ince 1983, the Positive Health Program at San Francisco General Hospital and Trauma Center (SFGH) has been recognized as a world leader in the field of HIV/AIDS medicine. Devoted exclusively to HIV/AIDS primary care, HIV research and HIV education, the program’s vision to provide and improve care for those living with HIV extends from San Francisco to the global community. The outpatient clinic serves 20% of HIV+ San Francisco residents in care, and leads three of the six specialized Centers of Excellence for the San Francisco Department of Public Health. A variety of HIV-specialized primary care clinics, clinical trials, and diverse educational programs are offered to meet the evolving needs of HIV patients, clinicians and researchers. Despite the challenges of working in an older facility with limited infrastructure, the program has repeatedly been ranked as #1 in the country for AIDS care by scientific and general publications, including U.S. News and World Report.
Primary care: PHP features an interdisciplinary approach to care that integrates medical, psychosocial and educational priorities. PHP serves some 3,000 patients, most who have little or no health insurance. In addition to handling urgent and primary care, PHP case management professionals compliment clinicians by maintaining ongoing communication with patients to help them connect with the myriad of community services that can address their needs. The clinic utilizes an electronic medical records system designed specifically for HIV care. Specialized programs include a dedicated women’s clinic, services for patients co-infected with Hepatitis C and services for patients using self-injected intravenous therapy.
Research: World-renowned faculty direct multiple NIH and industry-sponsored clinical trials on various issues in basic and investigative translational science. These include: new HIV agents, drug resistance, treatment strategies, acute/early infection, long-term non-progression, post-exposure prophylaxis, HIV/Malaria and HIV/TB co-infection. Research programs include sites in San Francisco, Uganda, and Brazil.
Education: In pursuit of educating medical professionals, patients, and the public community, several model programs are focused on practical training at all levels. The Division has organized an HIV Clinical Scholar’s Fellowship, one of the nation’s only HIV specialist training programs for physicians. Physician researchers also receive training with faculty through an NIH-sponsored T32 translational research program. The weekly Grand Rounds lecture series provides an open public forum presenting topics from new medications and treatment protocols to clinical case studies and innovative care strategies. Medical Management of AIDS, an annual conference in downtown San Francisco, draws hundreds of local, regional and international providers with an intensive, three-day compendium of the latest advances in HIV clinical care.
International Work: International work includes training, clinical care and research collaborations with local academic and grassroots organizations in Africa. A longstanding collaboration between UCSF and the University of Makerere in Uganda brings together U.S. and Ugandan researchers specializing in HIV, TB, and malaria in adults and children. Faculty also influence HIV/AIDS policy through active leadership in the World Health Organization (WHO), setting global standards to treat HIV disease, establishing a Global HIV Drug Resistance Surveillance Network, and advising on the U.S. National AIDS Strategy.
Resources needed: Continued training for the next generation of HIV providers is essential. The HIV Clinical Scholar’s Fellowship for MDs seeking to become HIV experts is in need of support ($90,000 per year). Safe lodging for patients is also essential. A pilot program to provide short-term lodging for unstably housed patients resulted in improved medical adherence; the clinic is in need of funds or in-kind single-resident occupancy lodging to sustain this initiative.
