By David Templeton
“Relationships matter,” the Rev. Jane Spahr once preached. “Relationships matter because relationships are what really change the world.”
In the early 1980s, Spahr helped form a pair of San Rafael-based organizations dedicated to changing the world through building relationships between people in need and the wider community. Whether or not Spahr and the people she inspired actually succeeded in changing the world through such efforts—and many have argued that they certainly did—one thing is quite clear. Those relationships and ideals that were put in place more than 30 years ago have very definitely changed Marin County.
It was at the height of the AIDS crisis, a time when ‘gay pride’ was still a relatively new slogan, and gay people were dying amidst an extraordinary media storm and rising social debate fueled by prejudice, fear and a gap in education.
Having served as assistant pastor of First Presbyterian Church in San Rafael from 1975-1979, afterwards serving as executive director of the Oakland Council of Presbyterian Churches, Spahr had recently come out as a lesbian. Though she shortly thereafter resigned from her position, her story ignited a powerful nationwide conversation about gays in the ministry, the power of pride, the meaning of service and Jesus’ message of love and kindness to underserved and outcast communities.
In 1982, Spahr founded San Rafael’s the Ministry of Light, a nonprofit designed to provide needed services and emotional support to Lesbian, Gay, Bisexual and Transgender (LGBT) residents of Marin County. At the same time, she helped found the Marin AIDS Services Network. Today, the Ministry of Light has evolved, adopting the name Spectrum LGBT Center back in the ’90s, and the Marin AIDS Services Network is now the Marin AIDS Project (MAP).
After years of outstanding service to the community, the two organizations that Jane Spahr built are merging to form a stronger relationship as direct partners. Though the names Spectrum and MAP will continue for the time being, both groups are now working as programs offered by San Rafael’s The Spahr Center, envisioned as a kind of one-stop-shop offering a variety of services and programs serving the North Bay LGBTQ community (‘Q’ added to included ‘Queer’ or ‘Questioning’). Those programs include dozens of support groups for adults and teens, their families, health services, HIV testing, needle exchanges and legal and financial assistance.
The Pacific Sun’s David Templeton recently asked Spectrum Services Manager Julie Majdoubi and Marin AIDS Life & Community Relations Manager Andy Fyne to talk about the new merger under the Spahr Center banner, what it will mean for Marin County, the way the world has changed over the last 30 years and what might be changing around us at this very moment.
Pacific Sun: So, what’s happening with Spectrum and MAP? What is the motivation for the merge at this point in time?
Andy Fyne: Both organizations were formed in the ’80s, and though they have remained separate, there has always been close cooperation between us through the decades. Recently, the boards of both organizations decided to merge. One of the main reasons for that was just to be more efficient. We can offer more by working as one organization, and it just seemed logical to name the new organization The Spahr Center, after Janie Spahr, who founded both organizations.
Julie Majdoubi: As individual organizations, we’ve each accomplished a lot with very small staffs. We do it by leveraging what we do with volunteers, and we have good governmental and foundation support and excellent community partners.
Fyne: That gives us the ability to reach out to a lot of people and provide fairly expansive services. We have to be nimble and resourceful, and many of us here do many different things on any given day. We have a very talented and knowledgeable staff.
The Spahr Center is unique in Marin County, because it’s the only organization devoted exclusively to promoting the health and wellbeing of LGBTQ people and those living with HIV. Other organizations might serve these groups, but we’re the only organization that solely serves them.
Sun: Are you going to be letting go of the Spectrum and Marin AIDS Project names at some point?
Majdoubi: It’ll be a transition.
Fyne: I would say at this time, that Marin AIDS Project is a program of the Spahr Center, and the Spectrum LGBT is a program of the Spahr Center. Eventually, through this rebranding, we are eventually going to fully merge the organizations and stop using that language. The Spahr Center will have three focuses—LGBTQ services, services for people with HIV and services around HIV prevention.
Sun: Your organizations have been doing this work for a long time, and things have changed. What’s going on in the LGBTQ community of Marin that is new, either positively or otherwise?
