Twenty-five years ago, there was no drug treatment available for AIDS, and the cause wasn't even known. Dr. Diane Havlir started working at San Francisco General Hospital and Trauma Center in the early 1980s, just after she had finished medical school.
In January 1983, SFGH became the first hospital in the country to start a program for people living with HIV/AIDS when Ward 86, the outpatient clinic, opened. The inpatient HIV unit, 5B, opened in June that same year.
"The AIDS epidemic took San Francisco by surprise," Havlir, now chief of the HIV/AIDS division at SFGH and a professor of medicine at the University of California, San Francisco, recently told the Bay Area Reporter in an interview. "... It took away many young, creative citizens all at once. It was a time of great despair as a physician."
However, she said, it was also a time of inspiration.
Since the emergence of AIDS, it's estimated that more than 32 million people worldwide have died from the disease, according to USAID. But the division at SFGH is marking World AIDS Day on Monday, December 1 by acknowledging 25 years of dedicated HIV clinical care to people living with HIV/AIDS.
Havlir said the division has been part of huge advances in treatment and research for HIV/AIDS, which she noted has gone from being a fatal disease to a chronic disease.
The UCSF HIV/AIDS Positive Health Program at SFGH, a collaboration between the city's public health department and UCSF, has led in clinical care, teaching, and research from the beginning of the epidemic.
"The San Francisco community can be proud of its pioneers in HIV care whose dedication, commitment and compassion prevailed in the face of adversity since the onset of the epidemic," Havlir said in a statement. Events at the hospital on December 1 are "a tribute not only to the remarkable contributions of hundreds of SFGH providers and staff, but to the city's courageous public health response and to its unparalleled volunteer and advocacy community."
The HIV clinic now provides primary medical services for 3,000 HIV-infected adolescents and adults in the city. Havlir said these include people who are often marginalized, such as people with substance abuse and mental health issues.
Havlir told the B.A.R. the division has contributed to major accomplishments in the fight against AIDS.
For example, researchers performed studies that helped lead to the development of the Highly Active Anti-Retroviral Therapy cocktail. They've also made groundbreaking discoveries in the immunology of HIV, looking at what happens to people after they become infected.
The program has also identified other key areas, including the development of an HIV and aging clinic, and a multi-cultural patient education program.
The program is taking part in addressing the disease in other parts of the world, too, examining the intersection of HIV and diseases like tuberculosis and malaria. As part of an international program, doctors from Africa recently visited San Francisco, and division staff have also traveled to Africa.
But Havlir noted there are still struggles here in the city.
She said there's a risk of complacency, and housing is hard for many people living with AIDS to find as San Francisco becomes an increasingly expensive city in which to live.
While discussing the protests that have erupted after the passage of Prop 8, which eliminates the right of same-sex couples to marry, Havlir said, "We need to be reminded how powerful activism is," and noted, "activism in San Francisco brought AIDS to the attention of policymakers."
She said more involvement in the work to defeat AIDS is welcome.
"Our program is only as strong as the community that surrounds it," Havlir said.
The division will hold an event to mark World AIDS Day December 1 from noon to 2 p.m. Mayor Gavin Newsom and Health Director Dr. Mitch Katz are among those who have been invited to speak. The speakers program is from noon to 12:30 p.m. at the front lawn of the main hospital at, 1001 Potrero Avenue.
From 12:45 to 2 p.m. there will be a provider and patient forum in Carr Auditorium on the first floor of Building 100 at the hospital.
Also from 12:45 to 2 p.m., there will be a clinic open house for the Positive Health Program at 995 Potrero Avenue (at 22nd Street), in Building 80 on the sixth floor.
For more information on the program, visit http://php.ucsf.edu.
Other events
This year is the 20th observance of World AIDS Day. Dr. Kevin Fenton, the openly gay director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the Centers for Disease Control and Prevention, said that HIV remains a significant threat to the health and well being of multiple communities in the United States.
"Several U.S. populations bear the greatest burden of HIV," Fenton said in a statement. "The impact is most severe for gay and bisexual men, who account for approximately half of new infections and of those living with HIV."
He also noted that some minority communities are also disproportionately affected, particularly African Americans, who become infected at seven times the rate of whites, and Hispanics, at three times the rate of whites.
Around San Francisco, a variety of other events also will mark World AIDS Day.
AIDS grove
The National AIDS Memorial Grove's 15th annual World AIDS Day remembrance ceremony will be held December 1 from noon to 1 p.m. in Golden Gate Park.
This year's event marks the 27th year in the fight against AIDS and commemorating all those whose lives have been touched by the virus.
The theme, "Coming of Age with AIDS," recognizes that people of all ages are affected by HIV/AIDS, and the greatest risk for infection is among 18 to 26 year olds.
