Why I Love SF City Clinic
SF City Clinic knows you’re a competent, sexually active person. If you aren’t, they’ll kindly show you how to change that. Angelic humans work there. Where public education dropped the ball on sexual education, City Clinic picks it up. They anticipate your awkwardness, gently encouraging you to ask about anything. Yes, even “that thing.” Especially that thing. I would say their goal aligns with that of any good physician: to help you familiarize yourself with your own body. Treating STIs and learning how to protect yourself is a part of that, the way sex is a part of life.
San Francisco City Clinic offers a taste of socialized healthcare
It isn’t a health boutique. It’s not a private business masquerading as an urgent care facility. A complex system of grants and limited funding keeps this clinic going. The fee for services is $25, which covers everything, testing and treatment included. At the same time, no one is refused for inability to pay. I’ve done my fair share of bare-bones living. Sometimes a twenty-five-dollar fee is a choice between better health and dinner, a phone bill, a bag of weed. In many situations, every dollar counts.
When I lived in Portland, another supposedly sexually liberated city, treating an STD could be a chore. Treatment-forward clinics opened and closed months later. Others required insurance, ironically refusing Oregon’s Medi-Cal equivalent, OHP. It meant dealing with appointments days to weeks out, or visiting an emergency room if it couldn’t wait. Getting on Truvada, or PrEP, meant jumping through hoops with your doctor. Mine didn’t even know what Truvada, a life-saving medication and groundbreaking advancement in the field of HIV research, was.
SF City Clinic on the other hand has its own PrEP department. Care providers familiar with Truvada’s manufacturer Gilead can obtain the criminally expensive medication for you.
They take your potential exposure to pathogens very seriously
In 2014, I hadn’t tested for HIV after more than a year of uneducated barebacking, and I was terrified. It wasn’t a “death sentence” anymore, or so people said. Still my anxiety grew. What if I tested positive, and had unintentionally infected my new partner? My brain ignored the efficacy of modern retrovirals, the healthy lives of friends with HIV, and bombed my imagination with visions of our faces eaten up with Kaposi’s sarcoma. My mother always said it was a “gay” disease.
Ultimately I tested negative for HIV. The news did not exactly grant me the relief I expected. Where I was negative for one virus, another, more figurative kind lurked. One I had gotten from my mother. My reluctance to get tested was a product of my fear of HIV. I didn’t understand it, which made it all the more menacing.
All I had been told about HIV/AIDS before I moved here and sought all my sexual health services from SF City Clinic was, “Don’t get it.” I had zero idea how the diagnosis changes your life. It created a false veil between people living with HIV and those who weren’t. When somebody passed through it, their story ceased to be imaginable, and that frightened me.
I decided to ask during a PrEP visit. Truvada can take a toll on the kidneys, so clinicians test the blood quarterly to monitor the organs’ functions. This wasn’t tempting fate. Rather I was genuinely curious about what might happen should I one day test positive. The woman who assigned my blood draw had almost left the room by the time I spoke up.
She closed the door and sat back down in a way that told me this always happens. “We run a few more tests to be sure. If those come back positive, your doctor will want to know so they can see how much of the virus is present in your system. They’d prescribe you a drug regimen to reduce its numbers to undetectable levels. At that point it’s not wreaking havoc, and it’s no longer communicable.”
I blinked. And that’s how you save a life. Healthcare workers are the shit. “Thank you.”
That includes the usual suspects.
Did you know gonorrhea (Neisseria gonorrhoeae) and chlamydia (Chlamydia trachomatis) are friends? Both bacteria take about two weeks to set up shop, often going totally unnoticed. They hang out in your body like two stoner roommates; they don’t help your gut, and they make a fucking mess. I wasn’t aware until after my three-month check-up (they even text you if it’s been too long!). I’d attended a couple sex parties by then. Otherwise I didn’t hook up very much between then and my previous visit. Although I had doubts, I anticipated negative results.
They called the next day with my results. I had chlamydia.
I wasn’t surprised. After all, a mother knows. The clinician advised me not to have sex for the time being, and asked me to come in for treatment at my earliest convenience. I went in that afternoon for a shot in the shoulder and some azithromycin.
“Doubling down?” I asked the gentleman jabbing my upper arm.
He chuckled. “We’ve been seeing a rise in gonorrhea infections lately, and since it so often accompanies chlamydia, we’re gonna treat for both to be safe.”
I thanked him for that, and for phoning me as opposed to letting me find out later.
“Of course. It’s policy; with any positive result, we call the patient, and they have to answer. We don’t leave any private information on voicemail. Your arm might feel sore for a day or so, by the way.”
I’ve never once felt ashamed to visit.
When I was seventeen, my brother outed me to our mom by showing her the gay porn I’d downloaded to my desktop computer. I’d never seen her get so vitriolic. She called it, and me, disgusting. She wished to curry guilt, begging our trailer’s nicotine-stained ceiling to show her “where she went wrong.” Hot tears streamed down my reddened, angry face. Oddly enough, despite my Pentecostal upbringing, I felt zero guilt. I felt none then and I don’t feel any now. What I felt instead was shame—not my own, but hers.
Unlike guilt, itself spurred from the knowledge of having transgressed your own ethics and morality, shame is different. Shame is a public emotion. It is shaped and dictated by social norms. Our single-wide household was ostensibly a Christian one. I had embarrassed my mom before God. Even worse, I reminded her “that lifestyle” exists, and now it lay group-fucking right before her eyes. I felt her shame. It had the reviling texture of fear.
From my first visit, the medical staff at SF City Clinic obliterated shame. Their smiles are warm, never furtive or coy. The only whiffs of shame I get come from other patients—hypocrites there for the very same reason. I never worry that I’ll face some form of slut-shaming from from the clinicians. Whether it’s old folks or twenty-somethings, queer or straight, married or single, they know one thing is true in almost every circle: people have sex. They deserve informed, effective, compassionate medical care, and you do too.
They genuinely try to see every patient.
I once visited a clinic in another popular San Francisco neighborhood. The mostly male crowd looked particularly sharp, selvedge-denim jeans cuffed handsomely at the ankle of their desert boots. Really? How can I be underdressed for an STD clinic? The stuffy atmosphere, worsened by the magnified sunlight streaming through the window, was unwelcoming. Sweat gathered at my hairline. I debated getting up to leave but ultimately didn’t, like I’d signed some carbonless social contract hidden beneath the guest sheet.
They made me wait half an hour just to tell me I couldn’t be seen for another nine days. “We stay busy around here,” the receptionist giggled. “Should I go ahead and book that for you?”
“No, thank you. I’ll try my luck elsewhere.”
I took a train to Civic Center and walked to 7th between Harrison and Folsom. The blue awning with SF CITY CLINIC stamped on it held firm in the South-of-Market breeze. Indoors I found fluorescent lighting, tile floor, austere walls plastered with laminated educational posters. This is more like it.
Though you may be asked to come back later if the lobby’s full, SF City Clinic accepts walk-ins and appointments. They open bright and early at 8AM on Mondays, Wednesdays, and Fridays, and stay until 6PM on Tuesdays for the late crowd.
San Francisco City Clinic
356 7th St., (628)-217-6600