A 30-Year Legacy Ends

One of San Francisco's most critical HIV programs for low-income patients will shut down on Aug. 31.

Mish house (Courtesy of Noehill)

It’s easy to think we’ve beat the HIV/AIDS crisis. After a period in the 1980s and ’90s when San Francisco was ground zero for the epidemic, HIV can now be easily managed with antiviral medications. We even have Pre-exposure prophylaxis (PrEP) drugs that can keep HIV-negative people from contracting the infection, and only a few hundred San Franciscans are now diagnosed with HIV each year.

But those infections disproportionately hit the African-American community. The Centers for Disease Control estimates that a full 45 percent of all new HIV diagnoses are African-American patients — and now, a critical agency serving the African-American community and other underserved populations is about to close all its HIV programs.

Westside Community Services has provided home care, medical care, and counseling services to people living with HIV/AIDS since 1988. It’s part of a much larger program that delivers mental health and substance abuse treatment, along with services for infants and children, with a focus on the African-American community. The organization runs out of a historic, sprawling Victorian on Oak Street that’s known by local architecture enthusiasts as the Mish House.

But Westside won’t be providing HIV/AIDS services anymore. While it isn’t going anywhere, it will discontinue all its HIV programs at the end of the month.

“The decision to close these programs did not come easily for the Westside Board of Directors,” CEO Dr. Mary Ann Jones said in a memo obtained by SF Weekly, which stated that the center “has struggled to fund these programs for the past decade, and has had a structured deficit each year because the funding we receive does not support the operating costs of the programs.”

Westside provides an AIDS home-care program that serves hundreds of HIV-positive patients in the late stages of the disease or other medical complications who have difficulty leaving their homes. Its staff also runs an AIDS Case Management program that offers medical and social care. Their loss will be felt acutely.

“Our clients are the physically and emotionally frail: the blind, the daily dialysis patient, the socially isolated and the cognitively impaired,” Westside’s staff stated in a letter to the board, pleading to keep these programs in place. “Some [patients] wait on transplant lists, all have multiple appointments for care and endless treatments.”

These HIV-positive patients with severe mental health and memory impairments often have trouble remembering and attending medical appointments. Until now, Westside’s home-care programs have ensured that they get the medical attention and therapies they need, while also helping them pay their bills and perform routine home-maintenance tasks.  

But perhaps most importantly, home care provides a human lifeline, combating loneliness and isolation for some of the most disadvantaged San Franciscans living with HIV.

“Many [clients] have lost partners, friends, and family during the early years of the pandemic,” the staff points out. “For them, what will become of the links we all have patiently forged for crucial services? More importantly, what will become of our clients? There is no doubt that a number of them may be put at risk for homelessness.”

The closure of Westside’s HIV programs could leave more sick and elderly people living on the streets, at a time when San Francisco already has more than 7,000 homeless residents and a persistent accumulation of tent cities.  

While these programs may sound costly, the organization actually saves San Francisco a great deal of money. By serving late-stage HIV-positive patients in their homes, it keeps them out of hospitals or other city-funded care programs like homeless shelters.

Westside Community Services has been around for nearly 50 years. It’s survived a few crises, and will continue to provide the mental health and family services it provides now. But for hundreds of San Franciscans living with HIV, the closure of Westside’s AIDS programs represents a scary and uncertain future.

 

 

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