Notes from the Naughty Nurse Mobile 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