Jena Adams and Chris Jarvis

00:05 My name is Gina Adams. My age is 57 today's date is September is the Saturday, February 22nd 2024 in Fresno, California.

00:18 At my interview Partners Chris Jarvis and we've been friends for a long time and my name is Chris Jarvis. I'm 58 years old. Today is Saturday, February 22nd 2024 in Fresno, California. My interview partner is Jena Adams and we are close friends for many many years. So when did we meet because I always have trouble with that.

00:42 I know it was 25 years.

00:51 If not longer cuz it was when the express was still open and I right now I can't remember if I had already started working at the health department or if I was still working at Macy's First always bug me that I can't remember the moment we mad but anyway, we're here today to talk about you and we decided our Focus would be at your work in and with HIV AIDS because that's what you've been doing for 30 years. Now. How long is it been five years with the health department and I volunteered for at least three or four years before that with a local organization. So, I'm really curious what got under your skin about this issue this disease that got you involved.

01:44 I was living in Los Angeles in 82 when everything really started to hit the fan and I was going to school I was going to the Fashion Institute and that's when I first heard about grid gay-related immune deficiency and I have met some older gay men at a bar at The Detour and a friend because I have a lot of gay friends and prior to that. I had you know what the 70s was a very interesting time like 7 days because a lot of friends in high school were coming out and other junior senior year of high school where they coming out to you specifically or just out on January just out in general. Yeah, so I was already comfortable with the gay community by the time like I reach college and one of my one of the

02:44 Friends that I met in Los Angeles worked at a doctor's office and he was telling us what they were saying because they had a large clientele. Let me pause you for just a second cuz we've never talked about this. So what?

03:02 You know the 70s being this was before age. So we were kind of at a time where it was starting to get more acceptable to be gay. I mean there was more about it. So what what about you said? I'm okay with people being gay was there and was it a family that what it what what brought that about. I really don't know. I've actually been thinking about this as I prepared for this interview today. I just had friends that came out that's all you know, and I can tell you some funny stories that you know, we were in high school. I don't know how I got to stay out late this late, but we couldn't get into places because we were underage but we would drive over to the circle nightclub here in Fresno and we would sit on our cars and and we would wait for people to come out and find out where the after-hour parties were and

04:02 And if the security guard was wasn't at the door, I remember her name was Gwen and Gwen wasn't at the door. Then we could get in and nobody card here with me and so we would go in but but yeah, so that was when you were 16 17 years old 17 and then yes 17. That's when it started in 18 right after high school. I left Fresno and went to the Bay Area and went to the same fashion School in San Francisco. And of course more of the gay community. And ironically I ended up working at the at the Circle many many many many years and with the manager and we all are really really good friends. Anyway, sorry, I digress going anyway after a little over a year in the Bay Area.

05:02 I'm attending college. Then I went I moved to Los Angeles. And as I said earlier I met this group of older gay men and one of them worked in a doctor's office and was just informing us of there were a lot of men that were coming in that were sick and and a lot of them were hospitalized and were very ill and and so it didn't consume a lot of our conversation. But but I know that that's where it started. You know, that's when I first heard of it at the time you were studying fashion. Yes. I was my major was a fashion merchandising and it wasn't until 84. I moved back to Fresno in April of 84 and about a month later of a dear friend in Los Angeles was diagnosed with AIDS the first person you knew personally that was

06:02 Yes, and then about a month after that my cousin and and that's what changed every its. You know, when I when I heard about my friend in La I said, oh this is I think I'm going to this is going to be a problem. I think I'm going to know a lot of people because it. Sounds like you said it wasn't even called. Right? Right. And so again about a month after Toby's diagnosis. My my cousin Glenn was diagnosed and it was he was in Highland Hospital in Oakland and diagnosed with pneumocystis pneumonia and within a couple of weeks. He died two weeks. Well, yeah, I'm very sad they were they were dying very fast and he was in his twenties.

