For decades San Francisco's efforts to stem the tide of HIV infections in the Latino community have largely focused on the city's Mission neighborhood, where a number of nonprofits providing health care services to a predominantly Spanish-speaking clientele are located.
Representing the neighborhood and its needs at City Hall is the District 9 supervisor. With incumbent Supervisor Hillary Ronen termed out of office early next year, her successor will be elected in November.
As such, the Bay Area Reporter queried the candidates running in the race on what can be done to stem the tide of new HIV cases in the city's Latino community. As the B.A.R. previously reported, Latinos were the only group to see an increase in new cases (67 of 157 cases, or 43% of new diagnoses, up from 36% in 2021), according to San Francisco's HIV Epidemiology Annual Report for 2022.
New HIV cases increased more among Latinos than any other group in 2022, according to the report that was released December 5, 2023.
After a debate January 17, candidate Stephen Torres, a queer Latino man who used to be on the Castro LGBTQ Cultural District board and the city's entertainment commission and who works at Twin Peaks Tavern on Castro Street, told the B.A.R. that he agreed with the points about cultural competency made in a separate interview with Gustavo Ordonez, a gay man who is a program manager at AGUILAS, a longtime HIV/AIDS nonprofit catering to the Latino community. Ordonez told the B.A.R. that "just because you translate a program into a language doesn't mean it's focused on that community."
In other words, materials should be translated in a more culturally appropriate way, not just translated directly from English to Spanish.
Torres said there needs to be more of an effort to reach targeted populations where they are already.
"There needs to be more collaboration, working together to close the gap," Torres said. "We need to go out into the places where queer people of color gather."
Candidate Trevor Chandler, a gay man who sits on the California State Board of Pharmacy, referred to a PrEP bill by gay state Senator Scott Wiener (D-San Francisco) that Governor Gavin Newsom recently signed.
"We must remove as many barriers as possible to make PEP and PrEP universally accessible on demand," he told the B.A.R., referring to post- and pre-exposure prophylaxis. "I've been proud to support legislation on the California State Board of Pharmacy, authored by Senator Scott Wiener, to do just that."
Chandler was referring to Senate Bill 339. It authorizes a pharmacist to furnish up to a 90-day course of PrEP, and requires the California State Board of Pharmacy to adopt emergency regulations to implement these provisions by July 1.
PEP, or post-exposure prophylaxis, is a medication regimen taken soon after a possible exposure to prevent HIV. PrEP refers to pre-exposure prophylaxis and is medication taken daily.
Candidate Jackie Fielder, a queer Mexican and American Indian woman, echoed the cultural competence matter in her statement to the B.A.R.
"We need language equity, getting materials translated, and deep partnership with groups that work with undocumented people to get people info and care from trusted sources," Fielder stated. "I'm in touch with people deeply involved with the Getting to Zero program."
The city's Getting to Zero program aims to reduce new HIV transmissions and HIV deaths by 90% by 2025, in addition to reducing stigma.
Candidate Roberto Hernández, a Latino man and straight ally known as the "Mayor of the Mission," stated in an emailed message, "Since the beginning of the AIDS epidemic the city of SF has failed to adequately address the impact on the Latino community."
"At one point I proposed to the Department of Public Health and UCSF to test members of our community at the Carnaval San Francisco two-day festival," Hernández stated, referring to the popular annual May festival in the Mission that he's produced for decades. "I got some pushback from them since they felt it was a party and people would not want to be tested. I argued that those were exactly the people they needed to test. Ultimately, they agreed. The second day of the festival they panic because they ran out of needles to test people."
The B.A.R. asked Hernández when DPH and UCSF pushed back against testing at Carnaval, and he stated it was in 1988. A DPH spokesperson declined to comment. UCSF deferred to DPH, "since it's not a UCSF issue or decision," a spokesperson stated.
Candidate Michael Petrelis, a gay man who is a longtime AIDS activist, stated, "All recent HIV stats must be scrutinized in the context of COVID-19-related fluctuations in testing patterns across demographic categories."
"The health department's latest epidemiological report noted positive developments not widely reported: 'San Francisco continues to excel in many of the HIV prevention and care indicators [...] and new diagnoses remain relatively low,'" Petrelis stated. "Statistically, Latinos have a stable infection rate and we need to build on the existing assets to drive the numbers down.
"Release of the new figures, as is always the case with DPH, wasn't shared at a community meeting in the Mission in coordination with social service agencies serving the Latino gay male community," he added. "No effort was made to invite the public, especially sexually active queers of all races, to hear DPH plans addressing their needs for public insurance and health care on-demand regardless of ability to pay. Respectful engagement with the AIDS community was lacking as DPH generated alarming headlines and would go far to build cultural competency with at-risk of infection persons."
Candidate Julian Bermudez said that he believes in an "alternative approach."
"The city of San Francisco can only do so much in sex education and STI prevention," he stated in an email, referring to sexually transmitted infections. "The biggest hurdle the Latinx community has is the stigma surrounding getting tested and its accessibility. This issue can be approached by targeted marketing that normalizes regular health screenings.
"My suggestions are to promote these local organizations and resources to the Latinx community as a whole. Having collaborations with prominent queer Latinx artists and celebrities," he added.
Bermudez said that promotional materials tend to "be more 'straight leaning'" sometimes. He stated a good idea would be "to have a testing area or promotional booth at all major events throughout the Bay Area."
The B.A.R. reached out to candidate Rafael Gutierrez but did not hear back.
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