African Americans, Latinas, and Native Americans is IDU followed by heterosexual contact," stated the DPH report. "For Asian/Pacific Islander women with AIDS, 52 percent acquired their infection through heterosexual contact, 24 percent through IDU, and 14 percent through transfusion of blood or blood products."
The rate of women diagnosed with HIV or AIDS in San Francisco is also much lower compared to men. Women accounted for 10 percent of the new HIV/AIDS cases in 2011, men made up 88 percent, and transgender people 2 percent.
Thus the lion’s share of testing and treatment services at most of the city’s clinics, particularly in the Castro, is geared toward gay men and transgender women, who are disproportionately infected with HIV/AIDS.
"There are women in San Francisco getting HIV, but it’s not what you hear most folks talking about," said Dale Gluth, associate regional director of the AIDS Healthcare Foundation in the San Francisco Bay Area.
The relative silence on the issue can lead some women to falsely believe that they aren’t at risk for contracting HIV, he said.
It’s "dangerous" to tell a sexually active person that they shouldn’t worry about acquiring a sexually transmitted disease or infection, said Gluth, adding that everyone should be tested.
"AHF is an organization that provides services to anyone who needs it. That’s our strategy and it’s pretty effective," added Gluth.
Yet many of the gayborhood’s testing sites and clinics have limited services for women due to funding constraints.
"It’s always been a play or paradox between what we want to do and who we want to test," said Barbara Adler, the UCSF Alliance Health Project’s manager of HIV counseling and testing, about the desire to provide testing for women and the epidemiology game for funding.
AHP offers HIV testing for women at its Market Street services center. Adler estimated that only 4 percent of AHP’s HIV tests are administered to women.
For those women who test positive for HIV or AIDS, AHP will often refer them for treatment to either Lyon-Martin Health Services, a Market Street clinic for women, or the AIDS Healthcare Foundation, which operates a health care center at 100 Church Street at Duboce.