Brian McMahon

PrEP school

Erica Hanna
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32
PrEP school

Two weeks ago, the Centers for Disease Control and Prevention announced that it was recommending physicians consider Truvada, a medication used to treat HIV/AIDS, to prevent infection for high-risk patients who are HIV negative. Seen as a miracle drug by some and a “party drug” by others, Truvada has struggled to take off as a preventative measure and, prior to the CDC’s endorsement, foundered under its own controversy.

The drug regimen is known as pre-exposure prophylaxis, or PrEP, and involves taking one pill of Truvada daily. The most common side effects are initial nausea and headaches, but even those generally subside after a couple of weeks. Most impressive is the efficacy rate: Studies point to a reduction in risk of contracting HIV that is higher than 90 percent for individuals who take the medicine daily as recommended.

Additionally, the CDC has recommended PrEP only for high-risk patients — meaning gay men who have sex without condoms; intravenous drug users; and couples, gay or straight, where one partner is HIV positive and the other is negative.

“While a vaccine or cure may one day end the HIV epidemic, PrEP is a powerful tool that has the potential to alter the course of the U.S. HIV epidemic today,” said Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, in a press release.

But PrEP comes with its detractors, the most vocal of whom have come from within the HIV/AIDS and gay community. PrEP users often carry the stigma of being hypersexual gay men, looking to justify their promiscuous sex lives and disavowal of condoms with a daily pill. The label “Truvada whore” soon emerged as a means to shame PrEP users (though the term is now being reclaimed by PrEP activists as a source of pride through hashtags and T-shirts).

However, the loudest critic by far has been the AIDS Healthcare Foundation, a nonprofit organization based in Los Angeles that provides care to HIV positive patients around the globe.

“This is a position I fear the CDC will come to regret,” said AHF President Michael Weinstein in a public statement. “By recommending widespread use of PrEP for HIV prevention despite research studies amply chronicling the inability to take it as directed, and showing a limited preventive effect at best, the CDC has abandoned a science-driven, public health approach to disease prevention — a move that will likely have catastrophic consequences in the fight against AIDS in this country.”

The push for PrEP is playing out like a grand battle between two formidable foes. On one side is the multi-billion dollar pharmaceutical company that produces Truvada, Gilead Sciences, headquartered just a few miles south in Foster City. On the other is AHF, the largest provider of HIV/AIDS medical care in the US. While on the surface it may seem like a massive corporation taking on the not-for-profit underdog, the reality is much more complex.

 

THE TRUVADA TRAIN

When Truvada was first approved by the Food and Drug Administration 10 years ago, it was a revolutionary new pill used in combination with other drugs to help control the virus in HIV-positive patients. At a time when most HIV medications required taking pills throughout the day and carried intolerable side effects, Truvada was a once-a-day godsend.

Since then, Gilead has established itself as one of the leading companies for HIV medications, producing or helping to produce many top drugs, such as Atripla, Complera, and Stribild, all of which use components of Truvada in their formulas.

But Truvada’s truly revolutionary moment came in July 2012, when it became the first drug approved by the FDA to reduce the risk of HIV infection in negative individuals.

Controversy immediately ensued.

Medicating healthy people is not a popular approach, especially when those drugs cost $13,000 annually per patient (most insurance companies, as well as Medicare and Medicaid, cover PrEP). In comparison, the CDC estimates that the annual cost to treat someone who already has HIV is $23,000. If all of the 500,000 high-risk Americans who the CDC recommends use PrEP were to begin the therapy, the gross revenue for Gilead would be $6.5 billion — all for people who aren’t even sick.

Despite the potential for astronomical profits, as of September 2013 only 2,319 unique individuals had been prescribed Truvada as PrEP, according to Gilead. Half of those patients are women, suggesting that gay men are not being aggressively targeted for PrEP. When PrEP users who are part of research studies are included, the total number of patients is still estimated to be under 10,000.

One reason for the slow start is a lack of awareness. Outside of big cities, there is less dialogue surrounding HIV and prevention techniques. And even in metropolitan areas, familiarity with Truvada is often limited to the HIV specialist doctors treating patients who already have HIV and wouldn’t benefit from PrEP.

“We get a fair number of patients here who are rejected for PrEP from other physicians in the city,” said Dr. John Nienow of One Medical Group in the Castro. “I haven’t heard about widespread adoption in other offices, but I have heard of other physician groups not wanting to prescribe Truvada for PrEP.”

When asked whether the recent CDC announcement endorsing PrEP would change that, Nienow was hopeful.

The CDC announcement “will educate and legitimize PrEP’s use on a widespread basis,” he said. “I think physicians might be uncomfortable prescribing it, and this will make them more comfortable.”

Another reason PrEP has failed to gain traction is that Gilead has spent virtually no money on advertising its own drug. Well, sort of. It is true that Gilead has avoided advertising campaigns — drug companies that push their own drugs tend to stir up controversy — but many of the organizations that have come out publicly in favor of PrEP have received grants from Gilead. According to tax forms, Project Inform and the San Francisco AIDS Foundation, two prominent local nonprofits that support PrEP, have both received large donations from the pharmaceutical company.

One such grant was awarded to Project Inform, for the group to produce videos about PrEP targeted toward young gay men, particularly men of color, according to David Evans, director of research advocacy.

Was this donation a part of Gilead’s marketing strategy? It’s tough to say for sure; Gilead did not return Bay Guardian calls seeking comment.

Regardless of money, it is clear that a new approach is needed for combating HIV. New infections in the US have stubbornly hovered at around 50,000 incidences per year since the ’90s, despite pushes for condom usage and education efforts.

“Yes, PrEP is working. It works when it’s adhered to,” Nienow said. “It’s been extensively studied in populations at risk for HIV, and the conclusion was that it is dramatically successful. So much so that one expert even said that the debate about efficacy is now over.”

 

FROM SELF-PROTECTION TO “SLUT”

It’s true that the AIDS Healthcare Foundation is no billion dollar corporation such as Gilead. But with an operating budget this year of $904 million and a presence in 28 countries, AHF is still a force to be reckoned with.

Though the list of organizations that are loyal exclusively to condoms as a method of prevention is dwindling, AHF has been one of the most powerful and resolute allies of latex protection since the very beginning. Even before Truvada was approved by the FDA as PrEP in 2012, AHF campaigned to prevent it from happening. Even though AHF may be growing more and more isolated in its anti-PrEP stance, it is anything but ready to give way.

