Happy Folsom Month !

Notes from the Naughty Nurse Mobile 9/13/23

~ with SJI Founders and Directors

Dear Sex Workers,
We love you!

We love you, we are you, we support you, and we are so incredibly grateful for the opportunity to have served the sex worker, trans, drug user, and unhoused communities for almost a quarter of a century.

By now you may have heard that St. James Infirmary (SJI) will be closing over the next 6-9 months. Our housing, outreach, and syringe access programs are still in operation, and we hope to avoid any service disruption during the transition to new organizations. Unfortunately, there were circumstances beyond the control or knowledge of some of us. The co-directorship model initiated in 2020 was suddenly disbanded by the Board of Directors in March 2023 and SJI was faced with leadership and fiscal compliance issues. Our core programs struggled with various internal and external challenges, such as: COVID service interruptions and difficulties recovering programmatically as a result; lack of administrative support; inability to offer competitive salaries for key program positions; and changing needs among the community served. While our outreach and harm reduction programs are well-utilized, sex workers now have more options and go elsewhere for medical care and HIV/STI testing services. For example, in 2015 there were over 300 visits with SJI medical providers, and by 2022 there were only 8 visits for the entire year. Our HIV testing program together with the outreach program conducted over 1,000 tests in 2019, but less than 50 tests to date in 2023. Sadly, our critical mental health services concluded last month due to lack of competitive salaries. Our holistic care services and support groups were also funded under the mental health services program. In essence, we are no longer operating an “Infirmary” at this time.

It breaks our hearts to know that at this point there is nothing we or anyone else can do to “save“ the organization. We are now focused on ensuring our remaining programs and services continue with the support of community partners. Those of us who have been on the frontlines serving sex workers for decades are the blood, sweat, tears, heart, and spirit of St. James Infirmary, and will always be dedicated to the well-being of our communities as voiced by the communities.

St. James Infirmary, along with many passionate and dedicated allies, have accomplished so much towards fulfilling the needs and desires of our people for almost 25 years, including:

• street-based and venue-based sex worker outreach and supplies for safer working conditions
• weekly clinics for sex workers including medical services, hormone therapy for trans participants (STRIDE), HIV/STI testing, holistic services, food, and clothing
• mental health services
• syringe access and harm reduction services
• peer counseling and social support
• innovative trans-led housing programs for trans/GNC and sex worker communities
• trainings for medical students at UCSF, community service providers, and hundreds of sex workers
• frequent parties, celebrations, street fairs, marches, conferences, and shared meals
• the first San Francisco Marcha de Lxs Putxs
• Mujeres TransLatinas en Acción: our well-attended weekly gathering for Transgender Latinas
• local and state-wide policy initiatives on behalf of sex worker and trans communities
• serving as special consultants to WHO, UNAIDS, UN High Commission on HIV and The Law, Human Rights Watch, and many other organizations around the globe
• publishing and presenting ground-breaking research on sex workers
• award-winning humanizing media campaign “Someone You Know Is A Sex Worker,” among others
• and much, much more

Again, we love you, we are you, we support you! We look forward to all the different ways we will continue to connect, fight and build community in new and better ways!

In continued solidarity,
St. James Infirmary Founders and Directors:
Carmen Alicea, RN, LVN, Founding Clinical Nurse
Cary Escovedo, former HIV Services Manager
Celestina Pearl, LVN, Sex Worker Outreach Director
Charles Cloniger, MS, FNP, Founding Clinical Director
Corrie Varga, LMFT, former Mental Health Services Director
Dawn Passar, MFA, Founding Outreach Coordinator
Dr. Jeffrey D. Klausner, MD, Big Daddy
Johanna Breyer, MSW, Founding Executive Director, former Board Member
Juba Kalamka, MFA, Community Healthcare Services Director
Naomi Akers, MPH, former Executive Director, former Board Member

Screen Shot 2023-01-27 at 11.42.59 AM

In 2022, the World Health Organization (WHO) published the Consolidated guidelines on HIV, viral hepatitis and STI prevention, diagnosis, treatment and care for key populations. They provide guidance for public health and rights-based responses to HIV, viral hepatitis, and sexually transmitted infections (STIs) for key populations. The guidelines can be used by sex worker and other key population-led organizations to advocate for rights and evidence-based HIV, STI, and hepatitis programs, and by managers, policymakers, donors, and others to inform rights and evidence-based HIV, STI, and hepatitis policies and programming.

