Bay Area Reporter - April 24, 2008
Matthew S. Bajko, m.bajko@ebar.com

In response to a question at a meeting with community members Wednesday, April 23, Dr. Grant Colfax said he is not inclined to support ending the decades-long policy of restricting private rooms inside the city's sex clubs.

"My personal view is it is very difficult to justify re-opening the baths," said Colfax, who has been on the job six months and kicked off a listening tour this week in the Castro.

An HIV researcher with the health department for 10 years, Colfax said his opposition stems from the mounds of data that show men engage in high-risk sexual behaviors in venues such as bathhouses.

Even if Colfax felt the policy was no longer warranted, Health Director Dr. Mitch Katz has repeatedly said he sees no reason to reopen the baths. Without the support of the two openly gay men, the policy will likely remain in place for some time, though Katz has already announced plans to retire at the end of 2009.

Ken Pearce, a member of the city's HIV Prevention Planning Council, brought the issue up during the meeting. While he said the policy made sense during the 1980s when information about HIV and AIDS was limited and the epidemic was wiping out the city's gay male population, in today's age he said there is little reason to maintain it.

"Why can't we have a discussion on whether this makes sense to continue to ban bathhouses? We have sex clubs that are de facto baths," said Pearce, who has a master's degree in health administration and planning from the University of Washington and ran psychiatric hospitals for 15 years before retiring with AIDS, according to his HPPC bio. "We know people are going outside the city when they want to go to the baths."

Part of his rationale for rescinding the anti-baths restriction, said Pearce, is it would allow for direct HIV prevention efforts with customers. With men using the Internet as a virtual bathhouse, he said it is not as easy to direct HIV prevention messages to them online.

"As a member of the HPPC two years running I have brought it up. All we hear is Dr. Katz doesn't think it is appropriate but we don't know why," said Pearce. "A little part of me bristles when I hear that. It sounds like a parental mode of 'We know better.'"

Colfax said he had not spoken to Katz since taking on his now role inside the department. Though he did say he is not opposed to discussing the issue further.

"We can certainly have the discussion," said Colfax.

Roughly 35 people, mostly men, a majority of whom were Caucasian, attended the meeting. Many attendees either work for local service providers and the health department or serve on the city's two HIV planning bodies.

Those who spoke voiced a wide range of concerns, from wanting to see more information on hepatitis C and PEP, the post-exposure prophylaxis treatment for those exposed to HIV, to more focus on communities of color and gay youth.

AIDS activist and HPPC member Hank Wilson asked that more information be provided to the community about poppers usage being linked to HIV transmission. While he applauded Colfax for his work on the issue, he said community service providers are not focused on the issue.

"I don't want to see a contract where one agency responds to poppers. I want to see diffusion," he said.

He also complained that AIDS agencies are not equipped to deal with the latest news or controversies surrounding the epidemic.

"I see agencies become rigid and not able to deal with things," he said.

Colfax agreed that poppers are "definitely a problem" and said he wants to see them included in substance use strategies.

As for PEP, Colfax agreed many men do not know about the four-week drug regiment or where to go to get it. But he added data is lacking to show it truly works, and with limited resources, questioned if it made sense to launch a PEP-focused campaign.

Kelly Hart, who is HIV-positive and serves on the HIV Health Services Planning Council, inquired what the department was doing to reach men of color.

"What are we doing to reach out to the Latino community? Is there any talk about creating a Latino Coalition on AIDS?" asked Hart.

Colfax has commissioned reports on how to deal with HIV transmission in both the Latino and African American communities. He expects the reports to be completed later this year.

He said the feedback would be used to help shape the city's HIV Prevention Plan. Updated last in 2004, the plan is currently up for revision, and Colfax wants to have a new plan adopted by the end of 2010.

"The epidemic in San Francisco remains not terribly different from what is was five years ago. We still have high rates of infection centered among gay men and the transgender community. There are some women at risk, and we have continuing discrepancies in the epidemic, especially among African American men who have sex with men."

The plan review process, he said, will address "what are the priorities we need to fund over the next five years?"

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