Though the efficacy rate for using PrEP is upwards of 90 percent reduction in risk, AHF and other critics consistently cite a drastically lower 40 percent reduction. The difference between these two figures lies in patient behavior: When Truvada is taken correctly, that is, every day without skipping doses, then it’s been shown to reduce new HIV infections by over 90 percent. However, when research studies publish data they must include all participants, regardless of whether they took the dosage as instructed. Average out the effectiveness of the drug between participants who adhered religiously and those who didn’t take it at all, and you arrive at about a 40 percent reduction in risk.

But as AHF points out, the outcome for the participants who did not follow instructions is an important reality that should not be overlooked.

“When you read these studies carefully, what they say is that research modeling can be whatever percent effective, but research modeling is not real-world applicable,” said Ged Kenslea, AHF director of communications. “In every study participants were given incentives and paid to participate,” yet still didn’t adhere to instructions consistently.

“We can’t even get people who already have HIV to take their pills as prescribed,” Kenslea added.

Even amid legitimate concerns about health risks associated with improper use of PrEP or its inability to act as a safeguard against other STDs, much of the debate has become infused with anti-PrEP rhetoric rooted in stereotypical assumptions about the promiscuity of gay men. Patients who use it to protect themselves are reduced to “Truvada whores,” men who live capriciously and are always on the lookout for their next fuck.

“The last couple of years that we’ve been prescribing [Truvada], there have been reports from patients who have received negative reactions from some people,” said Nienow. “Some people, particularly online, regard it as a marker for whores and promiscuity, and others as a marker for self-protection. The stigma kind of ranges from, ‘Great, you’re protecting yourself,’ to, ‘Horrible, you’re a slut.’ My patients have seen all of those.”

Just last month, AHF President Michael Weinstein referred to Truvada as a “party drug,” setting off such a fury that a petition to remove him as head of the organization is now circulating around the Internet. It has amassed nearly 4,000 signatures.

AHF’s policy of championing condoms above any other method is strange, considering that it cites poor adherence to Truvada as the drug’s primary downfall. While the efficacy of the drug clearly drops when it is not taken correctly, AHF critics point out that condoms are not used consistently either, and having multiple methods of protection is better than one.

After viewing donations by Gilead to HIV/AIDS groups, the Bay Guardian requested a list of donors from the AHF as well, but the organization provided a 2012 tax form that did not include a donor list.

PrEP does have some efficacy, Kenslea said, and AHF clinicians are free to prescribe Truvada as a preventative drug.

“If an AHF physician feels that prescribing PrEP is appropriate, then we do not stop that,” Kenslea said.

Still, AHF’s uncompromising reluctance to consider endorsing PrEP is puzzling. AHF leaders repeatedly list reasons that the drug will not work, despite mounting scientific evidence stating the contrary. There is no doubt that PrEP should not be taken lightly or with a blasé attitude, but why eschew it with such fervor?

“We are not refuting the science,” Kenslea said. “We are disagreeing on the understanding of human nature.”

 

A DAILY ROUTINE

When Damon Jacobs re-entered the dating game in 2011, it was a completely different playing field from what he remembered. At first, he wasn’t sure what to expect after coming out of a seven-year relationship with his boyfriend, but he quickly realized there were some significant differences since he had last played the field.

“For me, getting back into the dating world and the cruising world, I was realizing that people were not using condoms as they were a decade earlier,” Jacobs said. “And I wasn’t using them like I was in 1990’s San Francisco either.”

But even scarier than Jacobs’ risky behavior was the reasoning behind it.

“I noticed that my thinking had changed,” he admitted. “I started thinking of HIV as a ‘when,’ not an ‘if.'”

It was during that time when the PrEP studies were just beginning to be published. After attending a forum about using an HIV treatment drug to prevent HIV, Jacobs gathered all of the information he could on this unconventional approach and ran back to his doctor. He knew he wasn’t being as diligent to prevent HIV as he once had, and PrEP seemed like an effective way to stay negative.

His physician had never heard of giving Truvada to a patient without HIV, but Jacobs showed him the research and promising results. He began taking PrEP in July 2011, exactly one year before its FDA approval for HIV-negative individuals.

“Those of us using PrEP now, we were the first ones asking for this, so we’ve had to be the educators and the advocates,” Jacobs said. “We even educate the doctors. Some doctors take that and say, ‘yes, I want to work with you.’ Others give tacit dismissal, and then some tell outright lies about it.”

In the past three years, Jacobs has never missed one of his daily pills. He has built it into his everyday routine: eat breakfast, brush teeth, take PrEP. If you can remember to brush your teeth, he postulates, you can remember to take your pills.

Unfortunately, Jacobs has dealt with the stigma that surrounds PrEP as well.

“If I’m on a date with someone who is negative and he finds out, he’ll ask me, ‘Oh, so you’re a whore? Do you have sex with everybody?'” Jacobs lamented. “It’s not a common reaction, but it stems from a misunderstanding of what PrEP is.”

Instead of being offended, embarrassed, or angry, he takes the time to educate, often resorting to the same analogy: that it’s very similar to women taking birth control; it reduces the unwanted consequences of condom-less sex.

Even though Jacobs disagrees with today’s critics of PrEP, he seems to understand where they are coming from. He volunteered with the Stop AIDS Project in San Francisco in 1992, while HIV was crippling the gay community and condoms were considered the only safeguard from a then-fatal virus.

“Michael Weinstein’s message has been that people should use condoms,” said Jacobs. “When I started volunteering at Stop AIDS [Project], we had a marketing campaign where we gave out pins and T-shirts at local bars and clubs that said, ‘100%’ because we knew that if everybody used condoms 100 percent of the time, we could eradicate AIDS by 2000. “Well I ask you, how did that pan out?”

Income gap

Michael Redmond
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4

news@sfbg.com

It seems like San Francisco may surpass itself as the city with the highest minimum wage in the country, as labor activists and business groups are each pitching their own fall ballot measures to raise wages for the lowest paid workers.

The city’s current minimum wage of $10.74 is the highest in the country, but that still isn’t enough, according the labor activists, not in the city with the most expensive rent in the US and one of the largest income gaps.

