FIFTEEN YEAR REPORT 1372 Mission Street San Francisco, California 94103 www.stjamesinfi rmary.org

Board of Directors Naomi Akers, Treasurer Johanna Breyer, Secretary Patsy Chan, Chair Margo St. James, Director Emeritus & Founder Carol Stuart, Diretor Emeritus & Founder

Staff Stephany Ashley, Executive Director Dr. Pratima Gupta, Medical Director Charles Cloniger, MS, FNP, Clinical Direcor Mae-Mae Taylor, CFO Liz Faber, FNP, Medical Provider Cyd Nova, Programs Director Daniel Wilson, Community Harm Reduction Representative Sunday Service, Administrative Assistant Sam Formo, NEX Coordinator Dee Michel, Harm Reduction Services Coordinator Mia Tu Mutch, Outreach Coordinator Anita O’Shea, Registration Coordinator Kalash Ka, Billing Coordinator Celestina Pearl, Triage Provider Vadan Ritter, Massage and Acupuncture Practitioner Jessi Ross, Outreach Worker & Harm Reduction Counselor Nikki Witt, Harm Reduction Counselor Carmen Alicia, Phlebotomist Patricia Neutall, Phlebotomist Marion Marion, Phlebotomist

Report design by Rachel Schreiber Letter from the Executive Director

23,000 clinic visits later, we still serve as the primary care provider of choice to many of our original community members while new community members come through our doors each week. We still provide gender-affi rming informed-consent hormone replacement therapy under the supportive guidance of Chuck Cloniger. We still provide acupuncture and massage through our holistic services program. We still provide condoms, clean socks, syringes, and referrals to sex workers on the streets of the Mission, Fifteen years ago, a group of sex workers Tenderloin, and Polk. We still provide peer and their allies had a radical yet simple idea counseling, where sex workers can talk to that would have manifold reverberations other sex workers about whatever is going throughout political and healthcare on in their lives. We still provide dinner and landscapes. Rather than being the subjects a movie, and community gathering space. of public health scrutiny and pathology, We still cultivate a space of learning from they posited: what if sex workers were to be one another, developing skills together, and the determiners of their own needs, and the creating jobs as service providers to one agents of their own health and wellness? The another. And we still do it all for free. idea was born out of a long and varied history of sex workers being treated as victims, In honor of our 15-year anniversary, I hope pariahs, and problems in need of solving you will enjoy the following report on from a moral and criminal framework. our work. When you fi nish it, I hope you The catalyst for the idea occurred when a will imagine what we can do in the next sex worker called COYOTE (Call Off Your fi fteen. The history of the sex worker rights Old Tired Ethics) from jail, having had her movement and the St. James Infi rmary is blood forcibly drawn by the SFDPH STD a rich one. With the continued support of Prevention & Control unit. Led by Margo St. people like you, our momentum will gain in James, the resulting collaboration between the quest for liberation from poverty, stigma, COYOTE, the Exotic Dancers Alliance, City criminalization and harm, and towards rights, Clinic (SFDPH STD Prevention & Control), respect, and wellness. and UCSF, would birth the fi rst Peer-Based Occupational Health & Safety Clinic for the sex worker community. In community,

Fifteen years later, the St. James Infi rmary has become an internationally recognized model for community-based healthcare, a leader in the global fi ght for sex worker rights, a hub of community organizing Stephany Ashley and advocacy, and a center of research and Executive Director education for the general population. We’ve taught in universities and lectured to law enforcement, presented at conferences around the world, launched a ground breaking media campaign, and published three books. We’ve collaborated with dozens of organizations and won some hard fought policy victories. Tribute to Naomi Akers

For the past seven Occupational Health & Safety Handbook. years the St. James She served on the Sex Worker Global Working Infirmary had our Group of UNAIDS, where she addressed the very own Saint for an White House on International AIDS Day Executive Director (ED). recommending meaningful participation “Saint Ho’s Up,” as of sex workers in research, program officially ordained by planning/evaluation, and policy work; the the Sisters of Perpetual decriminalization of sex workers; and the Indulgence, also known removal of the anti-prostitution pledge as Commissioner Akers, required for countries and agencies receiving led us through the good US HIV prevention funding (PEPFAR). times and the hard times, and made SJI what it is today. Naomi came to SJI in 1999 as a community member, and soon began volunteering, serving food and doing street outreach. Soon thereafter she became the Outreach Coordinator before landing in her leadership role as ED.

