SF Sex Worker Clinic Marks 15 Years

A San Francisco nonprofit that provides HIV testing, food, and other assistance to sex workers is marking its 15th anniversary as people in the industry - many of whom are LGBT - continue to face stigma, financial insecurity, and other challenges.

St. James Infirmary, which claims to be "the only peer-led and participant-driven sex worker clinic in the United States," will hold its anniversary party Thursday, June 5 at Temple nightclub.

Since 1999, St. James has offered free services including primary medical care, sexually transmitted infection testing, transgender hormone care, hepatitis vaccines, counseling, food, clothing, and syringe exchange to current and former sex workers.

For many people, the clinic "might be the only place in the world they're out as a sex worker or feel comfortable and free from judgment," said Executive Director Stephany Ashley, 28.

The nonprofit is housed in a nondescript gray building at 1372 Mission Street in the South of Market neighborhood. There's no sign on the mirrored front door or anything else informing passersby what goes on at the address.

"We like folks to have some privacy," said Ashley. Otherwise, a person "could potentially be outing yourself by walking through the door."

On a recent Thursday morning, one woman dropped by asking about services, and Ashley, who provided the woman with some information on what St. James offers, said the agency gets such visitors "a lot."

People often seek help at the clinic because of what's happened when they've gone to other places for assistance.

"A lot of our community members have had very negative, shame-based experiences with service providers," said Ashley.

Shannon Williams, who's 48 and lives in Oakland, has been a sex worker for 20 years.

Williams said she first went to St. James around 2002 after a police officer raped her.

She didn't report the incident to officials, and said she didn't even want to tell friends because "I felt like there was a good chance my friends were going to pressure me to go to the police or quit my work and say it was too dangerous."

Williams had heard about St. James, and she went there to get tested for STDs. When she got there, she was asked if she wanted peer counseling, and she said, "Sure."

The counselor she spoke with "was another sex worker, so I felt comfortable telling that person what had happened," said Williams, who works as a prostitute.

At St. James, "I got exactly the kind of supportive counseling I needed," she said.

Williams, who eventually volunteered at St. James as a peer counselor for about four years, said she's gone to other places for health care and she's been "afraid to be really honest about my sexual history," and scared that "I will get poor service from that person because of their own prejudices."

St. James continues striving to make clients comfortable.

"We try to keep all our services as peer-based as possible," said Ashley.

One example can be seen with the Stride hormone therapy program, which is led by transgender people.

The nonprofit's space includes several offices that double as counseling rooms, a lab, and a community room known for its popular "dinner and a movie" nights on Wednesdays.

A banner hanging on one of the room's walls makes clear St. James's support of sex workers.

"Outlaw poverty, not prostitution," the sign says.

The nonprofit's clients range from porn performers making "fantastic salaries" to people who are "exchanging sex for food or shelter," said Ashley.

St. James, which has a budget of approximately $427,000, has more than 3,500 unduplicated participants who receive in-clinic health care services.

Additionally, the organization's made about 30,000 contacts through its outreach program. The organization provides testing and counseling in locations ranging from the Nob Hill Theatre strip club to the San Francisco LGBT Community Center's youth meal night.

According to Ashley, "68 percent of our community members self identify as somewhere on the LGBTQQI spectrum." Almost one-third of people in the community identify their gender "as transgender or gender non-conforming."

While Williams and others engaged in sex work have expressed satisfaction with their career, many clients have faced increasing hardships.

Ashley said that as the Bay Area "gets less affordable," and fewer jobs are available, "people who may have been retired sex workers are returning to work," and other people are doing sex work to supplement their incomes.

Like its clients and any number of other nonprofits, St. James faces challenges of its own.

The agency lost $70,000 in Title X funding last year, which is federal family planning funding that could be used for HIV testing and treatment, birth control, and other needs. Ashley's been looking for ways to fill in the gap.

Other funding sources include the San Francisco Department of Public Health, and private foundations and corporations.

Workers' Rights

Ashley, whose salary is $70,000 and who identifies as queer, was once a dancer at the Lusty Lady. She said she had "a largely positive experience in the sex industry." Sex workers have lacked the ability to organize and gain access to better working conditions, she said.

According to the website of the now-shuttered Lusty Lady, it was "the world's only unionized, worker-owned peep show co-op."

Ashley, a former legislative aide to gay San Francisco Supervisor David Campos, first worked with St. James as the agency's harm reduction coordinator after she met former Executive Director Naomi Akers. Ashley became the agency's new head late last year. Akers is now a board member.

Since St. James started, "the political landscape around sex worker rights has changed dramatically," said Ashley, with sex worker rights being recognized by groups like the Joint United Nations Programme on HIV/AIDS.

However, "San Francisco is jumping all over the place" on the issue of sex work, she said. Positive developments have included District Attorney George Gasc-n joining Police Chief Greg Suhr in 2013 in agreeing to no longer use condoms as evidence of prostitution.

But Ashley finds troublesome the targeting of sex workers' clients in San Francisco and other places in an effort to "end the demand for prostitution."

Among other problems, said Ashley, is that from what advocates have seen, it "tends to be the nonviolent, non-problematic clients" who are arrested.

Tickets for the St. James anniversary party, which will include DJs, go-go dancers, and porn stars, are $20 in advance and $25 at the door. VIP admission is $40 presale or $50 at the door. The June 5 party is from 9 p.m. to 3 a.m. at 540 Howard Street.

All funds raised through the event will go toward health and social services for current and former sex workers and their partners.

For more information visit www.stjamesinfirmary.org. For more on the party, see this week's BARtab