You may not know anyone who has ever received care at the India Street Public Health Center. But if you live in Portland and you’re a gay man or a lesbian, or you’re queer or trans, you definitely do.
As a gay man myself, I know many who have been treated.
Four friends live with HIV and get their primary care at India Street.
Two more are recovering drug users who have gone there for the needle exchange and other services in the past.
Two other friends have said that they first learned about safe sex practices from the nurses at India Street.
Almost all my gay friends have been there for sexually transmitted disease testing or treatment at some point.
And this isn’t unusual. It’s common knowledge in our community that if you need care, you can go to India Street and they will help you. Full stop.
We know that the doctors and nurses at India Street understand the health issues that are of special relevance to us – like HIV and AIDS – better than anyone else north of Boston.
We know that they will treat us effectively, reliably and without judgment and without barriers to access.
If you’re a student, or you just got laid off, or your primary care doctor doesn’t know anything about HIV, or a sexual partner just tested positive for an STD, or you’re a drug user or a recovering drug user – the people at India Street will help you.
I know of no other health care facility in the entire state that provides the same kind of comprehensive care to our community, with the same expertise and comfort with LGBTQ issues. That’s what makes India Street unique and irreplaceable.
So the idea that we can just close the clinic, lay off all those doctors and nurses and somehow we’ll be able to get the same kind of care at the Portland Community Health Center – that seems laughably implausible.
It’s as if the city ran a nuclear plant, and one day decided to lay off all the engineers who have kept it running for 20 years and replace them with architectural engineers. They’re both engineers, but different kinds of engineers. You’re trading specialized knowledge and deep experience for the absence of those things. It doesn’t make sense.
There’s no commitment to hire any of India Street’s doctors or nurses at the Portland Community Health Center. That would mean tossing out not just their experience, but also the relationships they’ve built with our community since the AIDS epidemic started in the 1980s.
There has been no guarantee that the PCHC will offer drop-in STD testing and treatment with the same availability, price and quality. Losing that would mean more difficult access to testing and treatment, and that would mean higher rates of STD infections.
There has been no assurance that the Portland Community Health Center will hire more staff to handle the more than 250 HIV-positive primary care patients who would be transferred from India Street. That would result in a sixfold increase in the Portland Community Health Center’s HIV-positive caseload.
That’s a recipe for disaster: Patients with HIV need regular checkups and labs – sometimes as often as every six weeks – and they require doctors to authorize frequent prescription refills.
My HIV-positive friends are terrified that they are being dumped into an already-overloaded health clinic that doesn’t understand their needs. They feel like the city – their home – is gambling with their lives.
Have we really thought this through?
Were any India Street patients surveyed about a potential closure?
Has anyone studied the demographics of India Street’s patients and clients, and determined how big a role it plays in our city?
Has anyone put together a detailed plan – developed by medical professionals – of exactly how India Street’s experience and services could be moved to another facility without a decline in quality or access?
In 2012, the city of Portland commissioned a 112-page study to determine whether the city should privatize the Riverside Golf Course or continue to operate it as a city-funded facility. Why shouldn’t something this important get the same thorough treatment?
I urge the City Council to reconsider closing the India Street clinic. I urge them to talk to their constituents – in particular their gay, lesbian and trans constituents – and ask them how they feel about this. I guarantee you I know what they’ll say.
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