In addition to her suce$$ful hu$tle, Naomi brought us great political savvy, vision and guidance. In her time as ED, she published

a health assessment of San Francisco Exotic Naomi and sex worker activist KittenINFINITE speak to Dancers, founded the RenegadeCast, which former President of South Africa, Kgalema Motlanthe at utilized social media as a health promotion the International AIDS Conference in Washington DC. tool for sex workers, and spearheaded the publication of the third edition of our anniversary. th : Led by Margo St. James, Carol Stuart, COYOTE, Exotic Dancers Alliance, th SJI gets its own clinic space at 1372 Mission Street. Summer: SJI formally launces its Needle Exchange. Johanna Breyer resigns after 7 years of service Longtime as the founding Executive Director. volunteer and coordinator community member, Naomi Akers becomes Executive Director. Health, San Francisco Sex Worker Style published in Sexually Infections Online . Transmitted After 8 years of service, founding Medical Pratima Deb Cohen steps down; Dr. Director Dr. Gupta steps into role of Medical Director. Group Naomi Akers elected to the Global Working and HIV Policy to revise the UNAIDS on Sex Work “Guidance Note on HIV and Sex Work.” June 4 City Clinic (SFDPH STD Prevention & Control), and UCSF, the St. James Infirmary opens City Clinic (SFDPH STD Prevention & Control), and UCSF, its doors as the first ever Occupational Health & Safety Clinic by and for sex workers. SJI publishes is first edition of the Occupational Health & Safety Handbook. SJI celebrates its 4

1999 2002 2003 2004 2005 2006 2006 2007 2009 XV YEARS OF COMMUNITY COLLABORATION

American College of Traditional Chinese Medicine, City Clinic (SFDPH STD Prevention & Control), Desiree Alliance, DOPE (Drug Overdose Prevention & Education) Project, Glide, Harm Reduction Coalition, Human Rights Watch, Immune Enhancement Naomi Akers with former SJI Administrative Assistant Malcolm Hamilton. Project, Mission Neighborhood Resource Center “Ladies Night,” National Naomi led us to recent victory in ending the practice of police confiscation and use Reproductive Justice Network, New Leaf, of condoms as evidence of prostitution. Positive Directions, + SHE, She currently serves as a San Francisco San Francisco AIDS Foundation, Entertainment Commissioner, with the appropriately assigned badge number 415. San Francisco Sex Worker Film Festival, While we are lessened by Naomi’s departure Sex Workers Outreach Project (SWOP), from the position of ED, we are thrilled to TGIJP (Transgender, Gender-variant & have our own personal Saint now serving on our Board of Directors. Intersex Justice Project), TRANS Thrive, UCSF, Walden House STRIDE Program begins offering appointment based transgender primary care, including peer-based informed consent hormone replacement therapy. SJI publishes its third and most comprehensive edition of the Occupational Health & Safety Handbook. SJI launches its first media campaign “Someone generating great buzz Know is a Sex Worker,” You in the news. January: SJI provides consultation to the Health Organization in Switzerland. World June: Michel Sidibe, Executive Director of UNAIDS, visits SJI. UNAIDS globally launches the revised that “Guidance Note on HIV and Sex Work” included four annex papers written by the Group. Global Working April: SJI continues the fight to end use of condoms as evidence of prostitution and WINS! October: Naomi Akers resigns as ED, to continue her incredible work on the Board of Directors. Former Programs Director Stephany Ashley is hired as ED. June 5: SJI celebrates its 15th Anniversary with the party to end all parties: XV.

2009 2010 2011 2012 2012 2012 2013 2014 2014 “Not all sex workers need to be saved. I’m a sex worker and I love my job.”

Sex work is real work. XV Years By the Numbers

23,228 Clinic visits.

3,500 Unique clinic participants.

+3,000 Transgender Health Visits.

+11,000 Hot meals served.

+5,000 Acupuncture & massage treatments.

1,000 Unique sex workers receiving healthcare services each year.

