All posts by Carlos Mendoza

When Preparation Becomes Risk

Michael Slater, 27, presents his Truvada pill – a medication that prevents HIV by 99 percent. Photos by Martin Bustamante

By Carlos Mendoza

Two and a half years ago Michael Slater, a 26-year-old homosexual, received the worst news of his life. While supporting a friend who was afraid that he was exposed to human immunodeficiency virus, Slater decided to get tested too. When he received the results Slater had tested positive for HIV. Living with the results for an agonizing week before hearing word that it was a false positive left him speechless.

Shortly after, Slater’s father introduced him to Pre-Exposure Prophylaxis, otherwise known as PrEP. PrEP is a new HIV prevention medication, that, if taken daily, can have a 99 percent protection rate. After being sexually active for 13 years with men, and occasionally engaging in condomless, “bareback” sex, Slater took initiative and asked a doctor about PrEP.

In the handful of times Slater has participated in unprotected sex since he started taking PrEP his mind was more at ease.

[pullquote]”People finally feel safe when having sex for the first time in their life.” – Dr. Robert Grant [/pullquote]

“The few times that I’ve had bareback sex and said ‘fuck it’ this is something that I want to do right now, yeah there is a lot of comfort, it is like I am wearing a condom already,” Slater said.

The active drug in PrEP, Truvada, has stirred a cultural shift on the gay community on both sexual protection methods and condomless sex, according to Slater.

Knowing that a social stigma of promiscuity is attached to being on PrEP is apparent to Slater, but HIV is something that people don’t want to talk about whether you are practicing safe sex or not.

“Is it worth some people thinking that maybe you’re a little irresponsible about it, or very irresponsible about it, fine,” Slater said. “But if it means you are protecting yourself and making good choices so be it.”

Michael Slater, 27, in his bedroom Tuesday Nov. 17, 2015. Photo by Martin Bustamante
Michael Slater sits on his bed for a portrait.

This medication could not have been possible without the efforts made by Dr. Robert Grant, a UCSF professor of medicine and senior investigator at the Gladstone Institutes.

Dubbed the “father of PrEP,” Grant used Truvada very early on when it was just used for Post-Exposure Prophylaxis, or PEP, a pill in which you take after exposure to HIV. This led to a large study on Truvada for pre-exposure usage.

From 2007 to 2009 Grant conducted a large study on Truvada, which included 2,499 high risk men throughout Asia, Africa, Latin America and North America taking either a placebo drug or Truvada.

After four stressful years of observation, Grant and his team at Bridge HIV, a clinical trials unit, discovered that Truvada showed a 44 percent reduction in risk of HIV, according to operations director Aliza Norwood. This was a groundbreaking discovery for HIV awareness prevention, according to Grant.

“People finally feel safe when having sex for the first time in their life,” he said.

In 2012 Truvada was approved for PrEP and places like Bridge HIV, along with the San Francisco Department of Public Health, are responsible for furthering knowledge on prevention care.

“It is so important to do this research because it is providing an avenue to provide the drug to people,” Norwood said. “That’s what gets it approved, that’s what gets insurances to pay for it and that’s what gets people access to it.”

Approved for all genders and sexual orientations, but it is highly encouraged for high risk males (men who have sex with men) and transgendered women, according to Norwood. Anyone who has had condomless anal intercourse once in the last six months, exposed to erectile STI’s in the last year or has had sex with two partners in the last six months is strongly encouraged to begin PrEP.

“The people here have been so active and asking for it, asking for research, asking for treatment and asking for PrEP,” Norwood said.

This fairly new medication is on the rise within the local gay community, but the number of people taking action and using this drug is low, according to Norwood.

“In San Francisco, where PrEP knowledge is way higher than most places, most people or a lot more people, are on PrEP than other places,” Norwood said. “Still we are only meeting a third who are on PrEP, so about two-thirds of people who should be on PrEP are not.”

To qualify for a prescription people have to go through quarterly HIV/STI screening tests, urine tests and blood level checks for blood count and kidney function, according to Norwood.

Side effects begin fairly early in what Norwood calls the “startup syndrome.” Nausea, vomiting and kidney problems may occur, but fades within the first month according to Norwood. Kidney monitoring is important for everyone who is on the medication, and if problems arise the medication has to be stopped.