This Smart Guide summarizes and discusses the guidelines’ key recommendations for sex workers in plain English. The Smart Guide can be used as a tool when advocating for rights-based services. It is available now in English and will soon be available in Spanish, French, Russian, Chinese and Arabic.


Rest In Power


Ivory Nicole Smith

Ivory was a Site Supervisor at Taimon Booton Navigation Center, a shelter for TGNC people and sex workers. She previously worked as a Program Associate at the Transgender District where she helped organize events to promote the visibility and brilliance of the Trans community. Born and raised in the Tenderloin in San Francisco, Ivory supported the unhoused and most vulnerable people in her city and built community strength both in her career and her day-to-day. Her smile and love for her community will continue to shine in our memories of her.


Carol Leigh
AKA Scarlot Harlot

The mother of the sex worker movement. She coined the term "sex worker" to build solidarity and to bring respect to the profession. She was a tireless activist and advocate, our community's archivist, and brilliant artist and writer. She co-led the Sex Worker Film and Art Festival that always brought sex workers near and far to our fabulous city. She loved her mom and loved her many mentees and unrepentant whores of our community. She brought warmth and light everywhere she went while maintaining a fierce fight for decriminalization of prostitution and advocacy for the most marginalized. Thank you Carol, for supporting St James Infirmary. Thank you for everything you did to further the cause for civil rights for sex workers.

Check out BAYSWAN for her archives and links to her writings and videos http://www.bayswan.org


Community Support Line for Sex Workers Seeks Volunteers

SWOP Behind Bars is seeking volunteers for their Community Support Line especially for people located on the West-coast.

If you are a sex worker in need of support check out the link for online chat functions or

call 1-877-776-2004 ext. 1

Amanda Priebe art for St. James_ Color_ with flowers _1_

artwork by Amanda Priebe



What We Believe

There are many factors which affect the working conditions and experiences for all Sex Workers including the political and economic climate, poverty and homelessness, stigmatization, violence, as well as the overwhelming intricacies of the legal, public and social systems. It is the philosophy of St. James Infirmary to build upon existing skills and strengths in order to allow individuals to determine their own goals.

  • We are fundamentally against the criminalizing of Sex Workers—regardless of our different perspectives on decriminalization or legalization, the collective view of the St. James Infirmary is that incarceration of our community further marginalizes and disenfranchised us, which creates barriers to capacity building, and exacerbates a public health crisis.
  • We believe in revolution through healthcare. We challenge the conventional healthcare model that divides patients and providers and fosters unhealthy power dynamics. Our peer-based model creates a safe, trusted, and honest environment in which to provide services, and empowers our community to define our own well-being.
  • We are founded on the principles of harm reduction—St. James Infirmary supports Sex Workers being treated with dignity and respect, in every aspect of their lives

Our Impact

  • We increase access to primary healthcare and social services for Sex Workers throughout the San Francisco Bay Area.
  • We formalize communication and collaboration among individuals and agencies who serve Sex Workers to better serve our community.
  • We promote peer-based public health initiatives on behalf of Sex Workers, which may be used as a model for improving occupational health and safety standards and developing comprehensive medical and social services for Sex Workers around the world.
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From Our Blog


Join the Hos of Harm Reduction at the SF AIDS Walk

By sjidirector | July 14, 2008

St. James is raising money for the clinic and the AIDS Walk. In 2007, 25,000 walkers raised a record-breaking $4.6 million to help the San Francisco AIDS Foundation and 42 other Bay Area organizations fight AIDS. This year, we have a wonderful team, the Hos of Harm Reduction, and we would love to have your […]

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Podcast Social Media Sex Worker Style

By sjidirector | June 6, 2008

In 2006, St. James Infirmary published a study stating that our participants who are working in exclusively independent venues have higher rates of HIV and sexually transmitted infections than those who are organized and working collectively (Cohan et al., 2006). Although increasing the number of people working collectively could decrease HIV/STI rates, organizing is an […]

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