06:56 He had taken we were very close to take me to my prom. So yeah, I wasn't dating anyone at the time and I said, oh, you know what he is so handsome and he's a little bit older. And so I want all the women to go. Who the heck is that? So he drove to Fresno in a white Riviera. Yeah with white leather lowered Riviera and you were just in a white tux and I had a white dress on and it was 80. Yeah. So I mean I look at that photo now I'm laying in that was still 70s. So after he passed I came back home and said, okay, I need to get involved and that is a pretty dramatic shift from the fashion industry to

07:55 The health industry. Yeah, you can go about doing that.

08:00 I just came home and I've I found some to Valley AIDS team. And I I think I started going just to the group there was a family and friends support group O and I started with that and then from there became I went through their buddy program. And so I wish I was a buddy that really didn't last too long cuz that was really too devastating for me. I had two buddies and they died very quickly. And so I see I can't do the buddy system with the same time. I was I was hearing of more friends in my personal life. It was and a buddy system was going to their homes. And yeah, it was, you know, you were a buddy to the person who was sick as well as to be there for the caregiver.

09:00 And so for my the first person I was paired with I started out going to visit him and we went to lunch a couple of times. And the reason why we were paired was because he had lived in San Francisco worked in retail and you know, so we had that kind of connection and I'm and we went to lunch a couple of times but didn't his his health just declined rapidly after that and I could go over and walk into the room and say hi and he would know who I was and then I could he would fall asleep like within 5 minutes and then I would go back in a few minutes later and he didn't know who I was. And so I would spend most of my time visiting with his mother and you know, she was

10:00 Divergent word for the family is the second buddy was someone that I knew through a family member that there was a young man on African American.

10:14 That had been diagnosed in was with L. And I was a single child with a single mom. And so I had a connection I felt the connection there cuz I'm a single child that as a single parent and but I was just waiting for him to want a buddy and ask for a buddy. And when he finally did I was able to meet with him really sweet young man, and we made an appointment to get together the following week and I had I was at Fresno State that night. I remember I had an assignment that was due and and completed the assignment and I for some reason I I think I got a phone call from

11:03 From Central Valley AIDS team. I called and and they let me know that he had passed so I didn't even get a chance to see him a second time and that you know, that was so common in those days that you know, that's what we take for granted today is that there was no diagnosis of HIV. It was people were sick. They were symptomatic. They had an opportunistic infection or disease that was that they were diagnosed with and they were sick and

11:41 And you just dissed you heard someone was sick and then you know within a matter of weeks or months. They were gone. How did you move from that cuz you said that was pretty devastating the buddy system for you. How did you move to that to deciding you're going to take this on full time?

12:01 The same organization asked if I would like to be on their board and social values as a non-profit Fresno that was that was facilitating assistance for people with HIV and AIDS. And so I was on their board and and as a board member I met a couple of individuals from the public health department and one of them was Alan Gilmore who later became my supervisor and you're still good friends with her. Okay, and then what was your next step?

12:36 I started with the Fresno County Department of Health in 94-94. So that what was that 10 years between like 8494. Were you just doing Central Valley AIDS team? I was volunteering with Central Valley AIDS team and I was still like going back to school because from the fashion feels was an AA degree in fashion merchandising and that's actually what brought me back to Fresno was. I wanted to go back to school and and major in business. So I was I was in school. I was working at Macy's I was you. Just keeping busy and keeping my foot in the door with volunteering and you helping out at different events. And you know as I know if they came up but at the you know, these were also the years that

13:35 Every two to three months I was going to a memorial because someone was Donna. Yeah, and so this morning I put together a list of people that died and it just I felt so bad that there were their names. I just can't remember, you know, cuz there was just so many that we talked about this all the time we talked about the loss of I can't say a generation, but it's almost that bad. But we lost so many voices and a lot of these people more artistic and creative and they're just they were just gone so fast and I you know, there were the friends from Los Angeles that were a little bit older they were in there.

14:26 Thirties early forties at the time of their passing but there were friends from high school and I like my cousin that were you know in their twenties and by the time I attended my my 10-year reunions, I had already lost like five or six friends from high school. So they were dying very young to most of the people dying were very young. So what was your first position at the Department of Health HIV test I was testing in NR STD clinic and I worked at Fresno State and we ought we provided HIV testing one day a week at Fresno State Health Center and at Fresno City when when evening a week and I was at those two locations for about five years the first five years of the 2094 to 99 something like that. So at that time.