“We have the highest growing gap between the rich and the poor, and the economic disparity is so high right now,” said José Argüelles of Young Workers United. He said the raising the minimum wage “isn’t the whole solution, but it’s part of it. Folks working full time in San Francisco should be able to afford to live in San Francisco.”

But sometimes even working full time in San Francisco isn’t enough to live here. A 2012 study by the San Francisco Department of Health found that even in the most inexpensive neighborhoods of the city, one would have to work 3.4 full-time minimum wage jobs to afford rent in a two-bedroom market rate apartment. In the priciest neighborhoods, one would have to work up to eight full-time jobs to afford rent.

All of this is occurring at a time when minimum wage debates are taking place across the country. President Obama has suggested raising the federal minimum wage from the current $7.25/hour to $10.10/hour, although Congress has been less receptive. Here in California, the state minimum wage of $8/hour will rise to $9/hour this July, and $10/hour by 2016.

The San Francisco ballot measure favored by labor activists is an initiative to raise the hourly minimum wage to $15 by 2017, with a sliding time frame depending on the size of the business. Proponents of the measure, dubbed the Minimum Wage Act of 2014, are just beginning to collect the necessary 9,702 signatures to qualify for the November ballot, and a recent poll found that 59 percent of likely voters supported the increase, while only 36 percent were opposed.

Business groups are usually the first ones to object to higher wages, but the San Francisco Chamber of Commerce and other small business-leaders are working with Mayor Ed Lee to craft their own, albeit more watered-down, ballot measure to increase pay. Despite their efforts, the $15/hour initiative took them by surprise and they are “outraged,” according to a statement released by the Chamber.

“This initiative is nothing more than a thinly veiled attempt to influence the outcome of the consensus-building process that will begin this week under the leadership of Mayor Ed Lee,” Chamber President Bob Linscheid said in the statement.

But many small businesses actually want to see the minimum wage increased, said John Eller of Alliance of Californians for Community Empowerment, one of the labor groups sponsoring the $15/hour initiative.

“What we heard when we talked to small businesses was that big money is coming in to buy up properties, that prices are getting jacked up, and that they are getting displaced, just like the residents of San Francisco,” Eller said. “But genuine interest in San Francisco, supporting young people, getting people out of poverty, and dealing with displacement were the themes that kept coming up.”

The business community wants to see the higher minimum wage phased in over a longer period of time and supports a more “moderate” wage, although an exact rate has not been decided, according to an email sent by Henry Karnilowicz, president of the San Francisco Council of District Merchants Associations. Other concessions that business leaders ask for include a separate, lower minimum wage for tipped servers and new hires in-training.

Raising the minimum wage “is about being fair and being reasonable,” said Karnilowicz. “It’s not true that small businesses are making a fortune, and I’d hate to see a big Walmart or Target coming into town to take their place.”

But Argüelles says that including special exceptions and a piecemeal law is a step in the wrong direction.

“In the past, San Francisco has led the way [with fair labor laws],” he said. “I think we can set a higher standard than that.”

Opponents to raising the minimum wage often claim that doing so hurts jobs and the economy, but a study from economists at UC Berkeley says otherwise. Unemployment in San Francisco has dropped since the last major minimum wage increase, and businesses absorb the extra labor costs through reduced employee turnover and improved efficiency.

The study also found that affected workers are largely adults and disproportionately women and people of color, two groups for whom the income gap is especially vast.

A measure qualifies for the ballot in one of two ways: either by garnering enough signatures through the initiative process, or being placed on the ballot directly by the mayor or a group of four or more supervisors. As of now, it seems plausible that San Franciscans will have two minimum wage measures to choose from this year, one from signatures and another from Mayor Lee.

On May 7, the Chamber released a press release stating that it’s seeking a single, consensus measure rather than two competing ordinances. Labor activists also hope to see one measure, Argüelles said.

There are no details yet on what Lee’s minimum wage ordinance would look like, if he sponsors one. There’s potential for a compromise between labor activists and business leaders, meaning one ballot measure with wide support. Otherwise, it will likely be one measure pitted against the other.

The deadline for Lee to submit his ordinance to the Department of Elections is June 17.

Air district unveils new wind-powered ferry

Sasha Cuttler
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3
Air district unveils new wind-powered ferry

San Francisco, the city with the highest concentration of hybrid cars, may soon be the first city to boast a hybrid ferry as well. Officials today at Pier 1 ½ unveiled a vessel that runs on both wind and engine power, significantly reducing fuel use and air pollution.

The design, called the WingSail, involves a carbon fiber sail that resembles an airplane wing standing up vertically. The sail uses wind to efficiently propel the boat when available, but also works with the engine to keep the vessel moving if gusts die down, much like how a hybrid car switches between fuel and electricity. 

“The idea with wind technology is that we could use this every day, with more or less the same propulsion power [as an engine], depending on where you are,” said Damian Breen of the Bay Area Air Quality Management District. “Literally with the flick of a switch, you can go between wind power and fuel power.”

Already existing ferries that are retrofitted to include the WingSail can save up to 40 percent on fuel costs, and ferries that are designed and built with windpower in mind would be even more efficient. Currently, a motorized ferry that travels between San Francisco and Sausalito spends $250 million annually on fuel, according to Jay Gardner, president of Wind+Wing Technologies.

“My vision is to see a bay full of wind-powered ferries,” Gardner said. “I think that could be as iconic as the San Francisco cable cars.”

The trimaran on display today — a smaller scale model of would might eventually be full-sized ferries — just completed three months of test voyages around the Bay Area. Researchers at UC Berkeley will now begin to analyze that data to find the potential improvements in air quality and fuel cost savings. That study will be an important factor in how this technology is implemented in the future, and the results should be published sometime this summer.

The WindSail technology is already being used in racing for both land and water events — most prominently in the America’s Cup sailing championships here on the bay last summer — but this would be the first use of hybrid wind power in a passenger boat. The Wind+Wing Technologies webpage already shows designs for ferries that can hold either 149 or 400 travelers.

All of the builders and officials there today emphasized that the Bay Area is the perfect place to roll out this technology. Not only is it one of the most environmentally conscious regions in the world, but the bay is also windy enough to power the WindSail without relying too heavily on the engine.

One of the attendees asked when you would want to use wind power over fuel, and Breen immediately stepped forward to answer the question.

