For Portland’s LGBTQ Community, India Street is Irreplaceable (originally published in May 2016)
So I’ve been trying to figure what the disconnect is between the City of Portland and those of us in Portland’s LGBTQ community.
I have a theory.
Closing the India Street clinic and trying to replicate it somewhere else is based on the assumption that the services they provide there are interchangeable with other medical services. That any other medical facility can just pick up things like STD testing, a needle exchange, and HIV+ primary care.
And we gays, lesbians, queers, and trans people know that assumption is just plain wrong.
There are issues that are of special importance if you’re part of our community — things like STDs that we statistically have a higher risk for, STDs and infections that we can get in… let’s call them non-standard places, and above all HIV, which requires special expertise and frequent patient contact to manage effectively.
And that’s why India Street is so special: the staff there understands these things because they have decades of experience with them. They make sure to test in the right places. They have experience watching people respond to HIV meds. They know which drug abuse issues are rampant in the gay community that are not as common in the general population. They’ve spent years building very deep connections to our community.
You may not know anyone who has been India Street, but let tell you — if you’re gay or lesbian or trans or queer, you definitely do. I know lots.
Four of my friends have HIV and they go there for primary care.
Two more are recovering drug users who have gone there for the needle exchange, STD treatment and mental health.
Two other friends have told that they first learned about safe sex practices from the nurses at India Street.
And as for friends who have been there for drop-in STD testing and treatment, I stopped counting around 10.
In fact, it’s been difficult for me to find a gay friend who hasn’t been there for something at some point.
I’m lucky enough to have private health insurance and a primary care doctor elsewhere in town. But I’m pretty certain that I’m the first gay man that he’s ever treated, and there have things relating to STDs prevention and HIV that I have had to explain to him.
Not everyone is comfortable doing that with their doctor, and not everyone has a regular doctor they can do that with.
Which is why the staff at India Street is so irreplaceable. It’s not just a place where you go to pee in cup and leave; in our community it’s well-known as a reliable resource and an ally. You can’t expect another facility to build up that kind of experience and these kinds of relationships overnight. That sort of thing takes years.
The current plan to transition services to the privately-operated, non-profit Portland Community Health Center (PCHC) includes no guarantee that India Street’s staff will come along. It looks to us like all the experience and all those relationships at India Street are just being thrown away.
If all of India Street’s HIV+ patients transition to the PCHC (which is not guaranteed), their HIV+ primary-care caseload will go from 50 patients to around 300. That sure looks like a recipe for disaster. My friends with HIV are terrified.
The current transition plan does not include a concrete plan for re-establishing the needle exchange. It does not include a detailed plan for re-establishing drop-in, confidential STD testing and treatment services.
I can’t help but wonder: have we really thought this through? Were any India Street patients consulted? Has anyone studied the demographics of India Street patients to see what role they play in our city and our community?
Has anyone put together a detailed plan — developed by medical professionals — of exactly how there could be continuity of India Street’s experience and services in a transition, without a drop in quality or access?
In 2012, the City of Portland commissioned a 112-page study to determine whether or not they should privatize the Riverside Golf Course.
Why shouldn’t something this important get the same thorough treatment?
I urge the City Council to reconsider closing the India Street clinic. I would love it if they just kept it open and invested in it to make it a thriving healthcare facility, but if they do decide to close it, I hope they do so in a responsible way that’s best for the patients. Because like it or not, they are your patients, and you have an obligation to do them no harm.