The graph shows the numbers of people in San Francisco who have contracted HIV from the years 2006 to 2014. The number of men who have sex with men, transfemale and females with HIV have lowered due to advancements made with HIV prevention medication.
The graph shows the numbers of people in San Francisco who have contracted HIV from the years 2006 to 2014. The number of men who have sex with men, transfemale and females with HIV have lowered due to advancements made with HIV prevention medication.

Taking PrEP has proven effective, and if taken every day it has a 99 percent reduction in risk according to Norwood. If days are missed taking four to five pills a week would provide 96 percent reduction in risk. Despite the drug’s effectiveness, taking PrEP should not be the only means of protection when people are engaging in sexual intercourse, according to Norwood.

“PrEP should not take the place of condoms,” Norwood said. “Look at this as a tool box, you have all of these different ways of protecting yourself from HIV and this is an additional way, it can be extra prevention.”

For Matt Bradley, a 28-year-old homosexual, safe sex is important, and using both the medication and condoms is the number one method for preventing HIV and other STI’s.

“It’s not worth just doing PrEP, and then waking up and all of a sudden you have something awful going on down there,” Bradley said.

Bradley believes that the naysayers discouraging condoms and engaging in condomless sex in an effort to preserve the romance are wrong.

“If you need to fuck bareback in order to have romantic or passionate sex, then you don’t know what you are doing. You are not doing it right,” Bradley said.

The social stigma from being on PrEP does not affect Bradley, but it does have an effect on his sexual partners.

“I feel more pressure that declaring my status on PrEP from other guys means that they expect that I am going to have unprotected sex with them,” Bradley said. “I feel like that is a bigger problem.”

Overall, Bradley acknowledges the good that PrEP has provided to the gay community in San Francisco regardless of stigmas, and encourages others to get medicated too.

“I feel like every man who is physically able to take it, should be taking it,” Bradley said. “Because we have a chance of eradicating HIV.”

Instead of looking at the downside to PrEP, Norwood is looking at the positive aspect and is hopeful for the future.

“This is an epidemic and we need to treat this epidemic,” Norwood said.

The city’s flooding hotspots prepare for El Niño

Stable Cafe’s cafe manager, Francisco Garcia, shows how high the water level was during last year’s Pineapple Express Storm. Photo by Katie Lewellyn

By Carlos Mendoza

Francisco Garcia couldn’t sleep. All he had on his mind was the rain and the feeling that his place of work was going to flood again. He left early in the morning from the East Bay to the Stable Café located at 17th and Folsom Street in the Mission District. While on his way, Garcia received a text saying “don’t rush we are already flooded.” Reality struck the café for the fifth time.

After a tormenting four days of rain, the city of San Francisco accumulated nearly four inches of water from the Pineapple Express storm last December. Both residential and commercial flooding was inescapable, especially low-lying areas of San Francisco, leaving behind property damage.

One of the areas the city has problems maintaining is east of S. Van Ness Avenue and between 17th and 18th Streets where Mission Creek flows. The restaurant Garcia works at sits directly in the middle of that disaster zone. After the major storm hit in 2014, the Stable Café was engulfed with both stormwater and sewage. The mess rose up to three feet, leaving the café in a nasty swamp, according to Garcia.

“We want the city to pay attention to our neighborhood,” Garcia said. “I want the city to replace the pipes in the street.”

Garcia said everything in the café had to be replaced. From the refrigerators to the walk-in freezer the damage cost them close to three months of business. The city helped pay for the damages in an effort to bring the Stable Café and other nearby buildings back to life.

“It’s not satisfying because they just help us to be back to where we were before,” Garcia said. “We lost customers and we lost business. We start from zero every time.”

Flood-Map-Inset-Legend
17th and Folsom Streets intersect where Laguna Dolores sits. The lagoon is now paved over, but the area still remains one of the lowest lying parts of the city and is prone to flooding. Map provided by the San Francisco Public Utilities Commission. Produced by Carlos Mendoza and Drake Newkirk.

In the past five floods the Stable Café has experienced, none of them have occurred during an El Niño season. Garcia worries that rain during El Niño could bring even more damage than previous storms.

“Right now we are scared,” Garcia said. “We cannot sleep, and we are thinking ‘oh shit it is raining.’”

