Commitment to addressing this issue as well. Even though weve reached this incredible milestone here in our city, we know that there are still disparities that exist, specifically by race and ethnicity, by age, by gender, and, sadly, by housing status. These disparities highlight the work we have to do to continue to get to zero and really trying to remove the barriers, the stigma, the discrimination, so that we can truly end new infections, which is our ultimate goal. In fact, in 2018, africanamerican men had the highest diagnosis rate. Africanamerican women also had the highest diagnosis rate. Fighting this should be our focus and we are taking steps to do so. This week the department of Public Health will launch a competitive bid process where we will allocate 8 million in additional funding to Community Organizations primarily serving the africanamerican, latino, transgender and substanceuser communities in order to strengthen the work that we are already doing. [ applause ]. Mayor breed we have programs right here at ward 86 that others will talk about to really continue to help those that, sadly, we know are homeless. Just last week, we announced our new initiative to help those suffering from Mental Health and addiction who are homeless on the streets. This initiative, our heal our city initiative, will help us to serve, treat, and house those living with h. I. V. And help prevent new h. I. V. Infections. Again, i want to thank everyone here today who is doing work, including dr. Graham cofax who has been an advocate and working in this field for so many years, your incredible leader of the department of Public Health. I want to thank the positive Resource Center for their work. The San Francisco aids foundation which had an incredible event and continues to raise money to invest in this effort. The transgender law center. Aids legal referral panel. The lgbt center. All of the leaders of the getting to zero coalition. Your work is truly appreciated and the value of what you do makes a real impact, as we can see by the numbers that were presenting here today. It is something that we should be proud of. And yes, the work and the investments will continue to be made. This is a milestone for our city. I want to thank each and every one of you for your work and advocacy to get us to this point. With that i want to take this opportunity to introduce a champion in this effort. This and so many other issues that we need to address in San Francisco around Mental Health reform and others, supervisor Rafael Mandalman has been an incredible force in addressing this issue as well. The supervisor for ward 8, supervisor mandalman. Thank you, mayor breed. Thank you for your tremendous leadership on this and so many other issues. As i walked in today, i had a couple of thoughts. One is every time i walk into ward 86 i get a little bit ver clempt because of the amazing work that has been done here for decades and then the amazing work that continues to be done to chart a new path to actually get us to zero. I am such a fan of dr. Gandi and of all the folks who gave me a tour early this year or last year, i dont remember when it was. This is an extraordinary place. Walking in here and seeing this collection of the citys Public Health talent, i am just we are very, very lucky. [ applause ]. Yeah, they deserve some plaza for the work they do each and every day to keep this city healthy and make it healthier. This report has fantastic news. Dropping under 200 reminds me a little bit of 20 years ago, 21 years ago at this point. I am old enough, as some of you are as well, to remember when the bay area reporter had its first no abyss issue. Now we are trying to get to the next step of no deaths and no new infections. To the folks who conceived that several years ago and have been pushing for that goal, i want to extend profound thanks and congratulation on the success that weve made. Some of the data i mean, my aide got me some of the amazing statistics. Overall in the city, 94 of the People Living with h. I. V. Are aware of their infection. That is an extraordinary number. That is not true in the rest of the country. You know, there were no children under the age of 13 were diagnosed with h. I. V. Since 2005. Babies are not being born with h. I. V. In this city. That is an extraordinary accomplishment. We are getting people tested. We are getting folks into treatment. That is how we got closer and closer and closer to zero. That leaves the bad news in the report that were going to hear more about, which is the persistent challenges and, in fact, the increasing rates of infection among africanamerican, latin max, folks on the street, folks struggling with Substance Use disorder, and Mental Health issues. I want to thank dr. Cofax and mayor breed for the creative thinking they have brought to that issue. We know we will not get to zero until we get a handle on really getting care to the folks on the streets who are living with so many challenges, who you see every day in ward 86. I think what the mayor has recognized thank you, madam mayor for recognizing it it is going to require crossdepartmental collaboration, nonprofit government, private actors all working together to really solve these challenges. Everybody can do their part. Here at ward 86 youve come up with a popup, Innovative Program to give folks the care they need. They dont have to make the appointments. They come in and youll wrap around them and give them everything you can in each of those encounters you can. Monica gandi moved out of this ward, so im not happy about that. Im happy youre still in San Francisco. All of you who have gotten us to this milestone and going to get us to zero, thank you so much. [ applause ]. Mayor breed thank