Majdoubi: There are definitely a growing number of people with needs around gender identity. I see that as the big emerging issue. We certainly see it politically as well. Gender identity is left out of a lot of legislation, so there is a need for better rules regarding safety of trans people and gender queer people in schools and public spaces. As more people are coming out as gender queer, there’s a real need for more support there.
One of the most important things we do is to provide information. We are a resource for people who need to know what’s going on, and what services are available to them. We provide that information, even about services we don’t offer ourselves.
Sun: What kind of questions are you getting?
Majdoubi: I get calls all the time asking me for info about what health agencies in the area are transgender affirmative or gender queer knowledgeable. We recently got a call all the way from Monterey asking us, in Spanish, what would be the appropriate language to use, in Spanish, for a gender-neutral pronoun. When I don’t have the answers, I’m going to dig around and find out. It’s important to us that people have a place to call, just to ask those questions.
Fyne: I would say, in regards to the LGBTQ community, there’s a growing interest from providers to be more informed and affirmative around their care.
Majdoubi: And there is increasing family support on the whole. Not every family is supportive of their LGBTQ members. Certainly, in families of color there are still a lot of challenges in terms of family acceptance. But on the whole, we are seeing an increase in positive family support when kids come out. Kids are coming out earlier than in previous generations. The latest polls show that the average age LGBTQ kids are coming out is now 16 or 17.
Sun: And what effect is that having on the community at large?
Majdoubi: The youth, who are coming out earlier, and coming out prouder, are looking to build more of a community. A lot of the schools and the churches and service organizations in Marin are looking to support these kids. That’s something new, and it’s a good thing, and I think that should be something people are aware of. I get calls from all over looking for information and training on how to support all of these youth that are coming out. And a lot of those calls are from parents. That’s huge. In generations past, the parents would have been the last ones to ask how to be more supportive. So that’s a really big sign of progress. We know that family support, school and community support, changes the course for LGBT kids growing up healthy. That kind of support helps them steer clear of the risk factors of homelessness, substance abuse, HIV infection, suicide and depression. Those are still present risks, but they are decreasing, as support from our community increases. I’m really pleased to see that that is the growing trend.
Fyne: Gender is definitely the big hot topic right now. But that does not diminish the continued need for support on the other fronts as well. We continue to have a strong mission of prevention and outreach to the HIV infected and affected. We are the only safe access syringe exchange in the county. We do exchange, but we also provide syringes without the need for bringing in used syringes.
Majdoubi: In the interest of harm reduction, we have a room full of supplies we make available to people who are at risk. If you are going to shoot up, we want you to be able to shoot up safely, to reduce potential infection and spread of HIV.
Fyne: HIV infection, Hepatitis C infection and bacterial infection. We have safe injection supplies along with syringes. We have information and referral services.
Sun: Your needle exchange program, then, extends outside of the LGBTQ community? Can anyone who needs safe injection supplies participate?
Fyne: Yes. Basically, we’re really trying to brand it as ‘syringe access,’ so people will feel safe and open to coming in. The opioid addiction problem is growing in Marin, as it is everywhere else, and we’ve also responded by providing free Narcan kits. Narcan is a drug that’s been invented to reduce opioid overdose. We train injection drug users in how to safely inject their friends, what the procedure is and we distribute Narcan.
It’s a very important service that we’ve just begun in response to increased opioid use in the county, which comes with increased overdose risk, and with increased risk of spreading HIV and other diseases. This year we are distributing about 25 percent more syringes than we did the year before. We see that as a growing problem, as do many people in the county, and we’re responding by providing harm reduction services that are much needed.
Sun: What other ‘harm reduction’ services do you offer?
Fyne: The traditional method of harm reduction in regards to HIV and Hepatitis C is to encourage frequent testing for people most at risk. We do a lot of prevention outreach, to find populations that are at risk, and encourage testing.
Traditionally, in San Francisco, a harm prevention worker might go into a gay bar or bathhouse. We don’t have those facilities here in Marin, so we’re doing a lot of work online. We are also going out into the community where populations most at risk gather—the St. Vincent Dining Room, and other drug treatment facilities, places like that.