“Wind is zero emissions,” he said. “Wind is always better.”

City unveils plan to get tough at 4/20 gatherings

Sasha Cuttler And Mary Magee
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16
City unveils plan to get tough at 4/20 gatherings

City officials today announced a “comprehensive plan” to crack down on unpermitted 420 events at Golden Gate Park this Sun/20, saying it was necessary because last year’s debauchery got out of hand. That means more police, both in uniform and plainclothes, will be in the park for the greatest marijuana celebration of the year.

“Last year [on 4/20] we had a lot of challenges,” said Sup. London Breed, who is spearheading this year’s efforts since the park falls in her district. “We need to make the city and streets safe this year. We want people to come and enjoy San Francisco, but we also want them to respect San Francisco.”

The problems Breed was alluding to included underage drinking, traffic congestion, and massive amounts of trash left in the park, especially in the area known as Hippie Hill.

Last year, it took 25 city employees over 12 hours to clean up the five tons of trash left by intoxicated visitors, according to Phil Ginsburg, general manager of San Francisco Recreation and Parks. And because 420 activities are unsanctioned and without an official sponsor, the burden to pay for the cleanup falls upon the city. In 2013, the Department of Public Works spent more than $10,000 to restore Golden Gate Park.

In anticipation of an even larger crowd this year, for both 420 and Easter events happening in the park, the city is gearing up to deal with people and traffic. In addition to deploying additional law enforcement in plainclothes and uniform, officials also plan to ramp up parking control, utilize additional bus services, and employ city workers to direct traffic.

A press release issued by Breed’s office indicated that police would take “a strict enforcement approach to all code violations.”

But speaking at the press conference, San Francisco Police Chief Greg Suhr said officers will have zero tolerance for violations such as underage drinking, open containers, selling drugs, unlicensed vendors, and even walking while texting. Noticeably absent from the list of offenses he mentioned was actually smoking marijuana.

“The sale of marijuana is still a felony,” Suhr emphasized, “but I don’t think [the SFPD is] naive enough to believe that we can stop people from smoking on 4/20.”

Captain Gregory Corrales confirmed that maintaining safety is the station’s top priority. Last year there was only one violent incident and eight arrests for selling drugs, but there were zero citations for possession of marijuana.

Pot smoking, which has long been tolerated, if not embraced, in our progressive enclave, was officially deprioritized as a crime by the Board of Supervisors in 2006, barring incidents that involved driving under the influence, minors, or violence. Breed noted that while she does not “condone illegal activities,” she admits that this aspect of the 420 celebration is difficult to control.

So please, stoners of San Francisco, follow the cardinal rule of nature lovers by packing out whatever you pack in. And above all, have a safe and merry holiday.

Massage therapists hope for a happy ending

Sasha Cuttler
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41
Massage therapists hope for a happy ending

The California Massage Therapy Council, a statewide body that licenses massage practitioners, may expire at the end of this year unless extended by the California Legislature. Some anti-prostitution crusaders say reverting to local control will make it easier to shut down covert brothels, but the practitioners fear a return to the bad old days, when stigmas and stereotypes overcomplicated their lives.

On one side of the debate are the massage therapists, who say that the council protects them from unfair discrimination, replaces a patchwork of local ordinances, and provides a greater level of respectability to their profession. However, an array of city officials, police departments, and powerful groups such as the League of California Cities argue that the CAMTC makes it easier for illicit massage parlors to get away with prostitution and human trafficking.

“I receive complaints from neighbors all the time about certain establishments,” said Sup. Katy Tang about her supervisorial district in San Francisco’s Sunset District. “We can inspect, but we have no ability to enforce any of our regulations. If there are any penalties, we can’t enforce them.”

Tang’s frustration stems from Senate Bill 731, legislation that was signed into law in 2008. That bill created the CAMTC, a non-profit organization that has the authority to certify massage practitioners and therapists in California. Prior to the creation of this body, each city and county enacted its own certification procedures, leading to a messy patchwork of rules all over the state.

Before the CAMTC, “there were 550 different kinds of regulations from city to city,” said Ahmos Netanel, CEO of the organization. “Within a radius of one mile, you can have a situation where different cities have their own standards. One city may require no training, and another right next door may require 1,000 hours.”

A massage provider working in California pre-2009 not only had to be savvy with the medley of laws, but also needed to purchase expensive licenses for each city he or she planned to practice in. The CAMTC creates a universal—though voluntary—system, where licensed practitioners can travel and work freely around the state.

The contentious part of the law comes from the protection that it offers to licensed practitioners. Any establishment that employs all CAMTC-certified massage providers is exempt from city ordinances that target massage businesses. Law enforcement agencies claim that these restrictions impede their ability to crack down on illegal parlors, but the massage therapists say that they are necessary to fight off discriminatory laws.

Some of these unfair regulations targeted entire establishments, such as zoning rules that forced all massage businesses into run-down or dangerous parts of town, with the assumption that they were brothels. Massage providers argued that this was neither fair nor safe for, say, a 75-year-old woman seeking out massage for arthritis, or a soon-to-be mom trying to obtain a pre-natal massage.

Other laws targeted the therapists themselves. Stacey DeGooyer, a certified massage therapist in the Bay Area, remembers times when practicing massage meant mandatory STD testing and reminders from police to not wear undergarments as exterior clothing.

“I remember thinking, ‘Wow, this is for my profession?’” DeGooyer said.

To massage practitioners’ chagrin, they are still lumped into the same category as adult entertainers and subjected to “archaic prostitution laws,” according to DeGooyer, while similar legitimate therapies, such as physical rehabilitation, are overlooked. Most massage providers aren’t looking to be on par with physicians, but they don’t want to be on par with prostitutes, either.

Bodywork in San Francisco

Currently, the city of San Francisco has its own certification program that is regulated by the Department of Public Health. To practice massage in the city, the provider must have a license from either the city or the CAMTC. However, only those who have the state CAMTC license can legally call themselves a “licensed massage” therapist or practitioner.

Tang has been one of the most outspoken critics of the CAMTC in San Francisco, urging the Legislature to let the body sunset at the end of the year.

“I wouldn’t say that I’m against [the CAMTC], but there are structural flaws in how it was designed,” Tang said. “It was created for good reasons, since there were so many jurisdictions and they wanted to standardize it and create a cohesive process.

