In 1983, San Francisco was an epicenter of the HIV epidemic. In the face of the mounting loss and suffering from the mysterious and powerful virus, a young physician, Paul Volberding, MD, along with colleague Connie Wofsy, MD, led efforts to found Ward 86 at San Francisco General Hospital – the first dedicated AIDS clinic in the country.
“We didn't know what (AIDS) was,” said Volberding, now director of the UCSF AIDS Research Institute. “But the patients desperately needed help. They had nowhere else to go.”
Thirty-five years after its launch, Ward 86 continues to be a global leader in HIV care. Driven by the research of its providers – all UCSF faculty – the clinic has significantly influenced milestones of HIV care and prevention, including the development of antiretroviral therapy in the mid-1990s – which transformed HIV from a fatal disease to a chronic illness—and the implementation of PrEP (Pre-Exposure Prophylaxis), a daily pill to prevent HIV acquisition.
“The impact of Ward 86 is profound,” said Monica Gandhi, MD, MPH, medical director of Ward 86. “Our work is shaping HIV care worldwide.”
For decades, UCSF has embraced its partnership with the San Francisco Department of Public Health to help Ward 86 deliver innovative, flexible and comprehensive patient care. The San Francisco Model of AIDS Care introduced the idea of patient-centered care, an approach that encourages doctors, nurses, social workers, and other healthcare workers to collaborate.
“The San Francisco Model demonstrates the power of integrating an entire community,” said Susan Ehrlich, MD, clinical professor and CEO of Zuckerberg San Francisco General Hospital. “At Ward 86, medical care, social services, science, and emotional care combine to provide care in the most compassionate and effective way, and at the same time, end the epidemic.”
Despite significant progress, there is still no cure for HIV. More people than ever are living with HIV– 37 million worldwide – including 16,000 in San Francisco. Fortunately, infections have continued to decline in the city since the epidemic’s peak in 1992. Over the past five years, new HIV diagnoses in San Francisco have fallen by 52 percent, compared with an eight percent decline nationally. In 2017, San Francisco experienced 221 new HIV infections, the fewest since the early 1980s.
With treatment advances, people are living longer with HIV and that creates a new set of challenges. In 2017, 65 percent of persons living with HIV in San Francisco were over 50 years old, compared with only 38 percent in 2005. In response, Ward 86 developed Golden Compass, a specialty program for older adults with HIV that provides multi-disciplinary care, including cardiology, brain and memory health, and social support, that launched last year.
Gandhi believes Ward 86 will continue to adapt to the changing face of the AIDS epidemic. “Ward 86 has always served as fertile ground for collaboration, innovation, and patient care,” she said. “And we will continue to do so.”