15:26 For at least I know it's before the medication came along right because remember act act didn't come on the scene until 1987. Right and the cocktail didn't come on the scene until about 95, right? Yeah ride is my husband died in 94 the end of 94 and the cocktails happened right after that. I remember there's a local Advocate. I remember seeing him at A Mother's Day run and in 94, and he looks so frail and I thought oh my God, he's so you know, we're not going to have him much longer and the next time I saw him. He had looked like he gained probably sixty pounds and he just was full of life and wasn't no hobbling around and it was because he had started the medication.

16:26 And he's still with us today. And that's what I didn't mean to say there were no medications before that. There was a ZTE but it was so I have that history, you know. Yeah. So so you were testing people at Fresno State? What did you get as a feeling from the kids there about the fear of testing in the fear of is it nice or had back then testing was what it was two weeks or something there two weeks to get test results. Yeah. So testing at Fresno State and Fresno City were very interesting.

17:03 It always amazed me when kids would come in like during finals week test results soon. Like how can you take that crap and you're going to a final right after this, you know, but what was interesting about those days is that it knocked out a lot of kids room remembered my name, but they knew me and so I could go out in the tower district and people would stop me and say hey are you going to be at the health department this Thursday or are you going to be at Fresno City on Wednesday night? Cuz it's been 6 months. And that was the great thing. Is that young people were

17:52 There was no Stigma. I mean, I'm sure that there was but but there were so many young people that just knew that this was the thing to do we had to do it and and they knew that I should get tested every six months and I'm so they didn't care if other people around them or like what what are you doing? And then and they're like, well don't you get tested every six months I get tested I go to the health department and you know, and so there was a I love that and unfortunately that has gone. I don't hear that anymore. You don't do your people getting tested now, they only get tested now when something comes up in their health if that scares them and they get tested or do they do they test after in Risky experiencer?

18:43 Because I am not testing like I did back in the store and I can't really answer that question accurately, but

18:57 It's just I mean I can tell you that our testing numbers have gone down dramatically over the years and that's and that concerns me well because so many fewer people are dying that it's not this is the fear isn't there that was there when we were growing up with it and the prevention message is has been lost. And so you don't hear when you ask a young person in their teens to early twenties about HIV always the answer is always

19:37 After the fact it's after I've tested positive in. Well, I can just take medication because medication is better and they know that there are combination pills and that how I can just take a pill is treatable. It's treatable and which is yes it is and that is great. But but what are you doing to prevent? And and that is that prevention messages lost and that and that is very concerning. So, what did where did you end up at the Fresno County Department of Public Health? Which what's your title now today is I supervised HIV and STD prevention program department for 20 years and how have you dealt with the

20:28 The drama over David over the years. I've course. Now, it's two completely different than it used to be but you know, I've talked to you from time to time about do you tell me this young kid came in and they tested positive and you know, we never share names or anything, but it's clear the having a young person test positive especially in this day and age is you know, just devastating it is and it

20:54 It continues to be the quickest growing population of New diagnosis is young people and and I continue to ask myself why I mean it seems like they're there is so much information out there. So I don't understand why this is this is happening. And I think that's kind of why I agreed to do this interview today because young people don't know the history and and if there's some way that my hearing of my history whether they hear this interview at some point or not, but you just understand where we came from that we keep this with this disease that we you know, it was knew there was no medication people were dying and today. Yes. We not only

21:54 Do we have better medication? So not only is it treatable but we can treat HIV as a chronic condition. But we also have medication to use as prevention right with you. And so prevention of HIV prevention today is not just use a condom. It includes prep for pre-exposure prophylaxis, but it's also on for the person who is hiv-positive is treatment as prevention and so for someone who is hiv-positive and who is taking their meds and is adhering to that regimen and is undetectable their chance of transmitting HIV through sex is extremely low to wear tweed today. We now use we now say undetectable equals untransmittable.

22:54 Medical so when we look at the HIV care Continuum in Fresno

23:03 And we save that if we can increase the number of people who know their HIV status and get them into care and increase the number of people who are taking their medication and suppressed viral load. We can reduce the number of new cases of HIV.