“But there are jurisdictions like San Francisco where we have our own robust process, but when an establishment uses all CAMTC practitioners, they can bypass all rules. More and more people are starting to become aware of this and are starting to do CAMTC instead, and the city can’t do anything.”

But Netanel disagrees.

“Some cities are claiming that the CAMTC makes it more difficult for law enforcement, but that’s not the reality,” he said. “We even got a thank you letter from the Santa Monica Police saying we made it easier for them, not harder. Cities that cooperate and partner with CAMTC greatly benefit from our tools and protocols to go after bad apples. Other cities have a misinterpretation of the law, and choose to take a different approach.”

Netanel said that even though some cities, such as San Francisco, compete with the CAMTC by providing their own massage licenses, over 150 other California cities have made CAMTC certification mandatory within their jurisdictions. He also points out that many applicants who are denied a license by the CAMTC often turn around and obtain a license within their cities, which generally have lower standards than the state organization.

The number of massage establishments have surged since the adoption of the CAMTC, which critics use as evidence for a growing number of illicit parlors. But Netanel referenced multiple points in the original bill which allows law enforcement to do its job to prevent prostitution. The CAMTC has no real enforcement power to go after illegal establishments itself, but instead works to prevent them from existing in the first place. Out of over 63,000 applicants, Netanel said, they have never certified a single person who has been convicted of illicit activities. They also utilize an online complaint form to report questionable behavior, and respond to all complaints within 24 hours.

The Department of Public Health and the SFPD—the two city entities which police illegal massage business—both ignored multiple requests from the Bay Guardian to find out exactly how and if the CAMTC makes their work more difficult.

The CAMTC is set to be dissolved at the beginning of next year, unless the Legislature decides to extend the original law. A current bill in the California Assembly would extend the CAMTC’s authority until 2019, an additional four years, and massage therapists across the state are pleading for that to happen.

“Even with those who criticize [the CAMTC], we share the same goals,” Netanel said. “We want a safe, healthy, and reliable certification process, so consumers can trust their therapists. Even more, we want to put an end to illegal massage parlors so they are no longer categorized with honest providers.”

Glimmers of sunshine

Michael Redmond
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3
Glimmers of sunshine

rebecca@sfbg.com

For 29 years, San Francisco Bay Area journalists have gathered in mid-March — around the birthday of founding father and free-press advocate James Madison — to recognize reporters, attorneys, citizens, and others who fight to shake or keep information free.

The act of standing up to defend the principle of freedom of information can be rather unglamorous, sometimes leading to grueling lawsuits. It’s grown even more complicated with the rise of the Internet, the decline of traditional newspapers, and the dawn of an Information Age that delivers instantaneous material that is at once more slippery and abundant than ever.

And yet, the digital realm has opened up a whole new battlefield in the fight for open access to relevant information the public needs to know. This year, the Northern California chapter of the Society of Professional Journalists’ Freedom of Information Committee took the rare step of granting a posthumous Public Service James Madison Award to Internet activist Aaron Swartz.

As a leader in the digital rights movement, Swartz, who died at the age of 26 by taking his own life, was on the forefront of a movement that fought to uphold open access to information in the face of a corporate power grab that threatened to result in online censorship.

The fight against SOPA (the Stop Online Piracy Act) and PIPA (the Protect Intellectual Property Act) in early 2012 marked just one of Swartz’s accomplishments as he fought for free and open access to information. Among his other contributions was RECAP, an online listing of court materials that allowed free access to documents held in the federal, paywall-protected court filing system called PACER.

To commemorate Swartz’s work, the Bay Guardian presents in this issue an illustrated history of his activism. While recipients of James Madison Awards have typically been individuals who took on government bureaucracies to wrest information out of the shadows and into the public eye, Swartz’s battle revolved around freeing information that is locked up by private interests, or protected by copyright.

“We need to take information, wherever it is stored, make our copies and share them with the world,” he wrote in a 2008 essay titled “Guerilla Open Access Manifesto.” “We need to take stuff that’s out of copyright and add it to the archive. We need to buy secret databases and put them on the Web. We need to download scientific journals and upload them to file sharing networks.”

But first, here are a few updates on the fight for open access to information in San Francisco and beyond.

 

NO SHINING EXAMPLE

In 1999, San Francisco voters enacted a law to strengthen citizens’ access to government records and public meetings. To ensure that the open-access law was properly upheld, it also created a local body called the Sunshine Ordinance Task Force.

At each meeting, San Franciscans frustrated by their inability to get the information they sought from city bureaucracies appear before the board to air their grievances, in the hopes that the decisions to withhold documents will be reversed. Typically, citizens lodge around 100 complaints per year, according to task force clerk Victor Young.

But the Sunshine Ordinance Task Force has not been going at full speed for some time now. There’s a backlog of 62 cases, in part because the body could not legally meet for five months in 2012 because it did not have a member who was physically disabled, in accordance with the law establishing criteria for who can serve. (The previous member to meet the criteria, Bruce Wolfe, was denied reappointment. In an op-ed published in political blog Fog City Journal, task force member Rick Knee links this and the Board of Supervisors’ general foot-dragging on Sunshine with a political skirmish dating back to 2011, when the task force found the Board of Supervisors to be in violation of the Sunshine Ordinance.)

There have been two vacant seats on the task force for around two years, as well as two holdover members whose terms have technically expired. Applicants have sought out those seats, but the Board of Supervisors Rules Committee hasn’t gotten around to appointing new members; the most recent appointment was made in October of 2012, according to Alisa Miller, Rules Committee clerk.

Come April 27, meanwhile, all of the current task force members’ terms will expire. Miller said she expects the Board of Supervisors to revisit nominations before the end of April. There are a grand total of 10 applications for all 11 seats. Given all of this, plus a lawsuit revolving around the city’s refusal disclose how the City Attorney’s Office advises agencies on Sunshine Ordinance interpretations, San Francisco is going through some dark days for open government.

 

NAVIGATING FOIA

Anyone who’s ever tried to request public documents from government officials under the Freedom of Information Act knows that it feels more like a bureaucratic nightmare than a federal right. But a new project from the Center for Investigative Reporting is hoping to streamline the entire process into a (relatively) painless procedure.

