Speakers lined up last week at a meeting in San Francisco and told President Barack Obama's top domestic AIDS policy adviser that they want to see funding, minorities, housing, transgenders, and other areas of concern addressed in the national HIV/AIDS strategy that the administration is developing.

Jeff Crowley, director of the White House Office of National AIDS Policy, took center stage at the Friday, October 16 meeting, and was joined by local political leaders and HIV/AIDS officials.

The meeting, held at the Mission Bay Conference Center at UCSF, was one of a series of events being held across the country to gather input for the national AIDS strategy.

HIV still infects more than 56,000 people in the United States each year, according to the White House Office of National AIDS Policy.

Crowley, who is openly gay and used to work at the National Association of People with AIDS, noted that the president has articulated three goals for the national strategy: reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities.

Crowley, who said that San Francisco provides a model for communities across the country, also acknowledged California's severe budget cuts this past year. However, he told the crowd of about 150 who attended the event, "don't have the expectation at the federal level we have the ability to come in and backfill" the cuts.

In July, Governor Arnold Schwarzenegger used his line item veto power to eliminate nearly $500 million in order to balance the budget. The move included slashing the state Office of AIDS budget in half by $82.4 million.

When East Bay resident Jesse Brooks, who is living with AIDS, addressed Crowley Friday night, he referred to Crowley's "backfill" comment and the hundreds of billions of dollars the federal government started spending before Obama took office to assist the country's financial sector.

"Where's our bailout? When is our bailout going to come?" asked Brooks.

He also called for a national state of emergency in the African American community, which in recent years has been one of the communities hit hardest by HIV.

Others also talked about HIV prevention in the Asian Pacific Islander community.

Jeff Crowley, the director of the White House's Office of National AIDS Policy, addresses about 150 people who attended last week's meeting in San Francisco. Photo: Jane Philomen Cleland

Lance Toma, executive director of the Asian and Pacific Islander Wellness Center, made recommendations that included working to reduce stigma among Asians and Pacific Islanders.

Housing was another primary theme, and several people associated with the AIDS Housing Alliance/San Francisco voiced their concerns.

Brian Basinger, the organization's founder and director, said that 40 percent of low-income people with HIV in San Francisco are homeless and he called that "a tragedy and a crime."

Basinger pointed out that even when people have access to health care, it can be difficult for them to adhere to their medication schedules if they're homeless.

Supervisor Bevan Dufty said that "housing is prevention, housing is care" and shared the concerns of many others when he said that transgender people have been "marginalized" in the fight against HIV/AIDS.

Crowley also heard people talk about the importance of boosting HIV education in schools. One speaker talked about the number of youths already sexually active by 14 and said, "We need to educate them."

Such topics, which can seem fairly mainstream in San Francisco, could be controversial at the national level. One man urged Crowley to "be bold on this project" and to "be bold in your language."

At the end of the event, Crowley told attendees that "We all need to be bold enough," and he said that he and other officials "got a lot out of this."

In a phone interview this week, Dufty told the Bay Area Reporter that housing, the transgender community, and other issues that can seem mainstream in San Francisco but controversial at the national level "have to be" included in the national HIV/AIDS strategy.

Dufty, who is running for mayor in 2011, called the HIV seroconversion rates for members of the transgender community "unacceptably high" and said culturally competent and trans-specific programs are needed.

Dufty also pointed to a change the administration announced this week regarding medical marijuana, which is used by many PWAs and those living with other illnesses.

"Obviously the Obama administration is looking at making some changes in terms of medical marijuana," said Dufty.

On Monday, October 19, the U.S. Department of Justice released a memo telling federal prosecutors that they generally shouldn't focus federal resources "on individuals whose actions are in clear and unambiguous compliance with existing state laws providing for the medical use of marijuana."

"I hope that's a sign that we're going to make our decisions based upon science and reality, and not based upon out-of-step mores of times gone by," especially in providing clean syringes to intravenous drug users, Dufty said. That practice has been credited in San Francisco with helping to keep down HIV transmission rates among IDUs.

Asked after the discussion Friday night about not backfilling states' budget cuts, Crowley reiterated to the B.A.R. that the federal government doesn't have the resources. He said, however, that, "We've enacted an unprecedented level of assistance."

As an example, Crowley mentioned the existing federal medical assistance percentages, which are used in determining the amount of federal matching funds for state expenditures for assistance payments for some social services, among other things.

Dr. Michelle Roland, director of the state AIDS office, made brief remarks before the discussion Friday night and also took notes on people's comments. Asked about Crowley's "backfill" remark afterward, Roland told the B.A.R., "I knew that. That's not news."

Upcoming events

The LGBT Community Partnership of San Francisco's Department of Aging and Adult Services and a work group of senior service and HIV/AIDS providers is sponsoring a proposed community forum on aging with HIV/AIDS. For more information on the January event, contact Karen Rosen at (415) 355-6790 or mailto:karen.rosen@sfgov.org.

Besides the national discussions and other actions, comments made through the Office of National AIDS Policy's Web site – http://www.whitehouse.gov/onap – will also be part of developing the strategy.

[Updated for address change: The next national AIDS strategy discussion in the Bay Area will be Sunday, November 1 in Berkeley, from 2 to 4 p.m. at the Little Theatre at Berkeley High School, 1980 Allston Way.]