Creating a community center as a structural intervention to promote sexual health among gay men in San Francisco
S. Gibson1, R. Blue1, A. Cano1, S. Charfauros1, D. Gluth1, C. Hall1, R. McMichael1, K. Roe1, T. Ryan1, W.T. Steward2
1SFAF, San Francisco, United States, 2UCSF, Center for AIDS Prevention Studies, San Francisco, United States
Issues: San Francisco has seen endemic rates of HIV, with 800-1000 new infections annually, 77.2% of which are among gay-identified and other men who have sex with men (G/MSM) (SFDPH 2004). Additionally, syphilis has increased, with 70% of all new cases diagnosed among HIV positive G/MSM (SFDPH 2008). As many prevention campaigns continue to focus on individual behavior change (testing, disclosure, condom use), gay men are adopting seroadaptive strategies to reduce acquisition and transmission of HIV (NIH 2008).
Description: A multi-year planning effort led by gay men sought to de-stigmatize sexual health and provide education that moved beyond an AIDS-based paradigm; integrate services; and instill men with a sense of ownership over their health. From this work, Magnet was created. Magnet, a program of the San Francisco AIDS Foundation (SFAF), is now in its sixth year of operations. Magnet is a sexual health services and community center located in the city’s primary gay neighborhood. Magnet’s convenient and visible location is intended to normalize utilization of HIV testing, STI screening and treatment, and substance use and mental health counseling; and to integrate these previously disconnected services.
Lessons learned: Magnet has provided services to more than 24,000 visitors, far exceeding original projections of 1,500 clinical visits annually. The high demand and utilization of clinical services is helping detect HIV infections and linking gay men to appropriate care.
Next steps: SFAF is coordinating an international effort with Epicentro (Lima, Peru) and Health4Men/PlayNice (Cape Town, South Africa) to convene similar interventions being designed in gay communities outside of the US. A scientific analysis is now underway with the UCSF Center for AIDS Prevention Studies to understand if Magnet has also affected men’s HIV prevention social norms and their sense of ownership over their sexual health and the health of their partners.