70% Participants had never discussed sex work history in a healthcare setting prior to SJI.

65% Participants who’ve self-identified as LGBT.

XV Years of…

Physical exams, evaluation & treatment of acute and chronic medical conditions such as asthma, skin conditions, respiratory infections, abdominal pain, high blood pressure, high cholesterol, anemia.Reproductive healthcare, gynecological & urological care. Pap smears, breast exams, colposcopies, testicular exams, & prescriptions. Contraceptive counseling, free birth control, emergency contraception, IUDs & Depo-Provera. Peer and mental health counseling. Wound & abscess care, vaccines & flu shots. Confidential counseling and testing for HIV, gonorrhea, chlamydia, herpes, hepatitis C & syphilis. Onsite treatment for gonorrhea, chlamydia, & syphilis. HIV & STI testing and counseling at Nob Hill Theatre, Eros, Ladies Night, 6th Street Syringe Exchange, Occupy SF, & Project Homeless Connect. Free meal night for LGBT homeless youth. Outreach and volunteer work at Folsom Street 13 Muni buses displaying de-stigmatizing messages about sex workers.

$18,000 Tuition assistance distributed.

~500 Healthcare professionals, students, and service providers trained by SJI each year.

9,182 Cute outfits acquired from our clothing closet.

+30,000 HIV tests.

+30,000 Outreach contacts made on the streets and in venues where sex workers work.

621,814 Syringes distributed.

Fair, Dore Alley Street Fair, Castro Street Fair, Transgender Health Fair. Peer counseling, risk reduction counseling & psychotherapy. Syringe access & disposal, overdose prevention training, Narcan distribution, satellite syringe exchange. Outreach to massage parlors, strip clubs, internet providers, street workers & SROs. Trainings & support groups offered onsite & at SF County Jail including legal advocacy, drugs & their effect on the body, self care & burnout prevention, sex work & the internet, know your rights, work smarter not harder, harm reduction during the holidays, violence prevention. Peer-based, informed-consent hormone replacement therapy and transgender healthcare services. Acupuncture, acupressure, cranio- sacral therapy, reiki, Swedish and deep tissue massage, trigger point therapy and Zen shiatsu. Community based research. Cultural competency training for service providers and healthcare professionals. Anti-stigma media campaigns. Publication of three editions of the Occupational Health & Safety Handbook. Political advocacy, community organizing and education. XV Years of Culture Change

“Someone You Know is a Sex Worker”

In keeping with our philosophy that social stigma contributes negatively to the health and wellness of sex workers, SJI launched a media campaign in collaboration with Rachel Schreiber and Barbara DeGenevieve. The campaign included ads on Muni buses that ran in October of 2012, and a series of posters and postcards. The goals of the campaign were to illustrate that sex workers are valued members of the community, that sex workers rights are human rights, that sex work is real work, deserving of labor rights. The campaign led to SJI being invited to consult the World Health Organization, in developing International guidelines on reducing violence against sex workers in the context of HIV. Occupational Health & Safety Handbook

