This approach, "Prevention with Positives," involves identifying who is HIV-positive faster, and then treating and linking them to continued care quicker. Treating people sooner and lowering their viral load — the amount of disease in the blood — makes it less likely HIV will spread, even during unprotected sex.

The department is also in talks to begin piloting a pill called PrEP (pre-exposure prophylaxis) that HIV-negative men would take daily as another form of protection against the disease. Because condoms serve the same purpose, this indicates that men could respond better to some prevention strategies than others. As part of this rollout, the city would first give pills to the men most susceptible to HIV, which include men who have multiple male sex partners or a primary partner who is HIV-positive.

The strategy came to a head on Sept. 1, just weeks prior to the town hall meeting, when SFDPH's new funding contracts for community-based HIV/AIDS organizations went into effect. It was evident from the allocation of the available $7 million that SFDPH was prioritizing testing and treating over risk-reduction programs.

Claude Wynne has no problem with people going to sex clubs. He just wants them to wear condoms.
J.P. Dobrin
Claude Wynne has no problem with people going to sex clubs. He just wants them to wear condoms.
Gehno Sanchez doesn’t think 
monitoring for condom use will fly at his Cockpit parties.
J.P. Dobrin
Gehno Sanchez doesn’t think monitoring for condom use will fly at his Cockpit parties.

Several organizations were left with little choice but to scale back their prevention programs. The Stop AIDS Project, for example, announced at the end of October it was merging with the San Francisco AIDS Foundation. Up until that point, Kyriell Noon, the Stop AIDS Project's executive director, said that the organization had halted in 2011 its visits to sex clubs to give presentations and provide condoms.

Experts around the country largely herald SFDPH for leading the pack in HIV/AIDS research and treatment, though they caution the city not to lose sight of traditional behavioral models of prevention that help the uninfected change and avoid risky behaviors, and keep the infected from abandoning their treatments and jeopardizing the health of others.

It is curious then that the department says it is revisiting the issue of sex clubs at a time when it is shifting its focus toward more tests, treatment, and care, and when funding has prevented organizations from doing their usual outreach in sex clubs.


The Department of Public Health began formal, internal discussions about the sex clubs and private parties during the second week of November. The STD Prevention and Control unit oversees most of the department's outreach in sex clubs, from checking to see if its guidelines are voluntarily followed, to offering on-site HIV and STD screenings (as of September). Director Dr. Susan Philip says the city has a good relationship with the clubs, but that it is difficult to reach out to the private parties, since they are not permanent fixtures, and because the clubs are not required to regulate or report their activity.

If the city were to try to extend its voluntary sex club standards to the private parties, it would likely be futile, especially at parties people attend to bareback.

Gehno Sanchez, the man behind some of TIM's press releases, and organizer of the sex party SF Cockpit, says as much. He has worked with the department to arrange HIV and STD tests for Cockpit members, and says he too is concerned about the ambivalence he sees in the younger generation to finding out their HIV status. Sanchez says he is all for providing resources to encourage safe sex. He is even changing his party from a one-size-fits-all format to separate parties for people of different statuses. But he says he draws the line at telling people to wear condoms, if that ends up being what SFDPH wants.

"If I started monitoring people, they would hide," Sanchez says. "I want people to monitor themselves."

Philip declined to offer any fact-based or anecdotal information to suggest the department believes barebacking at sex clubs or private parties is increasing or that it is a setback to its new HIV strategy. Rather, she says the department's discussions were prompted by community complaints.

"Any decision we make ... we would want to make sure it actually promotes public health, instead of decreasing privacy and people's ability to determine their own levels of risk," she says, singing a familiar tune.

Interestingly, the biggest setback to the bareback movement has come not from SFDPH or HIV/AIDS organizations, but from the state's Division of Occupational Health and Safety. Cal/OSHA's rule prohibiting the spread of blood-borne pathogens in the workplace, including through semen, has caused TIM and BarebackRT to take their filming out of state rather than put on condoms.

"From what I understood, they had already fined Treasure Island, and we were just like, 'Yeah, that's not going to work,'"Mastrosimone says.

Meanwhile, SFDPH continues to deliberate doing anything more than the status quo. Philip says a decision will only come after heavy community input.

The department can count on at least one person to participate.

After Wynne checked in his clothes at the CumUnion party, a man approached him. He wanted to have intercourse. But Wynne hesitated, and bargained for other sexual activities. He wants to stay HIV-negative.

Wynne acknowledges that continuing to go to bareback parties doesn't send the strongest message of opposition; in fact, it borders on hypocrisy. Temptation has gotten the best of him before; he has had unprotected anal intercourse, but has never been on the receiving end, which reduces his odds of infection. Still, it is a constant battle.

"In a way, I'm asking the government to protect me from myself," he says.

E-mail Taylor.Friedman@SFWeekly.com

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