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SFAF's Dr. Tyler TerMeer says he'll continue to fight for health care for all


<p>SFAF's Dr. Tyler TerMeer says he'll continue to fight for health care for all</p>
courtesy SFAF

As the first Black CEO of the San Francisco AIDS Foundation, TerMeer is focused on protecting the health and wellness of marginalized communities as we move forward under a new administration.


On the Monday following the 2024 presidential election, Dr. Tyler TerMeer, CEO of the San Francisco AIDS Foundation, was processing its effects. “I’ve got a case of the Mondays,” he said. It was a fleeting moment of levity before discussing weightier topics. Still, TerMeer’s resolve is unshaken, even in the face of the challenges ahead.

Vice President Kamala Harris’s loss to Donald Trump loomed large for those navigating the intersections of queerness, race, and other marginalized identities. The fear and uncertainty were palpable following election day.

“Honestly, 2016 was a shock to all of us,” TerMeer reflected. “But I don’t think we had yet experienced how the world would live and breathe under a Trump administration. Now we know exactly what we’re walking into. And there could be a million other horrific things we don’t even know about yet.”

As the first Black CEO of the San Francisco AIDS Foundation — and one of only a handful of leaders in the HIV and AIDS movement living with HIV — TerMeer understands the gravity of the moment. His leadership, while historic, isn’t about symbolism. It’s about action.

As the CEO of San Francisco AIDS Foundation, Tyler TerMeer believes in taking a people-first approach.courtesy SFAF

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Since taking the helm at the San Francisco AIDS Foundation nearly three years ago, TerMeer has prioritized rebuilding trust with communities that have long felt excluded or underserved by major HIV and AIDS organizations. This work has required a willingness to confront the organization’s history while charting a new path forward, he shared.

“I often transport myself back to the moment I was announced as the first person of color to lead the foundation,” he said. “It was a proud moment for me professionally, but as a Black queer person living with HIV, I didn’t fully feel through my body the impact it was going to have on the communities we serve.”

That impact became apparent during one of his first meetings with Black Brothers Esteem, a support group for Black men and trans people. TerMeer introduced himself, sharing his story and vision for the foundation, only to be met with silence. “It was my worst nightmare as a CEO — to be vulnerable and then greeted with crickets,” he admitted.

But then a Black woman in the room broke the quiet: “‘Baby,’ she said, ‘It’s not that we don’t know what to say. It’s that we’ve been waiting 40 years for you to get here.’”

The moment, TerMeer said, was transformative. “It made me realize that my identity — my race — meant so much to people in the Bay Area who had been waiting for the foundation’s leadership to better reflect the communities it serves.”

The foundation has made significant strides in reducing new HIV diagnoses in San Francisco, with fewer than 140 new cases in 2023, a stark contrast to the city’s status as one of the hardest-hit areas during the early years of the epidemic. However, as TerMeer pointed out, disparities persist.

“When you look at the data, the largest disparities continue to exist in the same communities they always have — communities of color, cisgender women of color, and Latino men,” TerMeer said. “We need to figure out how to best reach these communities in ways that feel safe and affirming.”

Dr. TerMeer doesn't let being a high-profile leader in the community stop him from expressing himself through fashion.courtesy SFAF

One of the foundation’s flagship programs under TerMeer’s leadership is the Black Health Access Point initiative, which reimagines HIV care by embedding it into broader community health services. “It’s not just about putting ‘HIV services’ on the door,” TerMeer explained. “It’s about creating spaces where people feel comfortable coming in for what they need, whether it’s food access or general wellness, and then integrating health screenings and access to PrEP as part of that experience.”

The initiative also reflects a shift in how the foundation sees its role. “We don’t have to be the ones to implement every service,” TerMeer said. “Our name doesn’t have to be on everything. We can focus on training, capacity-building, and funding smaller organizations that have long-standing trust in their communities.”

The work is as much about addressing systemic inequities as it is about building sustainable infrastructure. “We’re not just funding programs; we’re investing in the long-term viability of these organizations,” TerMeer said. “That means helping them build capacity, training staff, and making sure they have what they need to thrive for years to come.”

The foundation has addressed barriers to HIV prevention, such as the slow uptake of PrEP among communities of color, TerMeer said. While biomedical advancements like injectable PrEP hold promise, stigma, lack of provider engagement, and systemic inequities continue to hinder access. “There are providers who still have a hard time even discussing sexual health with their patients, let alone talking about PrEP,” TerMeer noted. “This is especially true in rural areas where stigma and lack of training remain significant barriers.”

The foundation has developed programs to train and empower local health workers to combat these challenges, including a clinical assistant program that trains community members as health screeners and educators. Participants can also enroll in phlebotomy training, creating a pathway to careers in health care while directly reinvesting in their communities.

“We’re not just investing in public health strategies for today,” TerMeer said. “We’re building long-term sustainability by ensuring these organizations have the infrastructure and skills to serve their communities for years to come.”

Trump’s reelection has reignited fear and uncertainty in LGBTQ+ communities. Among them is Trump’s nomination of Robert F. Kennedy Jr., a vaccine and science denier, as secretary of Health and Human Services. Kennedy has falsely suggested that AIDS was caused in part by “heavy recreational drug use in gay men and drug addicts.” Scientific research has definitively established that AIDS is caused by human immunodeficiency virus, or HIV.

“As queer people, as people who sit at the center of so many identities, the weight of this moment is heavy,” he said of the challenges that lie ahead. “We have to figure out how we unite and fight to protect our entire community.”

He expressed particular concern for transgender Americans and communities of color, who he said will likely bear the brunt of new policy attacks. “We know that we have a history of turning on one another, of not lifting up all of the communities that need the dignity and safety to thrive,” he said. “The election results mean increased barriers for those of us living with HIV, higher risks for the whole queer community, and especially for trans folks, who will be at the forefront of so many policy implications from day one.”

Still, TerMeer remains hopeful. “The genesis of anti-Blackness, transphobia, all these attacks — it’s coming from the same place,” he said. “One community alone isn’t going to win this fight. We have to break down the silos that have separated our movements and work together to protect the dignity and rights of all our people.”

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