23:24 If we can increase the number of individuals who are negative to stay negative by increasing access to prep again, we can decrease your transmission which one breath is a whole other factor to deal with because of funding and insurance and cost but it's getting better. It's getting much much just in the last year. It's gotten a lot better there and there's some things on the horizon that are coming as well, but the one important

24:00 Doctor with prep is

24:04 More provider knowledge about prep and that is a challenge here in the Central Valley because as you know, what's my second husband died of AIDS and not the end of 94 and that was like we were talking about before the cocktails and I remember at that time knowledge was super scarce in Fresno that aids in general. I used to have to print stuff out and take it to his doctor and say have you heard about this and luckily he was very receptive to that. But even in this day and age is it just is it aids specifically or it just just like you bought that they don't know that crap. They don't know enough about I don't know enough about crap. Yeah, or they've never heard about it is that not just the doctor's but the people cuz we lived through the the height of the play. So the fact that still doctors in Fresno don't know enough and

25:04 And specifically you and I have talked about people who are get tested, but don't go into care. Don't go into counseling don't go in to follow up after they get tested. I mean, that's where the real hope comes from where you can get people into a program of some kind and we've had those programs cotton Fresno from time to time.

25:23 And

25:25 You know, there's I see some.

25:30 A glimmer of hope on the provider segment. I see more federally qualified Health Centers and just Community providers that show a growing interest in providing HIV care. So that is that's great, but that we're Rule and and so are and when you talk about LGBT issues and LGBT

26:07 Knowledge of you know by our providers there's

26:12 They need the education about the LGBT community so that they can relate to their clients because clients fear opening up about who they are. And so and if you have that disconnect in a medical situation, then you're not going to get either one's going to know there's not going to get the get the information update me to provide the best care. And so I think that's why people who are at risk for HIV transmission, they may have insurance but they will still seek testing at certain certain from certain providers like the health department or from a family Family Planning Clinic that is non judgemental, right? I still you know, we when I ran the community center for seven years. That was the number one question. Where can I find an lgbtq friendly doctor? I still get it on.

27:12 Facebook and social media where can I find a counselor? And I mean we are connected so we know a few people but do you think that a large part of that is still the conservative values in the in the Central Valley that the gay and HIV and all that stuff is still kind of off the table so to speak.

27:36 I think to a degree there that's still a problem. But at the same time I do know I've met some providers in the last five to six years that are there there, you know, they're there they want to help that they're very interested especially with HIV. And as we see a growing need for the STD epidemic in Fresno County and then Central Valley and the tire and West in various at-risk populations. Those providers are talking about their clientele and you know, just how can we assist their population but to talk to the patient the patient has the fear of opening up

28:36 And so but is it because they're really not open completely in their life and so they don't swim so they don't you know, so they're not really feeling completely empowered. Right? So if they're a twenty-two-year-old from Coalinga, well, maybe they're not going to access HIV testing services at a clinic in their Hometown because of fear that they may know someone that works in that clinic. Well, if if there's a student at Fresno State they can get tested their work.

29:18 But if if that test comes back positive while now where do they seek treatment back home? Is there is that even available risk being seen her doctor's office? I mean, there's all kinds of things involved that leads to an escalation of health issues because they're not pursuing Health the way they should because they're afraid I made an iced. I hear it every day to this day and I'm sure you do too. So around that time. It was so different mean the Fresno around HIV versus the cities versus HIV. What do you remember is the conversation here in Fresno and who would have HIV and who's not going to get HIV cuz a lot of people were just blocked on and I'm not going to get it. I'm not worried about it and other people were terrified.

30:14 Back in 94

30:22 Gosh, well, I mean I I was testing and I was I was really, you know, thank goodness. I had I had friends in the LGBT community that were owners of bars are worked at bars. So it allowed me to get into certain areas and say, you know, can we offer testing here in the condom Crusaders? I wasn't but I was friends with those folks and they were the ones I went to the local bars with me to give out free condoms. And we when I first started working at the health department, we use the back room at the express to offer HIV testing and yes, it took two weeks and we were doing blood draws a while and then

31:21 And people were drinking and partying cuz it was a bar and right and it's Friday night and but yeah, that would normally have access to the right and and yeah, it was horrible having to give a positive test result there on a Friday night. And yes, and it was it was horrible for the the individual and it was hard for us as you know as the counselors because you're leaving this situation and going home at 11:30 at night not going back to the office and being able to.