No Condoms as Evidence In an effort to disseminate knowledge In many cities across the US, and resources within possession of condoms is used as our community, SJI continues to publish evidence against sex workers to justify the only Occupational arrest for prostitution. The routine Health & Safety use of condoms as a tool to violate our Handbook for sex rd basic human right to protect ourselves workers. The 3 edition of the handbook from HIV and sexually transmitted contains 300 pages of infections, as well as prevent information on harm unwanted pregnancies, is unjust and reduction, health, safety and legal rights, along counter to sound public health. Prior with information on to 2013, San Francisco was one of 720 local, national and the many cities using condoms as international resources relevant to the lives evidence of prostitution and related of sex workers. The book is distributed to sex workers during outreach, and is available for charges. For nearly 7 years, the St. free download on our website. Health care James Infirmary urged City Officials professionals, professors, and social workers to cease this practice. As a result have heralded it as a uniquely valuable resource in understanding the health needs of of a collaboration between Human sex workers. Rights Watch, the Human Rights Commission, and the SF AIDS Office, December 17th in April 2013 the SFPD and the DA agreed to not use condoms as evidence Each year on December 17th, violence of soliciting or loitering in prostitution SJI participates in events held End to commemorate International related cases. This is a huge victory for against Day to End Violence Against our community. Sex Workers. The red umbrella, sex workers the international symbol of sex worker activism and solidarity, is used during these events. In San Francisco, SJI community members join the international sex worker community in DECEMBER 17 INTERNATIONAL DAY holding a vigil to remember TO END VIOLENCE the sex workers who have lost AGAINST SEX WORKERS their lives to violence and to speak out against this volence. The names of sex workers who have died are shared throughout the community and read during this vigil. These vigils serve to remind us of our fallen friends and to remind the world around us that we are human and that we deserve protection, justice, and rights. XV Years of Gratitutde to: b Agrimony Photography b Naomi Akers b Gina Alexander TAP Communications b Michael De Luna b Darcie Jean b Katrina Anderson b Laurel Anderson b Robert Anderson M. DeBolt-McNeal b Deviant Nation b Amol N. Doshi b Stephanie Anderson b Wyndi Anderson b Elizabeth b Kimeron Duff b Gene Duffy b Kellene Eagen b Susan Andrews b Anonymous Donors b Antler b Erin Archer Englander b Zoe & Michael Erwin b Mark Espinosa b Beth b Raquel D. Arias MD b Autodesk b Ricardo Avila b Glenn Everhart b Factory Video Production b Patrick Farley Backes b Shannon Badiee b Paul Barber b Carolyn b Feminists For Free Expression Inc. b Lyn Fischer b Zeph Barkin Elis b Nena Barnhart b H. Bauer b Scott & Nadine Fishlyn b David Flaig b Flying Bear Media Inc. b Conrad Baugh b Illanna Bavli b Mariah Bear b Bear Entertainment & Maureen Fong b Ford Foundation b Frank Strona Distributing Inc.b Bears Of San Francisco b Libby Benedict b Free Speech Coalition b Andrew Freeman Fried b Mark b Darren Benston b Skytrinia Berkeley b John Berry WM Garrity b Josie Gay b Guy Gayle b Maryl Gearhart b Beth Irael Medical Center b Tehmina b David Gerard b Alex Gerber b Allison Bhure b Eli Bishop b Jane Blakemore Gervais b Dan Girellini b GiveForward b Sylvia G. Blayse b Blue Shield b Global Impact / Yahoo b Ann Glucroft b Molly Bode b Dean Bodnar b Amy b GoddessUnbound b Tumeka Godwin Borden b Eric Boucher b Rhab Boughn b Deborah Gold b Golden Girl Press LLC b William Bradburd b Brass Liberation b Lucy Goldmen b Good Search b Teri Orchestra Goodson b Ron b Google Braverman Matching b Terrance Gifts Program and Nancy b Robert Brennand Gotch b Paul b Nicole E. Brenner MD Grace b Stivaletta b Tiffany Brett Graham b Donald b Henry Breyer b Johanna Breyer b Robert Grajeda b Gina Grant b Charmaine Brixey b Sarah Bromberg b Eric Grays b Christina Green b Sofia Bruckner b Terry Brumbaugh b R. Greenberg b Brawner Greer b Buchner b Colleen Buggs b Vern F. Brawnmeer & Susan Greer b Pratima Bullough b John Burton b Jonathan Gupta b The Soper-Gupta Family F. Bushnell b California Family Health b Kelly Gutierrez b Daisy Ha b Jae Koo Council Inc. b Greg Callahan b Mahealani Campbell + Kee W. 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Management LLC b Ronald Schmidt Lee b Matthew Leffel b Mitchell Lester b Ashley Marie b Fred Schoellkopf b Sarah Schoellkopf b Emily-Rose Lettice b Alan Leung b K. Levy b LFA Group b Serpent Scholvin b Rachel Schreiber & David Gissen b Andie Libertine b Robert Lieber b Rob Liptak b Luke Littell Schwanz b Sam Scott b Tara Seawright b Joey Sequeira b Local Independent Charities of America b Gloria Lockett b Seventh Generation b SF AIDS Office b Kimberly Sherrill b Jonathan Loh b Celecia Loke b Lovings.com b Luggage b Ships In The Night b Cory Silverberg b Ricky Sinz Store Annex b Melissa Lujan b Sadie Lune b Lusty Lady b Slippery Vixen b Alex Smith b Bryan Smith b Heather b Jennifer Luxenburg b Billy Bruce Maddox b Mark Maire Smith b Social And Environmental Entrepreneurs Inc. b Samantha Majic b Maria Makela b Savi Malik b Carolyn b Society of Janus b Lars Thomas Soensteby b Specs Mann b James Mar b Mary Marchett b Landa Marraccini Bar b Jon Spinner b Annie Sprinkle b Marian Spurgeon b Larry Marschall b Ronni Marshall b Edward Martin b Margaret St. James b Calvin Stanford b Shelby Starkey b Jim Matheson b Jason Maxwell b Edwin McCauley b Helena Stoddard b Carol Stuart b Stacy Swimme b Patrick McClellon b James McCormick b Christopher b Alexander Szeto b Eric Terrell b Anne Thalheimer b The McNeil b Karen Meckstroth b Ashley Meece b Molly Artie Fund/Mitchell Brothers b The Bone Palace b The “St. James is a wonderful place: a hot meal, non-judgmental counseling, acupuncture, massage, and psychiatric care, not to mention some of the best preventative health care I have ever had. St. James, you make me feel all warm and fuzzy inside, like there is love enough for everyone in the world.” —Participant, 2008

