Bay Area Reporter - July 3, 2008
Heather Tirado Gilligan

Scott, 64, co-founded APEB in 1983 and still sits on the board. His private practice includes 4,000 patients, about 10 percent of whom are HIV-positive, Scott said. A significant number of his patients are without insurance and paid for by the county, he added.

Scott has also taken his practice to Africa in recent years. Every three months, Scott goes to Zimbabwe to treat HIV infected patients there as well, bringing with him several months of AIDS medication and donations from individuals and organizations.

Traveling across continents with life-saving medications or across town to see homebound patients are just two examples of Scott's decades-long devotion to the fight against the disease.

Scott started APEB when he noticed an increasing number of HIV-positive patients appearing in the private practice he began after completing his residency at Stanford University in the late 1970s. He has maintained close connections to APEB throughout his career.

"I've been blessed to be a board member for 22 out of the past 25 years," Scott said.

"There is only so much a doctor can do," he added, recalling some of the steps he took to bring treatment and prevention to the streets in Oakland. "Even 25 years later, there is still a lot of risky behavior."

He remembered waiting in city parks where people were having public sex without protection and approaching them afterwards with condoms to discuss safe-sex practices.

He also recalled that AIDS patients would regularly become so ill in the early days of the disease that he, his staff, and his volunteers would travel to their homes. They provided medical care, and sometimes did dishes and cooked for the patients who could no longer care for themselves.

Scott's bring-it-to-the-people brand of HIV prevention is still practiced by APEB, according to Alvan Quamina, the organization's executive director. Young people working for APEB hand out literature in the streets, in churches, and in parks, Quamina said.

"We take seriously our obligation responsibility to young people for care and prevention," Quamina said.

"People have become so accustomed to HIV/AIDS that they don't take it as seriously as they used to," he noted as one of their primary challenges in prevention.

People fighting to treat and prevent HIV must be proactive, Scott added in an interview later in the evening.

"We need to go where the people are," Scott said. Many people fear getting tested for the still-stigmatized disease, he noted, and outreach strategies need to account for that by reaching out to the public in ways that give people who want to be tested a sense of privacy.

No one should assume that they are safe from infection, Scott said. Sexual activity of any kind is a risk factor, and anyone who is sexually active should be tested, he added. It is not uncommon, he said, for new patients to seek him out asking for an AIDS test that other doctors refused to provide based on their evaluation of the patient's risk.

Still, fear of disease and stigma prevent many more from seeking a diagnosis at all. "People come to my office with a late diagnosis," Scott said. "They are very ill when they get here."

As Scott and Quamina focused on prevention and how much work remains in defeating the disease, state Senator Carole Migden (D-San Francisco), who also was honored by APEB for her decades-long work on HIV/AIDS issues, paused to remember how much their efforts paid off.

"Twenty-five years ago we faced the worst kind of devil that we've turned into a chronic disease," she said.

The fight continues, Quamina pointed out, as the agency struggles to keep up with the complex needs of its clients, who are seen at two clinic locations. He noted that it is especially difficult to meet administrative costs, which aren't covered by grants. Donations are essential to keep the program running, as grants and other funding often require matching or in-kind donations.

For more information on AIDS Project of the East Bay, visit http://www.apeb.org.

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