In the 1980s, many people doubted that women would be impacted by HIV. Then, in the early 1990s, women increasingly arrived in San Francisco HIV clinics. These women tended to be very different from the male patients. They were often poorer, less educated, and lacked the kind of family and community support that the men had. Many of them felt very ashamed to be there.
In the Bay Area, a wonderful model of care had developed which was based on collaboration between the gay community and health care organizations. Like the initial AIDS cases, these services were directed to men. When HIV began appearing among women, it became obvious that these women, with their unique needs, would not be well served in clinics designed for men.
The challenge of HIV infection in women is frequently coupled with complex issues that include mental health, domestic violence, and poverty. Addressing these medical and psychosocial needs goes hand-in-hand in providing effective treatment to this underserved group.
Ruth Greenblatt, MD, an HIV specialist at UCSF, realized that, while the services provided to bay area men did not apply well to HIV+ women, the concept of a community care model was a powerful one. Dr. Greenblatt and her team created the Women’s HIV Program (WHP), an innovative, multi-disciplinary program specifically for women, designed to meet their unique health issues.
At WHP, women with HIV are seen by a primary care doctor that is a specialist in HIV and women’s health. They also have access to a gynecologist with expertise in HIV because of their high risk for cervical cancer, and if necessary, in pregnancy care and safer-sex counseling to prevent transmission of HIV to their children. Because of the huge number of medications often required to treat HIV, the WHP team also includes a HIV pharmacist and medication adherence expert. All of these services are offered in a friendly and warm environment, providing HIV+ women the safe space they need to feel comfortable discussing their unique issues.
For the past 17 years, the WHP at UCSF has provided comprehensive health and social services to women and children living with HIV/AIDS in the San Francisco Bay area. It is the only program in the bay area that provides care for both HIV+ women and their children in a single setting. The Program is a principal care setting for HIV+ women in San Francisco and is considered a national and international model of effective and compassionate care for this vulnerable population.