Last week, at the 2006 State of Santa Clara County address, dozens of lesbian and gay residents joined a packed auditorium of community, business and political leaders to hear Board of Supervisors Chair Jim Beall make a public plea for "additional funds for a public health department capable of protecting us all."
In articulating the financial benefits of a strengthened public health system dedicated to disease prevention and early diagnosis, Beall said, "We all benefit when we reach out and help the most vulnerable in our community."
Beall could not be more right.
Twenty five years after an article in the New York Times reported an outbreak of a rare "cancer" in gay and bisexual men living in New York City and areas of California, nearly 550,000 Americans have lost their lives to AIDS.
Among those dead Americans are nearly 2,000 residents of Santa Clara County. As Santa Clara County is near the heart of our nation's HIV/AIDS epidemic, most county residents know of at least one close friend, a beloved family member, a respected business associate, or a friendly neighbor who has courageously battled this disease.
Another one of those dead Americans is my first partner, Dr. Robert Wisler. A highly regarded anesthesiologist, Robert learned of his HIV infection in 1990 after developing an AIDS-related pneumonia. With a low CD4 count and after fighting off numerous opportunistic infections, Robert died in the spring of 1994 at the tender age of 36. Widowed at 27, I pledged to do whatever I could to prevent other gay and bisexual men from losing the ones they love.
Today, over 2,500 Santa Clara County residents know that they are battling HIV, the virus that causes AIDS. With the Centers for Disease Control and Prevention reporting that one in three Americans infected with the virus remain undiagnosed, an additional 800 Santa Clara County residents could have the disease but do not yet know that they are infected.
The cost to Santa Clara County taxpayers of this hidden epidemic is enormous. Researchers estimate that the average, per-patient, lifetime cost of HIV treatment is $155,000 and these costs escalate dramatically if patients' learn of their HIV diagnosis only after suffering a serious illness. In Santa Clara County, far too many newly diagnosed persons still learn of their infection only after receiving hospital-based emergency room services.
In 2003, the CDC announced several key public health strategies that could reduce the nation's estimated 40,000 annual HIV infections. With updated HIV prevention efforts now focusing on risk reduction counseling to persons known to be infected with HIV, the CDC strongly recommends that local health departments expand and improve their public HIV test counseling programs in order to identify more persons infected with the virus.
At the center of our nation's HIV/AIDS epidemic, the San Francisco Department of Public Health long ago developed dozens of HIV test counseling locations that are strategically placed in communities with populations seeing moderate to high rates of HIV infection. In comparison, despite an LGBT population estimated to be well over 100,000 residents and a county population that is twice the size of San Francisco, Santa Clara County operates just one permanent location for anonymous HIV test counseling services.
As nearly 80 percent of all local cases of HIV/AIDS are among gay and bisexual men, many South Bay community leaders are urging the county to establish an additional permanent, fulltime, HIV testing and counseling program at the Billy DeFrank LGBT Community Center. Celebrating its 25th anniversary in serving a diverse LGBT community in the South Bay, the DeFrank center has a long history of providing quality HIV prevention services for persons and communities at greatest risk of HIV.
With Latinos, homeless and runaway youth and chronic substance users disproportionately affected by the local HIV/AIDS epidemic, the Santa Clara County public health department also needs to develop and implement a network of at least five permanent, part-time, HIV test counseling sites located throughout the county.
In urging cost-effective legislative action that will improve the overall health and well-being of all county residents, Supervisor Beall spoke for all of us whose lives have been impacted by HIV/AIDS when he said, "The hands of human need are close – not far. They are the hands of people reaching out for hope. We must reach back, grasp them with our hands, and embrace them with our compassion, to help them survive through hard times."
Clark Williams, MSW, is the interim executive director of the Billy DeFrank LGBT Community Center and a nonprofit management consultant. Williams managed Santa Clara County's HIV prevention, counseling, and testing programs from 2001-2003 and lives in San Jose with his partner, James Moore, and their 2-year-old daughter, Caroline.