HIV testing can be done in your doctor’s office, if you just speak up and ask—but if you don’t have access to a doctor, if you’d rather do it in a community-based setting, these people can call Marin AIDS Project or walk in, and we will test them within 24 hours.
Sun: Who should be tested?
Majdoubi: Definitely the people who are most at risk, which means men who have sex with men, people who have HIV-positive partners, intravenous drug users and people of color who’ve never had an AIDS test.
Fyne: We offer free, confidential, walk-in HIV testing every Tuesday and Thursday from 4:30pm to 7pm, with results given in just 20 minutes.
Sun: In terms of HIV and AIDS, there have been a lot of medical discoveries over the last several years. Are there any new tools or medicines that are altering how those with HIV are being treated?
Fyne: We do have a new tool in prevention. That’s PrEP, which stands for pre-exposure prophylaxis. Very simply, it’s a one-pill-a-day regimen that, taken on a regular basis, will prevent HIV infection. PrEP is proving to be over 99 percent effective in reducing HIV infection.
Sun: Does the Spahr Center offer PrEP to its clients?
Fyne: No. It’s something that has to be prescribed in a clinical setting. But we’re providing the navigation and information people need, helping them to get onto insurance that might pay for it. Helping them find programs that might pay for it. For a lot of people, simply getting a prescription and then getting it filled can be a huge barrier. So, we’re helping them work the system to get PrEP, and stay on it. And we are advocating for more outlets in this county that will prescribe PrEP. Right now it’s mainly prescribed by private doctors or in limited public settings.
Sun: Along with the other services you offer to the HIV community, I imagine some of it has to do with the population aging? Are you seeing that as a growing factor?
Fyne: Well, the general population of Marin is aging, too, so in terms of our services to people living with HIV, our work has a lot to do with having them age in place, providing support services that allow them to stay in their homes. We’re definitely doing that on a larger scale than we have in the past, as the population gets older.
We’re still providing the same menu of services we’ve provided over the years—benefits advocacy, mental health services, emergency financial support, housing assistance, a food pantry with the support of the Marin County Food Bank, nutritional support in the form of cash, home-based care and many other things.
Sun: What have you both found are the biggest misunderstandings that still persist within or about the communities you serve? Are there any false ideas you’d like to clear up?
Fyne: Well, around HIV care, a lot of people still get confused regarding documentation status. If you are undocumented in this country, you may not be able to get onto expanded Medi-Cal or an ACA health program. However, if you are living with HIV, even if you are undocumented, you get a full range of HIV health services free of charge. The fact that you’re not a legal resident shouldn’t be a barrier for getting tested, learning your HIV status and getting appropriate care. The drugs will be paid for.
In terms of syringe access, our needle exchange is anonymous and legal. People are still a little worried about having to identify themselves. Also, when our needle exchange access site is closed, people should be able to go into a pharmacy and buy as many clean syringes as they like without a prescription. It does depend on the pharmacy, but that’s something they should be able to do at most pharmacies.
We’d also like to change people’s perception that HIV drugs are toxic and difficult to take. That idea is sort of old school, and we’d love for that idea to go away. Taking HIV drugs has become a very easy thing, less toxic and with fewer side effects than it ever was.
Sun: Do you think HIV will ever be a thing of the past?
Fyne: I don’t know about elimination, but I will say that the path to eliminating HIV is in finding people who don’t know their status, who might be positive, and getting them on meds if they are. That will be one of the big hammers in bringing down the spike of HIV.
Majdoubi: You asked about misperceptions we’d like to change? One big one I’d like to change is the idea that you have to cross a bridge to get care, or to find services. There are a lot of people in the LGBTQ community who still think you have to go to San Francisco or the East Bay to find a community. That community is here. And those services are here. And that’s kind of my main thing I’m shouting out from the rooftops, to let the county of Marin know that we are offering the services the LGBTQ community needs. We are connecting people and supporting people. I want the community of Marin to feel that sense of support from the Spahr Center. We welcome everyone with a sense of openness and inclusion and understanding. We are here for you.
The Spahr Center; 910 Irwin Street; San Rafael; 415/457-2487; thespahrcenter.org.