By Bill Wolf

During the last year, in the fight against AIDS in Oaxaca, there has been mention on repeated occasions, “The San Francisco Model” and it has been suggested that there is something in that model which can be applied here.  Statistically, there are many similarities between San Francisco some ten years ago, and Oaxaca today.  The number and increase of cases reported in that city in the years 1981, 1982 and 1983, are almost identical to those numbers in Oaxaca in the years 1989, 1990 and 1991.  During the years immediately following 1983 in San Francisco, AIDS increased rapidly and the city faced an enormous number of cases.  However, during those same years, the city and the community began a massive program involving all sectors of society with the single goal of stopping this disease from spreading to persons not infected.  For several years, infection by the virus continued to increase, though in smaller numbers.  Around 1986 the percentage of new infections began to decrease and today it is almost zero, for which the city of San Francisco is practically unique in the world having stopped the spread of AIDS in its population.  The actions taken and the programs initiated by the city and the community have become know around the world as the “San Francisco Model.”

            In this essay, I would like to examine this model and what San Francisco did during the last decade.  It is hoped that Oaxaca might see a reflection of itself in this discussion and encounter ideas and actions which could be useful in this city as they were in San Francisco, that is, to prevent the spread of this disease in the population of Oaxaca. 

            At the head of the decade of the 80’s, the future of the epidemic looked bleak.  There was not a cure on the horizon, nor hints of a vaccine, only far in the future.  The city became aware that  the only battle to be fought on a local level was prevention.

          During this time, there formed a number of local volunteer organizations dedicated to AIDS prevention and I observed their work.  These years saw an enormous increase in AIDS cases and soon the vast majority of people knew someone with AIDS.  There opened testing centers and many people discovered they had the virus.  There was much fear and apprehension, stories of bus drivers wearing rubber gloves and persons afraid to eat in certain restaurants.  It was rumored that the virus was spread in the water, the air or by simply touching someone infected.  There was an urgent need for correct and truthful information about the virus and its transmission.

            Two things happened.  First, the highest levels of government and health officials launched as strong program to inform the populace about the disease.  In 1983, the city sponsored a symposium about AIDS under the mayor’s auspices, open to the public and to the press.  There were presented in clear and corrects terminology, the facts about transmission of the virus and prevention.  There were frank discussions about sexuality and safe sex in open meetings.  The Department of Public Health committed itself to “an aggressive campaign to inform the public and all resources necessary to complete it.

            Second, the people of San Francisco responded to AIDS by forming, in the first few years, dozens of new community-based organizations to address the many needs of the community as a result of AIDS.  A food bank was established to give food to AIDS patients who needed it.  Groups form safe-sex workshops in the neighborhoods.  Groups provided therapy to patients, to HIV positives, to their families and friends.  “Open Hand” began providing hot cooked meals brought to the homes of AIDS patients, and P.A.W.S. “Pets Are Wonderful Support) organized volunteers to walk the dogs and help care for the pets of persons with AIDS.  The church offered support as well as many small businesses in the city.  The Shanti Project began training volunteers to be counselors for AIDS patients and the AIDS Emergency Fund began raising money to give direct grants to help with the basic necessities of needy AIDS patients.

            The art community, hit hard by this virus, responded with theatrical benefits and spectacular entertainments to inform the public about AIDS and raise money for the battle.  Direct telephone lines were set up with AIDS information and counseling 24 hours a day.  The press and television actively decided that the health and well being of their public was in their highest interest and published ample reports and extensive coverage of AIDS in San Francisco.

            Further, the importance of the condom was embraced as public policy with hurricane fource.  There were condoms everywhere, bars and clubs, theaters, newsstands, private parties, benefits, clinics and hospitals.  They were free and we were told to “have them when you need them!”

             There appeared large posters and billboards urging condom use.  The insides of buses and trolleys, the walls of the metro stations, all had messages about safe sex.  They presented openly and explicit sexual materials about prevention and reduction of risk.  It was felt the money spent on free condoms and advertising programs about safe sex was well spent.

            It is considered that the strong commitment by health authorities, medical researchers, health workers and the general populace in San Francisco was the first step in the battle against AIDS.

            The actions of the people of San Francisco came from the strong need to respond to this disease in a way that was positive, free from prejudice, insisting that persons with HIV/AIDS receive the best medical attention available.  Through these actions many persons gained new personal values, taking control of their bodies and their lives.  The self-esteem acquired through these steps has been seen to be vital for true conduct change.

            Thus the city of San Francisco put in march a program on an enormous scale that has become a mark against which others are measured; it has become known as the “San Francisco model” and the people of this city can be rightly proud of their achievements.

            Today the city continues to suffer under the great weight of this epidemic.  However, there exists a positive feeling among the people, who find courage in knowing that their efforts have gone a long ways toward halting the advance of this virus in their population.

Bill Wolf

AIDS Emergency Fund

San Francisco, California