Bay Area Reporter - May 25, 2006
Rob Akers

"An ounce of prevention is worth a pound of cure," he said. And although there is still no cure, that old adage was the basic message about the state of the battle against HIV/AIDS.

Carmona, who was appointed surgeon general in 2002 by President Bush, applauded efforts by organizations like API Wellness Center who have taken up the battle to fight the stigma placed by society on those who are living with the disease.

"Thanks to new antiviral drugs, people are not only living longer with this disease, but are living healthier," Carmona said. "Now, the biggest thing for us to combat is the stigma on those who are forced to live with this disease. It is efforts by this group, and others like it across the country, to keep the light on it."

API is spearheading The Banyan Tree Project; a multi-year, nationwide campaign to fight HIV related stigma and discrimination.

Carmona, who grew up in Harlem, was a young doctor at the University of California who treated the first HIV patients here in San Francisco when the disease hit 25 years ago.

"I remember what it was like very clearly. We just did not know what to do. We had these people coming in with this wasting disease. We tried surgery. We tried antibiotics. Nothing worked," he said. "Today, we have an estimated 1 million cases in this country with 40,000 new cases reported each year. What usually makes the headlines is the impact this disease has on our economy and other health related stories. But what usually does not make the headlines is people's pain and loss."

Carmona said communities must be involved in engaging in dialogue about the issue.

"In order to battle the stigma and urge prevention we must take action on a community level," he said. "The unique part of the program here is the translational element. We must ask ourselves the question, how do we engage those folks who have a family member that is living with HIV/AIDS."

"They get it here," he said of the staff at API. "They understand how to relate to people on a one-to-one basis, to break down the barriers," he said.

"Due to the increased immigration and its impact, sometimes the absolute numbers can fool you. San Francisco is one of the most diverse cities in the world. It is a challenge for any health care provider."

Carmona said that HIV prevention "is still number one" in fighting the disease.

"Much of what we pay for today is preventable. It is just like the person who comes in who has never exercised, eats whatever they want and lives a generally unhealthy lifestyle ... they probably might end up with heart disease," Carmona said. "The message still is ... if you do not practice risky behaviors, you probably will not get AIDS."

When asked by the Bay Area Reporter why the latest information on the surgeon general's Web site concerning HIV/AIDS dates back to 2003, Carmona replied, "We actually have several Web sites and new information should be posted on a daily basis. If something has been left off, it is probably an administrative snafu."

"I make 200 to 300 speeches every year, mostly concerning HIV/AIDS and whatever new research is being done is always being posted," he said. "There is much to be happy about ... but there is still a lot of work to do."

John Manzon-Santos, API Wellness Center executive director; Tien Bui, an API board member; and Carol Chen, Miss San Francisco, joined Carmona at the news conference.

Bui, who is employed in the field of HIV/AIDS as vice president of Monogram Biosciences Inc., said she joined the board at API Wellness Center in order "to give back."

"I have been working in the field since 1996 and have seen some major advances" in fighting the disease, she said. "I have seen some great strides in understanding and treatment, but also have seen the disparity for people of lower socioeconomic backgrounds. This became more apparent to me as the disease shifted to minorities and adolescents."

Chen, the first-ever Asian Miss San Francisco, introduced Carmona during the news conference, stating, "It is very important to fight the stigma of HIV that hinders treatment and prevention."

Statistics released by API noted that San Francisco's Asian and Pacific Islander AIDS incidence rate is the highest in the nation, at more than six times the national rate, according to the Centers for Disease Control and Prevention.

The number of AIDS diagnoses increased among Asians and Pacific Islanders by 34 percent from 1999 to 2003. The HIV infection prevalence rate rose from 2.6 percent to 3.8 percent among API 18 to 29 year olds in San Francisco.
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