This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://info.ahrq.gov. Let us know the nature of the problem, the Web address of what you want, and your contact information.
Please go to www.ahrq.gov for current information.
San Francisco's response to the AIDS epidemic
dramatically altered sense of community
San Francisco is the U.S. city most affected by the AIDS
epidemic, with nearly two out of 100 San Franciscans dying of
AIDS-related complications. San Francisco's response to the
epidemic, which began in the early 1980s, dramatically altered
that city's notions of community by 1995, according to a study
supported by the Agency for Health Care Policy and Research
The epidemic gave previously noninteracting neighborhoods, for
example, Hispanics, blacks, and gay white men, a common language
of discourse, that of HIV (human immunodeficiency virus)
prevention and AIDS caregiving. Representatives of these groups
now perceive common goals and shared concerns, even though they
may still compete with one another for HIV/AIDS funding and
attention, explains James W. Dearing, Ph.D., the study's lead
He and colleagues at the University of New Mexico and the
University of California, San Francisco, interviewed staff of San
Francisco's 20 most highly targeted HIV prevention programs.
These interviews revealed three waves of prevention efforts. The
city's initial prevention effort from 1981-1987, which involved a
proliferation of education and support groups, was spearheaded by
gay men, many of whom were HIV-positive or had AIDS. In 1988, the
AIDS epidemic began to infect minorities, who demanded city
funding for prevention programs aimed at their groups. As groups
began jockeying for funding, organizations fine-tuned their
prevention messages to audiences defined by their age, ethnicity,
sex, sexual orientation, language spoken, alcohol use, and drug
use. Finally, in 1994, the city's Department of Public Health
encouraged proposals for groups to form coalitions to provide
prevention and support services.
HIV prevention activities in San Francisco in the 1980s achieved
a high rate of awareness of HIV and a dramatic reduction in
high-risk behavior among certain populations, especially gay
white men. Targeting HIV/AIDS prevention efforts to unique
groups, particularly by members of these groups, was responsible
for much of the success of San Francisco's HIV/AIDS prevention
efforts, according to a related study by Dr. Dearing and
colleagues. They studied strategies based on social marketing and
diffusion of innovation concepts in HIV prevention programs
targeted to unique populations in San Francisco from 1993-1995.
They found that barriers to reaching unique population groups,
which are typically closed to outsiders, were overcome by using
interpersonal communication about HIV and AIDS from members of
that group. Repeated in-person interactions enabled "insider"
program personnel to establish trust and credibility.
For more information, see "Communication and community in a city
under siege: The AIDS epidemic in San Francisco," by Everett M.
Rogers, Ph.D., Dr. Dearing, Nagesh Rao, Ph.D., and others, in the
December 1995 issue of Communication Research 22(6), pp.
and "Respecifying the social marketing model for unique
populations," by Gary Meyer, Ph.D., and Dr. Dearing, in the
Winter 1996 issue of Social Marketing Quarterly, pp.
Return to Contents
Proceed to Next Section