FOIA Machine (foiamachine.org) is a website to request public documents at the federal, state, or local level, and is described by its creators as the “TurboTax for government records.”

“We wanted to make the FOIA experience better for journalists,” said Shane Shifflett, a data reporter at The Huffington Post who helped build the tool. “We built up a prototype and applied for grants. Then we put it on Kickstarter and it went crazy. That gave us a lot of confidence to see it through to the end.”

On Kickstarter, FOIA Machine raised over $53,000 from more than 2,000 backers, more than triple its goal.

FOIA Machine allows registered users to prepare requests, search a database of contacts, track the status of a request, and work with a community of fellow users.

Shifflett considers the community aspect to be the site’s strongest feature. “It’s crowdsourcing, so as people create requests, they can add contacts into the database. Now there will be a history of who worked with who, and it makes the process of figuring out where to send requests so much simpler.”

The site is still in development, and users who try to register promptly receive an email asking them to “stay tuned” for information in the coming weeks and months. Shifflett said that the group hopes for FOIA Machine to be up and running by June.

 

LEAK US YOUR DOCUMENTS

From time to time, sources have told us at the Bay Guardian that they would love to share sensitive information for news articles, but fear they would be retaliated against or even terminated from employment if they were to do so.

We have found a way around that.

Sources who wish to retain their anonymity while sharing information they believe the public has a right to know now have the option of using an encrypted submission system to anonymously send documents to our news team.

Created by Bay Area technologists in partnership with the San Francisco Bay Guardian, BayLeaks uses the latest cryptography software to protect the identities of our sources. This is a secure, anonymous way for concerned citizens to communicate with journalists to release information.

Our system uses SecureDrop, a whistleblowing platform managed by the Freedom of the Press Foundation, and Tor, an online anonymity network that has gained the trust of Internet users around the world.

To learn more, visit sfbg.com/bayleaks-intro

 

MONEY IN POLITICS

It’s not really a secret that big money has a colossal influence on politics, but the groups and individuals that write those hefty checks to lawmakers often prefer to stay secret themselves. And while political donations aren’t illegal, most voters would like to know exactly who is funding a piece of legislation or a political campaign, and where that money is coming from.

Fortunately for us in California, we already have a resource to easily find that information.

“There’s a collective influence of money in our political system,” said Pamela Behrsin, spokesperson for MapLight, a nonpartisan research organization based in Berkeley that tracks the influence of money in politics. “Our founders said, ‘Look at all this money, and how this legislator voted on this bill. Do you think the money had any influence on how the legislator voted?'”

Through the website, users can also search by bill or proposition to find, for example, that big companies such as Philip Morris spent nearly $48 million to defeat Prop. 29, a proposed cigarette tax in California, on the June 2012 ballot. Supporters of the tax, such as the American Cancer Society and Lance Armstrong Foundation, could only muster a quarter of that amount.

“There’s a whole breadth of people wanting to understand the problem of money and politics,” Behrsin said. “This is one of the largest issues in our democracy right now. People are starting to stand up and say unless we get money out of our system, it’s going to be that much more difficult to fix.”

Wiener’s resolution to study waterfront initiative written by its opponents

Sasha Cuttler And Mary Magee
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Wiener’s resolution to study waterfront initiative written by its opponents

Developers and activists are once again at odds over San Francisco’s waterfront, arguably the most valuable bit of land in one of America’s most expensive cities. Ahead of a June ballot initiative that would require voter approval for proposed waterfront buildings that exceed current height limits, development groups are already reaching out to politicians to tip the scales in their favor.

E-mail and text exchanges obtained by initiative proponent Jon Golinger via a public records request show that Gabriel Metcalf, executive director of SPUR; and Jack Bair, senior vice president and general counsel for the San Francisco Giants, urged Sup. Scott Wiener to use his authority to direct city agencies to report on the Waterfront initiative. Wiener introduced a resolution calling for this report, which will be considered at tomorrow’s [Tues/25] Board of Supervisors meeting.

City law normally prohibits the use of public resources for political activity that could sway the results of an election.

“There’s a law that once a petition qualifies for the ballot, there’s a very bright line that separates government resources from being used [to defend or oppose it],” explained Golinger, who is managing the campaign for the Waterfront initiative. “These emails demonstrate that there are more political maneuvers than genuine intent to inform the public.”

A representative from the City Attorney’s Office declined to comment, but a memo issued last September by that office clarified that municipal resources can be used to objectively investigate and evaluate the impact of a ballot measure, but not to take a position on it.

Wiener denied that there was anything improper about requesting a report in response to concerns raised by Bair and Metcalf. “[The proponents] have been very reckless in their accusations,” he said. “First they said it was illegal, but we pointed out that there’s a provision that allows this. They backed off, and now they’re making another frivolous accusation that although it is legal for me to introduce the resolution, it’s inappropriate for me to talk with anyone who has an opinion on it.”

But e-mail records show that the study was initially requested by Metcalf, and that the first draft of the resolution was written by SPUR. Wiener later presented that resolution to the Board of Supervisors, asking seven city agencies — including the Port of San Francisco, the Planning Department, and the Mayor’s Office of Housing — to produce reports on the impact the ballot initiative would have if passed.

The purpose of the reports, according to a press release issued by Wiener’s office, is to provide an “impartial analysis” so that the public can make an informed decision at the ballot box.

Activists doubt that impartiality, but Wiener says that their claims are “completely baseless.”

“First of all, the only thing this resolution does is direct city departments to provide an objective analysis on the possible impact of the ballot measure,” Wiener told the Guardian. “I find it bizarre that these folks are fighting so tooth and nail to fight more information for voters.”

Metcalf of SPUR, a research and advocacy group with a pro-development stance, also maintains that there is nothing dishonest about the exchanges. The job of lobbyists is to reach out to politicians, he says.

“Every group in the city that’s trying to influence public policy has to talk to supervisors just like this,” Metcalf said. “I’ve worked with this resolution to make the public debate more sophisticated, so people can think before making a decision.”

Metcalf told the Guardian that while the organization’s ballot analysis committee has already recommended a “no” vote on the measure, SPUR does not have an official position until the board of directors votes at its March meeting.

Bair of the Giants did not respond to a phone call from the Bay Guardian. The Giants have a vested interest in seeing the measure go down at the polls, given the massive development project that the team is proposing at Pier 48.