John Monteverdi, a professor in the Department of Earth and Climate Sciences at San Francisco State University, explained that this El Niño is on track to be record-breaking. Some of the heaviest El Niño years were 1982 and 1983 where the city accumulated 38 inches of rain and 1997 and 1998, which saw 47 inches of rain. This year, El Niño is predicted to give San Francisco 30 to 35 inches of rain, but could surpass those predictions. On average the city only sees 23 inches of rain per year.

The San Francisco storm and sewer system is not well equipped to handle copious amounts of water such as with last year’s Pineapple Express storm or the upcoming El Niño season, according to Jean Marie Walsh, the Communications Manager of the San Francisco Public Utilities Commission.

“No system is perfect and no system can handle all storms,” Walsh said. “That’s what makes it challenging when we have heavy rains. You can only build a system so big. At some point that system reaches capacity, and there is no more room in the pipes and in the system.”

The majority of San Francisco relies on 25,000 storm drains and catch basins according to the SFPUC, a network that Walsh calls the “combine system.”

Drains located in the newer areas of San Francisco direct storm water out to the ocean and the bay. Catch basins provide the same service, but escort the water to the main sewer pipes beneath the street, and into transport storage boxes.

These giant boxes lie beneath the Embarcadero and the Great Highway where their main purpose is to hold storm-water before it is treated.

San Francisco has 1,000 miles of sewer pipes beneath the city, but even with all this underneath, it is still not enough to hold the amount of water substantial downpour can bring. These storm drains and catch basins can get clogged up with leaves and debris, which leads to residential and commercial flooding, especially in low-lying areas of the city.

Walsh explained that 17th Street and Folsom Street is a major flooding zone in the city and provides a significant challenge during heavy rain seasons.

Aside from that area, there are additional pockets of San Francisco that are low-lying and are at a risk of flooding. “Challenge areas” include spots in the Sunset, and Bayview Districts. In an attempt to prevent flooding, SFPUC crews clean out the drains and catch basins prior to predicted storms.

Walsh described the crews as crucial, especially during the rainy seasons and in the months leading up to them. The crews are on stand-by and some even work late night shifts.

The SFPUC developed a “hydraulic analysis” where engineers developed a sophisticated model that tests the topography, soil and sewers of the low-lying areas of San Francisco. They do this to potentially predict what will happen during a storm, according to Walsh.

Walsh explained that residents need to understand what area of San Francisco they are moving into.

“Know your risk,” Walsh said. “A lot of people move into a neighborhood, it’s dry sunny beautiful weather, and they have no clue that their property is located over a historic creek, and when we get heavy rains they might flood.”

David Campos didn’t realize flooding plagued District 9 until he became its supervisor. Campos acknowledges flooding in the Mission District specifically along 17th and Folsom Streets, but he does not see any viable solutions.

“Until I became supervisor, I didn’t really know that this was an issue,” Campos said. “Because it is the lowest point in the city, it’s extremely expensive to fix. Even if you spend billions of dollars on it, there might still be flooding.”

Currently the city reimburses residents and business owners affected by floods, which Campos said may be the best solution. Between claims and cleanup, the Pineapple Express storm cost the city several million dollars, according to Walsh.

“It might be cheaper for the city to continue to pay that on a yearly basis than to be able to find the billions of dollars that is needed,” Campos said.

A short-term solution was presented to the board that would have cost the city $200 million, a price they did not feel was worth for a fix that might not even work. The SFPUC does not have the funding to work on a long-term study that could find a permanent solution, according to Campos.

While the city attempts to come up with a more permanent solution, Thomas Lackey, the owner of the Stable Café, is fed up with the perpetual delays. He wants to see a system that doesn’t put his restaurant out of business after every big storm.

“It would be worth it for them to bite the bullet and fix the problem,” Lackey said.

Proposition C

By Carlos Mendoza

Proposition C’s plan on regulating lobbyist that spend an amount of $2,500 or higher on city officials and legislations in City Hall creates an equal atmosphere in the political realm.

The proposition is aimed at individuals, party groups and unions who spend the regulated amount to disclose information. The information would contain how much money was spent, and who or what the money was spent on.