Merryman b Marcel Miranda b Luke Miratrix b Carol G. Children’s Place b The Exiles b The Imperial Council of San Mishell b Shiela Mitchell b Nicola Miziolek b Johanna Francisco Inc. b The Institute of Advanced Study of Human Mock b Simon Modery b Milly Mohr b Tim Molinare Sexuality b The Matching Gifts Center b The Sisters Of b Lady Jean Moondance b Rusty Mae Moore b Alicia Perpetual Indulgence Inc. b The Steamworks (DBA) Great Morris b Kevin Mosley b Museum of The African Diaspora Works Inc. b Third Wave Foundation b Hale Thompson b Jill Nagle b Network for Good b Jim Newberry b John b Steven Tierney b Karla Tillers b Brian Tingle b Titan Media Newport b Joyce Newstat b Peter Nicoll b Johnnie b Dennie Tompers b Powell Tori b Michael Torres b Gary Norway b Hilary O’Connell b Robin Ogilvie b John Osborne Tregoning b William Trupek b Laura Turiano b Robert b Dean Ouellette b Pacific International Marketing and Turnbull b Benjamin K. Urish b V. Valdivia b Brad Vanderbilt Promotions b Melissa Palguta b Paradise Spa b Celia b Paul Vanotti b David Vasquez b Manuel Vasquez Paris b Laddawan Passar Kaner b Ruby Pearl b Peet’s b Kimberly Vaughn b Terry Veevers b Sasha Vodnik b Les Coffee and Tea b Tara Perkins b Tatjana Persch b Barbara Vogel b Kyla Wagener b Christopher Waldapfel b Gregory Petterson b Daniel Douglas Phillips b Michael Phillips Walker b Deborah Wallach b Jeff Walsh b Ralph Walton b Poems Book Group From Redbook b Point Defiance b Ian Washer b Erica Weinstein b Victor Weissner AIDS Project b Dianne Pontius b Erin Marie Pray b Tammy Wells b Wells Fargo Community Support Campaign b Theodore Pride b Alyssa Prinz b Joelle Puccio b Sara b Kristina Wertz b Michael Wheeler b Patricia Whelehan Pulis b Qualcomm b Seeley Quest b Rodolfo Quintero b Elizabeth White b Larissa White b Anna Wijnen b Bahman Rabil b Raging Stallion Studios b Rainbow b J.H. Williams b Stewart Winogra b Alan Winslow Grocery Cooperative b W Preston Raisin b Felix Ramirex b Tanya Wischerath b Kristin M. Wofford b Kirsten b Henry and Susan Reents b Claudius Reich b Shelly Wolfe b Jessica Wray b Wendy Wright-Williams Resnick b Sharon Reynolds b Rhab Boughn b Lani b Rheena Yangson b Kathleen Zaretsky b Jerry Zientara Riccobuono b Jennifer Rich b Wolfe Richard b Daly b Michael Zimmerman b Amelie Zurn I SF