In San Francisco, Permit Process Turns into Proxy Fight Against PreP-Skeptical Agency

A permit request by the AIDS Healthcare Foundation to relocate its pharmacy in the Castro has turned into a proxy fight over the Los Angeles-based agency's stances regarding HIV prevention and AIDS funding.

The agency has faced derision in San Francisco for its opposition to widespread usage of PrEP as an HIV prevention tool. AHF does support PrEP as "a good solution for individuals who have multiple partners and never use condoms," but contends strategies such as HIV testing, treatment for people living with HIV and AIDS, and condom usage should be given higher priority by health officials when it comes to funding.

AHF has also come under criticism locally for supporting condom usage on all porn sets in the state. After legislative efforts to enact such a policy failed, the agency worked to put an initiative before voters this November. It was behind a similar ballot measure in Los Angeles County that passed in 2012.

Those policy fights are now at the center of opposition to seeing AHF be granted city permission to relocate the pharmacy it owns on 18th Street into the street-facing portion of the storefront at 518 Castro Street. It relocated its health clinic into the rear of the space in the fall of 2014.

The city's Planning Commission is slated to vote at its meeting Thursday, January 14, on whether to approve AHF's permit request. The need for the AIDS agency to seek a permit has been the focus of an ongoing spat between AHF and city officials.

Initially, city planners in 2014 had granted the permits "over the counter," meaning AHF did not have to argue its case at a public hearing before the planning commission. The planning department then reversed course and said that AHF's pharmacy fell under the rules governing chain stores, even if it changed the name from AHF Pharmacy to Castro Pharmacy, and would need to secure a conditional use permit in order to relocate it.

AHF appealed that decision to the city's Board of Appeals, which last March ruled against it. Also, in July 2014, the city's Board of Supervisors passed interim legislation aimed at closing the naming loophole AHF had used to skirt the formula rules. The temporary zoning change was recently extended due to the pharmacy permit request still pending.

In response to the city's actions, AHF filed a lawsuit against it and gay District 8 Supervisor Scott Wiener, who represents the Castro, claiming the city had unlawfully targeted it with the interim zoning rule. But last April AHF announced it was putting its lawsuit on hold and would seek a conditional use permit in order to consolidate its pharmacy under the same roof as its health care center.

"We are asking them to approve a project that gives our patients the highest quality of care in a single location. It is not a novel model," Dale Gluth, AHF's Bay Area regional manager, told the Bay Area Reporter this week.

Support

AHF has received support from Bay Area Young Positives, which it has funded over the years, for its permit request. In a letter to the planning commission, BAYP Executive Director Curtis A. Moore wrote, "AHF has been one of our main HIV service partners because of the expertise of their staff, flexibility, and convenient location."

And Glenn-Milo Santos, Ph.D., a senior research scientist at the San Francisco Department of Public Health Substance Use Research Unit, also submitted a letter to the planning commission encouraging it to approve the pharmacy permit.

Opposition

Yet the agency's permit request has attracted strong opposition from Castro groups, residents, and HIV advocates. Both the Castro/Upper Market Community Benefit District and the Castro Merchants group voted to oppose AHF's pharmacy permit request.

In its letter explaining its opposition, CBD Executive Director Andrea Aiello wrote that AHF "has not significantly contributed to the neighborhood" despite its having a presence in the Castro for years. And she pointed to AHF's dispute over a rent hike with local hospice Maitri, its landlord at its former space on Church Street, which resulted in a legal dispute the two agencies agreed to settle.

Aiello also noted how AHF's policy stances are counter to the city's plan to eliminate new HIV infections.

"They clearly are not working with San Francisco's model to get to zero HIV infections; a model recently adopted by the World Health Center," she wrote.

Speaking before Castro business leaders at their meeting in November, Eric Paul Leue, the director of sexual health and advocacy at http://www.Kink.com, urged them to oppose AHF's permit.

"Every community member I have spoken to about AHF has responded with the same message: Keep your cookie-cutter medical model and sex-shaming, fear-based politics out of San Francisco," said Leue, who splits his time between the city and Los Angeles, where he serves on the LA County HIV Commission. "You're not welcome here. This is our community, and we will not let you defile it."

At the merchants' meeting, AHF's Gluth said the agency had donated $480,000 to local Bay Area groups in 2015. He also noted that AHF does prescribe PrEP to clients who wish to use it and that its pharmacy fills prescriptions for the once-a-day drug.

"This project has gotten pretty political. But it can't be about competition or disagreement over HIV prevention," said Gluth. "This is a land use issue."

The planning commission meets at noon Thursdays in Room 400 at City Hall, 1 Dr. Carlton B. Goodlett Place.