Supported by the San Francisco Ethics Commission, Prop C not only regulates funding, but it also prohibits individuals or groups to provide city officials with gifts higher than 25 dollars.

Setting the political field in a fair environment is crucial because it guarantees that every city official and legislation has a fair chance of representation and eliminates the influence of money.

Proposition B

By Carlos Mendoza

Proposition B’s plan on expanding paid parental leave for all employees that work for the City and County of San Francisco is miniscule to the majority but helpful to the minority.

The proposition that is supported by Supervisor Katy Tang, will allow all government employees to receive a full 12 weeks of paid parental leave. This comes before employees are allowed to keep their 40 hours they have gained at the end of their leave.

According to federal, state and local law, all employees are granted 12 weeks of parental leave after arrival of a new child. Compensation comes after employed parents use their sick hours they have accrued.

This new proposition will make sure that compensation will happen during the full 12 weeks and let new or existing parents keep their 40 hours of paid sick leave.

Androgyny Is In

By Carlos Mendoza

Milan Fashion Week brought the clothing industry a new state of mind, and it was all thanks to Gucci’s spring summer 2016 collection. The suave pussy-bow tie chiffon and crepe shirts, followed by floral prints and vibrant lace button-up shirts graced the catwalk. Bell-bottom trousers appeared on the show with frail waif-like male models, which strutted confidently in clothes that are traditionally worn by women.

Just as Gucci made a statement last fall winter 2015 season, head designer Alessandro Michele is back with another 70’s themed collection that is testing the barriers of gender and clothing.

The reality is that fashion designers has always been on the brink of breaking down the wall of gender-specific clothing and incorporate gender neutral clothing in their collections and campaigns. Public School, a New York City based clothing brand, is well known for being gender neutral. Their spring summer 2015 collection displayed over-sized trousers tailored for men on women. The models featured in the show closely coordinated with the design by possessing androgynous looks to match the outfits.

Niki Snyder a freelance designer and recent graduate of the Fashion Institute of Design and Merchandise has had some of her pieces created and sold by the brand Betabrand. This modern minimalistic designer with a taste for textiles, believes that gender neutral clothing is a re-occurring fashion trend.

“Gender neutral clothes have always been around,” Snyder said. “We just never noticed it until now because of the times we are living in.”

The politics of gender, sexuality and orientation is on panel for discussion more frequently in comparison to other years according to Snyder.

Fashion and style, according to Snyder, should also reflect the times, and that clothes are all about comfortability.

“When I design something I don’t see it as a woman’s piece, or men’s, but rather unisex because depending on the person and their confidence they can pull off any type of clothing,” Snyder said.

Styling probably is one of the most important factors when it comes to the fashion world, according to Robert Finch a stylist/ fashion photographer.

“Style is everything,” Finch said. “You either have it or you don’t and every single item counts no matter if it comes from the woman’s department or men’s.”

Style according to Finch is iconography and can represent who you are as a person. When he style’s models or clients he doesn’t eliminate any options.

“I can style a woman and I will put on her a men’s white button up shirt because it is simple, chic and the way it fits a woman’s body is absolutely stunning,” Finch said. “For a man it can be as easy as an over-sized women’s coat throw it over the shoulders and he would look just as fabulous.”

Models also play a role in this transformation, according to Finch. There is a trend amongst models where their look is androgynous which provides a new sex appeal.

“Before there was models that looked strictly like men and women,” Finch said. “Now androgyny is in and people are getting in touch with their feminine and masculine sides.”

Finch admires this new look, because it provides a sense of eroticism and mystery to everyone.

A fad or a trend, but many people believe that this style might be around to stay for quite some time.

“I love everything about it and I know people are going to buy into this fashion trend,” Snyder said.

Reduce, Reuse, Restyle

Hair stylist Lexi Hernandez prepares model Kelsey Hernandez’s hair before the San Francisco Sustainable Fashion Week Green Glam Fashion Show in San Francisco Friday, Aug. 28, 2015. (Alex Kofman/ Xpress)

 

By Carlos Mendoza

[dropcap size=”50px”]A[/dropcap]s the room darkened, shades of florescent neon green and blue lights paved the way for a runway and the once loud grand ballroom at San Francisco’s Grand Hyatt fell silent as a woman stepped onto the catwalk. Eyes were fixed on the model’s ethereal rose pink dress which was made of wool with a simple silhouette and matching coat. The anticipation set in as the audience waited for the next look to emerge at the first show of the 2015 San Francisco Sustainable Fashion Week International.