you, supervisor mandalman. Now to talk a little bit about the report is the director of the department of Public Health, dr. Grant cofax. Thank you all, today. Its great to be back in ward 86. I worked here for over a decade and im looking forward to returning to the clinic to be a clinician as well. I experienced, as with many of you, the grief and the sadness and advances that weve made with h. I. V. I started as a medical student and weve seen the progression that weve made and the progress thats been accomplished. Whether youre a community provider, a clinician, a researcher, a member of the press, i think the legacy teaches us that it takes a collective vision, a collective effort. Prioritysetting, and understanding what are the priorities in the system to help us do better. Thats the San Francisco h. I. V. Model. Thats our homegrown model that got us here today with h. I. V. It will get us to zero. Getting to zero has the departments full support going forward. I think as importantly is the San Francisco model for what we do with h. I. V. Will also be the model for how we address what may seem like intractable Health Problems today. Think about where we were 20, 25 years ago. Think of where we started. Who would have thought were getting below 200 . We still have much more work to do. We must be bold. We must be innovative, both and h. I. V. And with Mental Health and with Substance Use and with addressing the intersection between health and homeless. Speaking of both vision and innovation and getting us to where we need to be, one of the key people in this city whos doing groundbreaking research, dr. Hyman scott of the Public Health department. Dr. Scott. [ applause ]. Thank you, grant. Thank you for inviting me to say a few words about some of the work that were doing, and the focus on really addressing disparities in our epidemic in San Francisco. Im a clinician here at ward 86. I came to San Francisco because this was the model of how you take care of people as they come. I think our focus on disparity has to focus on ensuring that we reach people where they are and that there are no hardtoreach populations. There are just hardtodeliver services and we need to rethink the way that we approach some of those services. I think popup is a great example of that. Some of the other street medicine and other opportunities to expand prep and treatment outside of the four walls clinics. Although my focus has been on prep and weve seen overall increases in prep use and continuation in San Francisco, we have seen lower rates uptake among black m. S. N. , for example, 10 in other race and ethnicities. In 2017, that was the case. In 2018, it does look like that gap is closing. Weve also looked at some of our data across our primary care clinics. It does appear when people start prep, they dont always stay on prep. The average duration on prep is eight months, despite continuing risk for h. I. V. Acquisition. We take care of individuals after they have been on prep and stop prep. Some of the barriers people have are related to access, costs, insurance changes, perceptions of risk, and discrimination. I think we really want to support people as they initiate prep in their communities, with their providers, to ensure that people who want to access prep can stay on prep. We also have a focus in ensuring that the systems in which people receive care particularly for prep and treatment are affirming places and that we address the structural issues, including Structural Racism that a lot of ou you know ive always wanted to do this job that drives my parents crazy we want to help people i wasnt i did not think twice about that. I currently work as cadet inform the San FranciscoSheriffs Department ive been surprised 0 work within criminal Justice System field i had an opportunity to grow within that career path. As i got into the department and through the years of problems and Everything Else that means a lot i can represent women and in order to make that change how people view us as a very important part of the Vice President you have topanga you have to the first foot chase through the fight are you cable of getting that person whether large or small into captivity that is the test at times. As an agent worked undercover and prevent external and internal loss to the company it was basically like detective work but through the company from that experience and the people that i worked around Law Enforcement that gave me an action when i came to be a cadet i saw i was exploded to more people and the security he was able to build on that. Unfortunately, we have a lot of women retire to recruiting right now is critical for us we gotten too low faster the percentage of women in the department and us connecting with the community trying to get people to realize this job is definitely for them our Community Relations group is out attempt all the time. In other words, to grow in the fields he capitalized any education and got my bachelors degree so i can current work at city hall i provide security for the front of the building and people are entering entering but within any security or control within the building and checking personal bags is having a awareness of the surrounded. There is so month people the brunet of breaking into this career that was every for easier for me had an on the with an before he cleared the path for laugh us. My people he actually looking at lucid up to poem like he joe and kim and merit made theyre on the streets working redondo hard their cable of doing this job and textbook took the time to bring us along. Women have going after their goals and departments line the San FranciscoSheriffs Department provide a lot of training tools and inspiring you to go into the department. They