This year's guest speakers are members of the Stirling Family, four of five of whom are HIV-positive. The Stirlings will speak about their family's struggle with HIV/AIDS, their "coming out," and their adoption of an Ethiopian orphan who was also HIV-positive.
Referring to the Stirlings, Gina Gatta, 2008 World AIDS Day co-chair and grove board member, said in a statement, "The Stirlings' story is that of Ryan White's challenges times four. Their story is powerful and inspiring for anyone facing challenging health care issues."
White was diagnosed with AIDS at age 13 and gained international notoriety fighting for his right to attend school. He died in 1990.
In addition to Gatta, co-chairs this year include Thom Weyand, grove board member, and 13-year-old Annie Wilson, the first teenager to ever co-chair the memorial's World AIDS Day event. Don Jacobs, who has volunteered at the grove since 1991, is this year's recipient of the Grove Award for HIV service.
The ceremony will include a musical performance by the Hamlin School Choir, and visitors will be invited to the Circle of Friends, where the recently engraved names of those honored there will be read aloud.
Light refreshments will be served following the observance, which is free, open to the public, and will take place in a heated tent in the grove's meadow.
The grove was created by a group of San Franciscans devastated by feelings of loss, searching for a place to remember friends and family lost to AIDS. The nearly all-volunteer constructed, landscaped, and maintained grove was designated a national memorial in 1996.
The grove is located in the eastern end of Golden Gate Park at the intersection of Bowling Green and Middle Drive East, across from the tennis courts.
For more information, visit www.aidsmemorial.org.
San Francisco Gay Men's Chorus
The San Francisco Gay Men's Chorus, the first chorus with the word "gay" in its name, will take center-stage at Louise M. Davies Symphony Hall on December 1, in celebration of its 30th anniversary and to mark World AIDS Day.
The chorus program will feature work by award-winning Broadway composer Steve Schalchlin, who has written New World Waking! Songs on the Road to Peace - inspired by John Lennon's piano and created especially for the occasion.
Grammy winner Jennifer Holliday will join the chorus to sing the suite's rousing finale, "My Rising Up."
Artistic director and conductor Kathleen McGuire said in a statement, "New World Waking! is truly a piece for our time and captures, in music, stories of incredible power, pathos and hope."
In 13 emotional, genre-transcending songs, New World Waking! explores violence in the community and in the world and celebrates the individuals who stand up to it and change the world in the process. The Community Women's Orchestra provides full accompaniment.
Two songs tell the true stories of ordinary mothers who fought against the homophobia their gay sons faced and both women will be in attendance.
A special arrangement of "Guardian Angels" sung with Kim Kuzma and dedicated to the caretakers of those who struggle with HIV is the centerpiece of a tribute, introduced by three-time Academy Award nominee Piper Laurie.
The concert will conclude with an upbeat selection of holiday music, reflecting the diverse traditions of the Bay Area.
Louise M. Davies Symphony Hall is located at 201 Van Ness Avenue (at Grove Street).
Tickets for the event start at $20 and are available from the community box office at the LGBT Community Center (1800 Market Street, San Francisco), by phone at (415) 865-2787, or online at www.sfgmc.org.
A portion of all proceeds will assist HIV/AIDS charities Under One Roof, Meals of Marin, and the Positive Resource Center.
Shanti
Shanti will be marking World AIDS Day and kicking off its 35th anniversary on December 1 at 111 Minna Gallery.
Founded in 1974, Shanti later became the first community-based agency in the United States to serve people with HIV/AIDS.
The organization works to enhance the quality of life, health, and well-being of people living with breast cancer and HIV/AIDS and works with organizations nationwide through its training and consultation programs.
Dr. Lisa Calpaldini and openly gay Supervisor Bevan Dufty will be honored for their work advocating for and serving people living with HIV/AIDS. The Sisters of Perpetual Indulgence will be on hand to offer a blessing.
Visual art from Bay Area artists and Shanti clients will be available for viewing and purchase during a silent auction.
There will be a cash bar. Appetizers and non-alcoholic refreshments will be provided. Each guest will receive a gift bag.
No one will be turned away for lack of funds.
The event runs from 5:30 to 8:30 p.m. at 111 Minna Street in San Francisco. A minimum donation of $35 is suggested. Tickets can be purchased at www.brownpapertickets.com/event/49069. For more information about Shanti, visit www.shanti.org.
LGBT center
In conjunction with Shanti, the LGBT Community Center will host a photo exhibit commemorating World AIDS Day. An opening reception takes place Tuesday, December 2 from 6 to 8 p.m. at the center, 1800 Market Street in San Francisco.
The exhibit, "A Look at LIFE," was created by participants in Shanti's Learning Immune Function Enhancement program, who use images and text of their own conception to examine life issues that have affected their health and well-being as people living with AIDS.
The exhibit goes up Monday and will be on display through January 15.