Getting to Zero SF
San Francisco is on the path to achieve the UNAIDS vision of “Getting to Zero”: zero new HIV infections, zero HIV deaths, and zero HIV stigma by 2020. From the very beginning and throughout the HIV epidemic, San Francisco has led the way in setting standards for prevention, care, and treatment recognized around the world. This ambitious initiative is made possible because of the tremendous work being done by existing organizations and the thousands of San Franciscans who choose to take an HIV test, opt into HIV care, negotiate safer sex practices, and champion an inclusive community.
Our goals are to reduce both HIV infections and HIV deaths by 90% from their current levels by 2020. The newly launched Ending Stigma Committee will identify a measurable goal for reducing HIV-related stigma.
Our strategic plan describes a comprehensive approach that continues funding for successful efforts and calls for 3 signature initiatives to start or expand—PrEP expansion, RAPID (Rapid ART Program for HIV Diagnoses), and retention in care—which focus on eliminating new HIV infections, preventing HIV-related deaths, and reducing health disparities for HIV-affected populations in San Francisco. We coordinate efforts around the city and leverage existing resources to maximize return on investment, working under the umbrella of the City of San Francisco.
What is working
The City has a robust HIV surveillance system, widespread HIV testing services, syringe access programs, comprehensive HIV care in the public and private sector, and strong linkages between internationally renowned community organizations and scientists. San Francisco General Hospital was the first in the country to recommend treatment for all persons living with HIV, a policy which has since been adopted nationwide. The City was among the first to conduct implementation programs for PrEP. As a result of all these activities, HIV prevention and treatment become more successful each year—now, 94% of San Franciscans living with HIV are aware of their infection, 89% are linked to medical care within 90 days of their diagnosis, and approximately 85% of all San Franciscans living with HIV are receiving antiretroviral treatment. Support for these programs must continue.
Where San Francisco needs to go
To reach our goals, we need to ensure that all San Franciscans, including youth, are knowledgeable about HIV, know how to protect themselves, and have skills to support friends living with HIV. All San Franciscans need easy access to medical, mental health, and substance use services. We need efforts to mitigate and measure stigma, because even today, persons living with HIV face stigma from family, friends, and community that hampers access to prevention and care. It will take a broad coalition of community members, schools, businesses, government agencies, and HIV providers working together to achieve this vision. Only by increasing knowledge and access to prevention strategies; increasing services for people living with HIV not in care; and providing support and services for substance use, housing instability, and mental health promotion can we get all the way to zero.