gave me any work ethics she spider me to do whatever he wanted to do and work hard at the intersection. If youre going to make change you have to be part of change and becoming Law Enforcement i wanted to show women could do this job it is hard not easy. Finds something our compassion about and follow roll models and the gets the necessary skeletals to get to that goal with education and sprirmz whatever gets you there. If this is what you want to do dream big and actually do what you desire to do and you can go vertebrae far it is a fast job i wouldnt do anything else. Good morning and welcome to the street scape project and muni project. I certainly as the public works director for the city and county here and i want to thank you for all coming out to celebrate this very exciting project that will improve the lives of the many people who use this inner sunset corridor. The project which spans all the way from aguelo to 19th avenue will improve the quality of life and Transit Services of this diverse neighborhood, which serves families, students, merchants and tourists alike president the street scape improvement is a collaborative project with the ms works and the utilitys commission. For the past two years, theyve been working together to make crucial improvements to the inner sunset street scape and nearby Transit Services that not only make the area more vibrant and more accessible, safe and reliable. When you look around the surrounding streets, you see the vibrant landscapes that add to the neighborhoods charm, improve seating, as you can see, visitor striving, new street trees. All of this creates a healthy environment and a great carbon footprint. What many do not see are the upgraded traffic signals, the repaved roads and all of the help to improve thed safety and transit service. Theres many components to this project that has not been seen. We have improvements to the underground sewer line and improvements to our water lines, our firefightings were upgraded or replaced, all to increase capacity and to minimize any destructions that will provide more Reliable Service to the community. Also, as a part of this project, theres more than 3,000 feet of pipe that was installed for the department of technology for future fiber optic cables and this is a great partnership. As we do many projects on patrero were installing pipe and well have the pipes electric in and, of course, less destruction to the neighbor while the projects happen. With all of that said, it brings me great joy to see the work that all of these agencies are doing together and how we come together to improve the quality of life of this diverse neighborhood in San Francisco. San francisco. I want to thank john thomas and our project manager, johnny farm, harlin kelly and his team from the puc and mr. Maguire and, of course, our contractor, who was out here everyday making sure that we got this job done. And now, the person who helps to make all of these projects happen, the person who makes our neighborhoods better for everyone, the person looking out for the future of San Francisco, without future delay, let me introduce our mayor, london breed. [cheers and applause] its so good to be back. I remember when we first set on the path to do this project for this neighborhood, andrea, i just noticed you were over there and its great to see you and martha and so many folks from the community. You all did the work because you wanted Something Better for this community. We have kids everywhere and these kids from stepping stone preschool are joining us today. And youll get your snacks in just a minute, so dont worry. [cheers and applause] we have kids, we have families, seniors, people who, basically, love this community and so many amazing restaurants, so many amazing places to shop. This is like really a jewel in San Francisco and, in fact, when improve was supervisor, i came to this community a lot to hideout and relax. And it was great. What was so important was to make it a lot offer annua and dl with safety and Public Infrastructure improvements. One of the things that i spent time with some of the neighbors doing is standing on the corner of ninth and irving and many of you know the familiar sound of some of the onl old muni trains which still come through this way, how loud and heavy they are. Remember i said the new trains will be much quieter. Did you just hear how much quieter the new trains are . A loa lot of the promises to ths community are finally happening and it was because of your patience. We know that it was very challenging to come in and the construction and the loss of parking and tearing up the streets and digging in and you all, through this whole challenge, you were very patient and we really appreciate that, because now we are here realizing just really a dream for community, an improvement to the sidewalks, an improvement to the infrastructure and an improvement to our water pressure system so that when there is a fire or emergency, the pressure i know this is not probably that interesting, but it makes all the difference when dealing with any emergency that water suppression and our equipment and the systems actually work when we need it the most. The fiber optic cables, improvements to the sidewalks, all of the Amazing Things that will make this community not just safer but more boost and sobeautiful. I want to thank thet park neighbors, at the time of the leadership of andrea yaguin, that you pushed us to give some attention to this community and shine a light on the challenges that exist here is why were here, as well as the inner sunset merchants association. The merchants here who serve the community, this is really not just a place where so many neighbors enjoy and eat and go to the Hardware