32:13 NFL talk to your supervisor or a co-worker and say, you know, I just gave this positive to this, you know gentleman and blah blah blah. No, I had to go home and on a Friday night and you know, there was no one to talk to so it was it was it was hard. It was hard and then technology changed and we were doing the swab is still that was 2 weeks and then by the time we were doing rapid testing we had the mobile unit. So we were still able to provide services at the Circle and the express but we didn't have to be inside the bar.

32:56 Question just kind of going off of what you just started having to go home and you don't sit with that. Can you talk a little bit about what you were feeling during those times? And what kept you engage with this work?

33:10 Yeah, but you know, sometimes it was it was just really challenging it was sad because you're going home. I'm reliving what happened in that session, you know, and sometimes people would just break down which is an experiment in which is expected and you need to be able to take me to take all the time that you need. But at the same time I'm thinking you don't want to take too much time because then your friends are going to be thinking why is he in there so long, you know and and so it was it was a you know, it's a stressful times where you just said I can't do this anymore.

33:58 No, I'll tell you but I will tell you the last 4 years of my career have been the toughest it had nothing to do with HIV and has has had to do with syphilis and the congenital syphilis epidemic and and the the stories of women who are pregnant homeless drug-addicted not in prenatal care, and we can't locate them in the end and that continues to this day.

34:40 Yes, it is sad, you know, yes, I can get emotional about a young person with HIV because that is forever. But when you have continuously

34:55 Throughout the year looking for women who are in that that this hardcore population of drug addiction and homelessness. It is horrible. It's been horrible. Yeah, and I know you've had lots of battles over the needle exchange program and stuff in Fresno that what's the status of that right now. Is that oh, that's a good look on your face. I like that.

35:21 Adjust on February 13th. We went to Kings County to visit the needle exchange program at the public health department. It was amazing to see what they're doing down there. And and so we are in talks with our Administration to see what kind of pilot project that we can develop for Fresno County. So cool. Cool. That's exciting. So going forward. What's how do you feel about where you're at? And cuz I know you're thinking about I mean, are you getting close to retiring hopefully?

36:10 Last Friday February 14th, we hosted it ending the epidemics Town Hall ending the epidemic of HIV hepatitis C and STDs. We need money in order to to do anyting on those topics. And are you finding like a lot of us and I know this isn't specifically lgbtq Q related these diseases, but I mean it's hard for the Central Valley to get money because a lot of the money goes to the cities and this town hall. This is actually part of a Statewide initiatives. And so they want they wanted to hear from the Central Valley and this is part of us. Like I said a Statewide initiative to getting more money for throughout the state so

37:02 What I would like to see is that additional funding come to the Central Valley so that we can increase the number of community-based organizations that are involved in assisting with the end of these epidemics and increasing awareness with providers as well as our community members because it's going to take all of us working together. What do you think the outcomes going to be do you think they're going to cure this HIV anyway?

37:36 I don't it's not going to happen before I retire I would I would like to see by the time I retire at least if you know if if we could have a 40 to 50% decrease in the number of new infections in a year. I would be really happy to go out like that but dares.

38:00 There are still issues when it comes to people of color accessing care and treatment that we have to address in order to get 200. Yes.

38:13 So anything else you want to tell me Gina Adams?

38:17 Know about this long journey, and I just tell you I respect you so much for doing what you've done for 20-plus years cuz as you know, I've been directly affected by and so many of our friends have and we just lost a very good friend Cynthia character who ran all about care and took care of a lot of people so it's going to be a huge loss when you don't do this anymore.

38:38 Thank you. Yeah, it'll be hard to not be in the field anymore. When I retire I will see what it will see what the next what the next chapter looks like. You deserve it. All right. I will thank you so much, and I appreciate you talking today. Thank you.