The Green Glam Fashion Show was part of the sustainable fashion week and showcased work from local, national and international designers. This was not merely a fashion show, but rather a statement and supporting bid to a small-scale trend that is financed by a limited market.

Tracy Moreland, a sustainable fashion designer based in the South Bay, displayed her five-piece collection the night of the Green Glam Fashion Show.

“It was all really simple silhouettes and then I just patchworked all the fabrics together to make those dresses,” Moreland said.

The bohemian environmentalist said she uses disregarded materials, that some people may consider ugly, in an eco-friendly manner.

“I really do think that it’s important to use what we do have,” Moreland said. “Use that up and get that out of the landfill.”

Sustainable fashion doesn’t mean that customers have to sacrifice style and creativity according to Moreland. Creating a demand for eco-friendly garments is important for San Francisco and the greater Bay Area, she said.

Tuan Tran, a local sustainable fashion designer, works mainly out of his living room in Potrero Hill. He does not like to identify as a designer, but rather as an artist. Tran, who designs one-of-a-kind dresses in a John Galliano couturier essence, believes that everything he creates with recycled materials represents more of an “art wear” than typical attire.

Tran got his start when a friend challenged him to design a dress with telephone wire, which became the start of his first collection. Four more collections have followed since.

“There are so many beautiful things out there that we don’t really recognize unless we take it, deconstruct it and find beauty out of it,” Tran said.

Tran doesn’t believe in mass producing apparel and prefers to make unique pieces in order to prevent the disregarding of clothes.

“The more we buy, the more we throw away,” Tran said. “The less we consume the better.”

[pullquote align=”right”]“There are so many beautiful things out there that we don’t really recognize unless we take it, deconstruct it and find beauty out of it,” Tran said.[/pullquote]

Working alone and producing elegant gowns can take weeks, sometimes even months. His custom dresses cost anywhere from $1,500 to $7,500 because of the materials and hours of production that go into their creation. Tran believes San Francisco is a leading sustainable city where consumers are looking for eco-friendly clothing.

Sustainable fashion is an emerging market, and according to Dr. Connie Ulasewicz, a professor at San Francisco State University who holds a doctorate in sustainable fashion, the industry is comprised of three domains: people, process and the environment.

The first domain, people, is composed of everyone from the designers to the consumers. Process is the growing, manufacturing and consumption of natural resources. The final domain of the cycle, environment, is the materials that are being used for both manufacturing and consuming.

“You can’t just look at one aspect of this, you have to look at the connection between them,” Ulasewicz said.

According to Ulasewicz, the city of San Francisco throws away 4,500 pounds of textiles every hour and a single person can throw away 65 pounds of textiles on average. All of this waste comes after using up to 2,700 liters of water to make one cotton t-shirt.

Using all of your sources to the very end, plus finding a way to reuse materials is a perfect method when practicing sustainability, according to Ulasewicz. Shopping at big retailers that do not practice sustainability with lower prices can be tempting to consumers, however, Ulasewicz believes it is up to the designers to provide the information.

For Russell Esmus, a local apparel specialist and advocate for sustainable fashion believes working with reusable materials is key. His latest project utilizes reused tablecloths and napkins from hotels to make tote-bags. The stained, misshapened tablecloths in his Mission District studio show what sustainability is all about.

The connection between eco-friendly food and sustainable clothing is apparent to Esmus, he sees the trends going in the same positive direction, with fashion at a slower pace.

“I think we are still 10 years out minimum from a strong consumer awareness,” Esmus said. “It takes people a really long time to understand.”

Esmus said a designer has to go above and beyond just using organic materials and labeling oneself sustainable. He believes that establishing a connection with consumers is a business practice that can help sustainability grow.

“By buying a brand that you feel like you can connect with, that you feel like is a better brand, you are more likely to keep it longer because you have more of a connection with it,” Esmus said.

Although the sustainable fashion industry is gaining traction, it still has a ways to go. The concept has yet to break into the minds of the mainstream consumers, but designers like Tran, Esmus, Moreland and others will continue to provide for the niche market in the Bay Area.