San Francisco is mobilizing to fight disproportionately high HIV rates among black men who have sex with men. Many black MSM are not only isolated from the city's larger gay community, but also from each other. In part to fight HIV, a community space linked to prevention services should be established for this population, say advocates.

From 2004 to 2008, HIV prevalence rose from an estimated 18.2 percent to 25.5 percent among older black MSM, according to preliminary data. Although not engaging more in risky sex, black MSM are likelier than other MSM to have black partners, forming a closed sexual network that fuels the disparity in infections, according to research by the city health department's HIV epidemiology section.

A department-tapped working group recently recommended community-based HIV testing and prevention campaigns targeting three neighborhoods: the Tenderloin, Bayview, and Western Addition. Another suggestion is a centralized "one-stop shop" gathering space where health care including HIV/STD testing is also accessible. The Magnet health clinic in the Castro and Village Health Foundation in Los Angeles are possible models, said Tony Bradford, a working group member and interim director of San Francisco AIDS Foundation's Black Brothers Esteem program.

However, such a space would need long-term funding sources, cautioned Dr. Grant Colfax, the city's HIV prevention director, who supports the approach. "There's no excuse not to do this, despite the budget travails we face right now," said city Supervisor Bevan Dufty, who begins his budget committee tenure next month.

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