There are two problems with the resolution, said Golinger. First, he believes the advocacy by opponents means city resources would be used for a political campaign. The seven city departments in question would be taking time away from their normal duties to write a report catering to the campaign opposition, he said.

The second problem is that since the resolution was essentially written by SPUR — which is already leaning toward opposing the measure — it would frame the way that the reports would be written.

The resolution “was crafted by opponents to get a preordained result,” Golinger said. “It asks skewed instead of open-ended questions, and they are designed to push and shape the analyses in a frank way.”

Nevertheless, Wiener maintains that he has done nothing wrong.

“It’s perfectly okay for me as an elected official to work with whoever I choose to work with,” he said. “I work with all sorts of different people on all kinds of different topics. That’s what democracy is about. I don’t sit in a cloistered room, I’m out there getting ideas from people. It’s a sad state of affairs that in 2014 you can be attacked for having the gall to actually talk to people.”

Fight for higher minimum wage resumes

Michael Redmond
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0

An event at the San Francisco Women’s Building on Feb. 6 marked the 10-year anniversary of San Francisco’s minimum wage ordinance, passed by voters in 2003 with Proposition L. The landmark initiative not only raised the minimum wage in San Francisco to $8.50 per hour, but stipulated that the amount would rise every year to reflect inflation. Thanks to Prop. L, San Francisco now boasts the highest minimum wage in the nation, at $10.74.

But in pricey San Francisco, it still isn’t enough.

“Who thinks living in San Francisco is really expensive?” asked one of the event organizers and staff member of the Chinese Progressive Association, Shaw San Liu. All hands in the room shot up before the Spanish and Mandarin translators even had a chance to repeat the question.

Raising the minimum wage in San Francisco has been a hot topic recently, and Mayor Ed Lee even endorsed a significant increase back in December. While a wage of $15 per hour has been floated, nothing has been set in stone.

In addition to celebrating the 10-year anniversary of the minimum wage ordinance, Thursday’s event was also the official launch of the Campaign for a Fair Economy, a push to support the city’s lowest-paid workers and close the ever-growing wealth gap.

Raising the minimum wage is only part of the campaign, and advocates are also fighting for accountability from large chain businesses, stricter enforcement of existing labor standards, and expanding access to jobs for disadvantaged workers.

“San Francisco has led the way for employment policies in the past,” said Kung Feng, lead organizer for Jobs With Justice, which is helping to lead the campaign. “We need to continue that.”

Despite San Francisco’s long legacy of championing workers’ rights, there is still a tough battle ahead. Currently, the minimum wage in the city automatically goes up every year to match inflation (on Jan. 1, 2014, it rose from $10.55 to $10.74). Any further increase requires voter approval.

While it seems a higher minimum wage does have strong support and has already been endorsed by major political figures, there’s still a powerful lobby against it from some businesses and restaurant associations.

Advocates for higher minimum wage celebrate past success and look ahead

Sasha Cuttler And Mary Magee
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56
Advocates for higher minimum wage celebrate past success and look ahead

Balloons, snacks, cake, live music, an open wine bar and nearly 100 guests marked a Thu/6 celebration at the Women’s Building in San Francisco’s Mission district. You might never guess a party this fun would be held to celebrate the birthday of a city ordinance.

February marks the 10-year anniversary of San Francisco’s minimum wage ordinance, passed by voters in 2003 with Proposition L. The landmark initiative not only raised the minimum wage in San Francisco to $8.50 per hour, but stipulated that the amount would rise every year to reflect inflation. Thanks to Prop. L, San Francisco now boasts the highest minimum wage in the nation, at $10.74.

But being the nation’s highest still isn’t enough.

“Who thinks living in San Francisco is really expensive?” asked one of the event organizers and staff member of the Chinese Progressive Association, Shaw San Liu. All hands in the room shot up before the Spanish and Mandarin translators even had a chance to repeat the question.

Raising the minimum wage in San Francisco has been a hot topic recently, and Mayor Ed Lee even endorsed a significant increase back in December. The number that keeps floating around is $15 per hour, but nothing has been set in stone.

In addition to celebrating the 10-year anniversary of the minimum wage ordinance, Thursday’s event was also the official launch of the Campaign for a Fair Economy, a push to support the city’s lowest-paid workers and close the ever-growing wealth gap.

Raising the minimum wage is only part of the campaign, and advocates are also fighting for accountability from large chain businesses, stricter enforcement of existing labor standards, and expanding access to jobs for disadvantaged workers.

“San Francisco has led the way for employment policies in the past,” said Kung Feng, lead organizer for Jobs With Justice, a group that fights for workers’ rights. “We need to continue that.”

To say that San Francisco is leading the way is no understatement. In addition to having the highest minimum wage in the country, SF was also the first place in the U.S. to mandate paid sick leave, and the Health Care Security Ordinance works to guarantee medical benefits for all workers in the city.

Despite San Francisco’s long legacy of championing workers’ rights, there is still a tough battle ahead. Currently, minimum wage in the city automatically goes up every year to match inflation (on Jan. 1, 2014, it rose from $10.55 to $10.74). Any further increase requires voter approval.

While it seems a higher minimum wage does have strong support and has already been endorsed by major political figures, there’s still a powerful lobby against it from some businesses and restaurant associations. Despite the upcoming battle, advocates seemed optimistic.

“Who in here can tell me the significance of the Year of the Horse?” Liu of CPA asked the audience, referring to the ongoing Lunar New Year. A small woman sitting in the front row excitedly responded, “Maa dou gung sing!”

“Success comes in the horse year,” Liu explained. “And this will be a year of success and accomplishments for workers rights in San Francisco.”

In the dark

Michael Redmond
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5

A battle for transparency that has dragged on for years is nearing a milestone, as Bay Area civil liberties advocates await a judge’s ruling on whether the federal government will be forced to hand over memos outlining its legal justification for overseas drone strikes targeting US citizens.

The First Amendment Coalition, an Oakland-based civil liberties organization, submitted a Freedom of Information Act request in October 2011 seeking a legal memo prepared by the Office of Legal Counsel to the US Department of Justice.

Initially referenced in the New York Times and the Washington Post, the memo reportedly justifies the legal arguments underpinning the DOJ’s decision to track down and execute Anwar al-Awlaki, an American-born Al Qaeda operative who was killed by a US drone strike in Yemen in September 2011.

