Important note: Information in this article was accurate in 2007. The state of the art may have changed since the publication date.
Bay Area Reporter - August 2, 2007
Matthew S. Bajko, m.bajko@ebar.com
"I wanted to help. I know that San Francisco is a model that is looked at worldwide," said Maynard.
Maynard joined nearly 100 people who attended a July 26 forum presented by the San Francisco HIV Health Planning Work Group. The 14-person work group is comprised of local health officials, AIDS agency executives, and people living with HIV and AIDS.
The group has been meeting over the last 18 months to devise a way to engage the community in a strategic process that will look at the status of HIV and AIDS prevention, care and support services in the city. Over the next six months various meetings will be held to gauge how the community would like to see that system reorganized to meet the changing needs of HIV patients.
The outcomes will help health officials prioritize services as they face financial constraints due to dwindling government support and new restrictions on how they can spend federal dollars. The audience at last week's meeting was broken down into smaller groups to address those issues.
"My group was about access, access, access. How to gain access to primary care and how to provide integrated primary care to the many facets a person with HIV might have to deal with, such as housing, psychiatric needs or substance use," said work group member Brett Andrews, executive director of the Positive Resource Center. "Taking your vitals just isn't enough."
Last week's two-hour meeting included an overview of San Francisco's current health care system by former Health Director Dr. Sandra Hernandez, now chief executive officer of the San Francisco Foundation and an HIV practitioner at San Francisco General Hospital.
Hernandez became a physician at the beginning of the HIV epidemic 26 years ago and lost a brother to AIDS. As HIV drugs have improved and her patients live longer, Hernandez said her clinical practice now resembles that of a "general medical practice." Her patients are dealing with hepatitis C infections, liver problems, and issues that come with aging.
"HIV isn't just a stand alone issue," she said.
Whereas back in the day she and her colleagues worked to keep their patients out of hospitals and hospices, today the concern is more about keeping them housed in their own homes.
"Affordable housing is a huge issue. You can not manage HIV well for people with unstable housing situations," she said.
For others it is not so much housing but access to care. Marin resident Joe Luna, HIV-positive for 17 years, said he has a home. He is more concerned about getting the runaround when it comes to getting the drugs and services he needs to stay healthy.
"As the epidemic changes, my status changes but I am not being kept up with what can be done for me," said Luna. "It is still a maze that a lot of people can't navigate. I would imagine being homeless and being newly diagnosed it is doubly hard to navigate."
If there is one overarching issue, it is making access to health services easier, said Hernandez.
"We are by no means perfect but we have state of the art medical care in this city. What we don't have is equal access to it," she said. "It is a maze. We didn't build it to be a maze. But you really need to know where to go to get certain services."
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