August 4, 2011
On Sept. 1, nearly $7 million in San Francisco HIV prevention contracts are set to be awarded to community-based AIDS organizations. The funds are being prioritized to promote earlier diagnoses and increase treatment rates toward the goal of achieving dramatic reductions in new infections. However, some advocates worry whether the city's "test and treat" approach will overlook certain populations, including women, youths, and some minorities. And the groups have been put on notice they will face greater oversight to ensure they are meeting agreed-upon goals.
Testing people regularly and offering treatment sooner are major HIV prevention priorities for the city. Another increased focus is reducing the population-level viral load, which new research shows helps lower new HIV infections.
"Unless we change what we do, we are not going to eliminate new infections, because we are in an endemic," said Dr. Grant Colfax, the city's HIV Prevention Section director. "How do you link people to care? It is hard. It is not going to be easy, but we have to do it."
To help cut new HIV infections by 50 percent by 2017, officials at a recent meeting identified several expected outcomes, including seroawareness for 75 percent of men who have sex with men, injection drug users (IDUs), and transgender women who have sex with men; and viral suppression for 85 percent of HIV-positive people.
The new focus is "really medicalized," and puts agencies in a position where "all we're trying to do is meet our numbers," said Jackson Bowman, a member of the HIV Prevention Planning Council (HPPC).
The department will work to ensure community groups can be successful, said Tracy Packer, the unit's deputy director. Given budget limits, HPPC "made a decision we are going to prioritize our funding" for risk groups such as MSM and IDUs, she said.
Bay Area Reporter (San Francisco)
07.21.2011; Matthew S. Bajko; Seth Hemmelgarn
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