In its request, FAC noted that it was not interested in factual information about intelligence sources, but rather “discussion of the legal issues posed by prospective military action against a dangerous terrorist who also happens to be a US citizen.”

It’s hard to see how releasing a legal memo would constitute a threat to national security, an exemption that allows government to classify much of its information about military operations, but nevertheless federal authorities refused to honor FAC’s request.

In fact, the DOJ took its denial a step further, stating that it “neither confirms nor denies the existence of the document described in your request … because the very existence or nonexistence of such a document is in fact classified.”

After filing an appeal and getting nowhere, the civil liberties organization filed suit in Feb. 2012, demanding the release of the memo. Attorney Tom Burke, of Davis Wright Tremaine LLP, is representing FAC.

“We are not interested in how the US government found Al-Awlaki,” he explained. “Our suit is to release that memo with all intelligence information redacted.”

In Oakland on Jan. 23, US District Judge Claudia Wilken heard arguments from Burke and DOJ lawyers in motions for summary judgment, seeking a pretrial decision to settle the matter. By press time, Wilken still had not issued her ruling.

“It’s hard to know the ruling,” Burke said in a phone interview a week after the hearing. “The judge was being very short and blunt.” He added, “We’ve been fighting for this for years. If the ruling doesn’t go our way, I look forward to taking this to the Ninth Circuit [Court of Appeals].”

Meanwhile, the US District Court for the Southern District of New York heard two similar cases, brought against the DOJ by the New York Times and a New York chapter of the American Civil Liberties Union. In January of 2013, that court decided in favor of the DOJ, albeit with grave reservations.

“I find myself stuck in a paradoxical situation in which I cannot solve a problem because of contradictory restraints and rules — a veritable Catch-22,” Judge Colleen McMahon wrote in her opinion. “I can find no way around the thicket of laws and precedents that effectively allow the Executive Branch of our Government to proclaim as perfectly lawful certain actions that seem on their face incompatible with our Constitution and laws, while keeping the reasons for their conclusion a secret.”

The New York Times and ACLU appealed the decision, and are currently awaiting further ruling from the Court of Appeals for the Second Circuit.

The American citizens at the heart of these convoluted proceedings are al-Awlaki, his teenage son, Abdulrahman al-Awlaki, and Samir Khan. Al-Awlaki and his son — who was 16 at the time of his death — were both born in the United States, while Khan was a naturalized citizen of Pakistani origin.

Although all three were killed in strikes associated with counter terrorism operations, the elder al-Awlaki was the only one specifically targeted, according to a letter Attorney General Eric Holder wrote to members of Congress last May.

While the US government’s use of drone strikes has always been politically contentious because of stray civilian deaths, the use of this tactic to target American citizens has been particularly controversial. How is it that the US government — a global beacon for democracy and due process — can find guilty and execute its own citizens without a modicum of a trial?

“Judge McMahon expressed serious concerns that what the government was doing was unconstitutional,” said Brett Kaufman, an ACLU attorney who is handling the cases concerning drone strikes. “But on the merits of [the Freedom of Information Act], which was the issue before her, she had to agree with the DOJ.”

Francisco Alvarado contributed to this report.

Public weighs in on dueling museum proposals at Presidio Trust hearing

Sasha Cuttler
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2
Public weighs in on dueling museum proposals at Presidio Trust hearing

The fate of development Crissy Field is still up in the air after a townhall meeting last night [Mon/27] at the Presidio, where nearly 150 community leaders and residents spoke out on three rival museum proposals, in addition to a large group that supports no proposal at all.

“I don’t think any of them are taking history into consideration,” said SF resident Mike Brassington. “It’s a national historic landmark, and to my knowledge none of the groups care about the history.”

The three groups in question are vying for the highly coveted spot on mid-Crissy Field now occupied by Sports Basement, and each has submitted a proposal to the Presidio Trust laying out its development plans. The first is a project from Star Wars creator George Lucas, who hopes to open an interactive museum dedicated to illustration, digital art, and animation. The proposed facility, which would be funded from Lucas’ personal finances, has already been endorsed by influential leaders such as Rep. Nancy Pelosi, Gov. Jerry Brown, and SF Mayor Ed Lee.

“Arts education is critical to our students, and the whole city of San Francisco is their classroom,” said SF Board of Education Vice President Hydra Mendoza on behalf of the Mayor’s Office, speaking to the Presidio Trustees during the meeting. “The Lucas Cultural Arts Museum will create a rich new environment for our students.”

The Golden Gate National Park Conservatory (GGNPC) is the official sponsor for the second proposal, the Presidio Exchange, which is more commonly referred to as the PX. The PX — which is endorsed and funded by powerful groups such as National Geographic, the California Academy of Science, and the Aspen Institute — would be a conservatory and cultural center for both locals and tourists. The PX building, at 55,000 square feet, is the smallest facility and just over half the size of the other two.

“All of our partners can bring a lot of content to the Presidio,” said David Shaw, member of the GGNPC. “This is the most important issue of our time: the intersection of human culture and the natural world.”

The third and final proposal, known simply as The Bridge, is seen as the least competitive due to its lack of funding. Indeed, a spokesperson for The Bridge admitted to the Trustees that while the project had “no firm or solid” financial resources, they “do have the right idea.” While their efforts are noble, the “right idea” isn’t likely to earn a vote of confidence when millions of dollars are on the line.

Using the couple hundred members in the audience as a gauge, the PX project seemed to be the most popular, receiving the most robust applause out of the proposals. During the public comment portion, when any community member can hold the floor for up to two minutes, many people asked the Trustees to hold off on a decision. Virtually everyone who suggested a postponed decision also made clear that the PX was the least of the three evils, and if something had to be built, it should be the Presidio Exchange.

Charlotte Hennessy, who is on the board for the Presidio Historical Association and carries a sign that reads, “May the farce be with you,” agrees that the best solution is to put Crissy Field back as it used to be before all of the over-development. Just as a police officer arrives to escort Hennessy off of the premises toward the “First Amendment area” for carrying a sign, she shares her ideal vision for the future of the Presidio.

“Space,” Hennessy said. “Just open space.”  

The Presidio Trustees gave no timeframe for making a decision.

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