Starting in 2006, San Francisco made HIV testing more accessible and widespread by simplifying consent. In 2010, the city made headlines by advising people to initiate treatment at HIV diagnosis, regardless of CD4 level. San Francisco also developed programs to accelerate linkage to treatment and scaled-up PrEP delivery.

The city’s Getting to Zero initiative focuses on wider access to PrEP, the RAPID ART program linking people to treatment, and efforts to reach people not currently accessing services, particularly those who face serious challenges to medication adherence. A coordinated multi-sector ground-up approach to designing and implementing programs, and its long-standing focus on harm reduction, helped San Francisco achieve substantial reductions in new HIV infections.

Citations

Das-Douglas M, Zetola NM, Klausner JD, Colfax GN. Written informed consent and HIV testing rates: the San Francisco experience. Am J Public Health. 2008;98(9):1544-1545.

Buchbinder S. Getting to Zero San Francisco: The Power of Collective Impact. Presented at: IAS2017. http://www.gettingtozerosf.org/wp-content/ uploads/2017/08/Buchbinder-IAS-2017-90-90-90-final.pdf. Accessed July 8, 2019.