What St. James Infirmary does

St. James Infirmary was a San Francisco-based 501(c)(3) nonprofit founded in June 1999 by the sex worker organizations COYOTE and the Exotic Dancers Alliance, in partnership with Dr. Jeff Klausner of the San Francisco Department of Public Health. The organization was the first peer-based healthcare clinic run by and for sex workers in the United States, delivering free, non-judgmental medical, mental health, and social services to sex workers, transgender, non-binary, gender non-conforming, and intersex individuals, people who use drugs, and unhoused community members in the San Francisco Bay Area. Its service portfolio included a weekly drop-in clinic, street- and venue-based outreach, hormone therapy (STRIDE), HIV/STI testing, mental health counseling, harm reduction and syringe access, peer counseling, and trans-led housing programs (Our Trans Home Subsidy Program and the Taimon Booton Navigation Center).

Service delivery was direct-to-client through physical channels: a weekly clinic, street and venue outreach, sanctioned syringe access sites, and two peer-led housing programs, with a mobile unit (Naughty Nurse Mobile) extending clinical care to TGI communities and cis-gender women. The revenue model was nonprofit grant and donor funded, with no fees charged to participants; the annual operating budget reached over $1 million under Stephany Ashley's leadership. The organization derived intangible value from international policy engagement, including presentations and consultations with the World Health Organization, UNAIDS, the UN High Commission on HIV and The Law, and Human Rights Watch, and it served as fiscal sponsor to Compton's Transgender Cultural District beginning in 2019.

St. James Infirmary announced its closure in 2023 and officially ceased operations on December 29, 2023, after nearly 25 years of service. Stated causes included the March 2023 disbanding of its co-directorship model, resulting leadership and fiscal compliance issues, COVID-related service interruptions, inability to offer competitive salaries, and the migration of medical and HIV/STI testing clients to other providers (medical visits fell from over 300 in 2015 to 8 in 2022; HIV tests fell from over 1,000 in 2019 to under 50 in 2023). Remaining programs were transferred to Lyon-Martin Community Health Services, TGI Justice Project, and San Francisco Community Health Clinic.

Name

St. James Infirmary

Legal name

St. James Infirmary

Website

https://stjamesinfirmary.org

Company type

Private

Founded year

1999

Operating status

Closed

Headcount range

11–50 employees

Short description

St. James Infirmary was a San Francisco-based nonprofit founded in 1999 that provided free, peer-based healthcare, harm reduction, and housing services to sex workers, transgender, drug-using, and unhoused communities. The organization closed on December 29, 2023, after nearly 25 years of operation.

Ownership category

akta.pro rank

Product category

Community Healthcare Services

NAICS

Offices of Physicians (except Mental Health Specialists) (621111), Other Outpatient Care Centers (62149)

SIC

Services-Offices & Clinics Of Doctors Of Medicine (8011), Services-Social Services (8300), Services-Specialty Outpatient Facilities, Nec (8093)

akta.pro primary industry

Community-Based Preventive & Health Promotion Clinics (HLAFAGAO)

akta.pro secondary industries

Sexual Health & STI/HIV Prevention Health Departments (HLAJAAAL), Sexually Transmitted Infections (STI) (HLAKAGAI), Companion Care & Social Support (non-clinical) (HLADAGAB)

Keywords

• Community health clinic
• Harm reduction services
• HIV and STI testing
• Peer healthcare services
• Trans housing programs

Headquarters

HQ city

San Francisco

HQ country

United States

HQ region

North America

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Infrastructure, Supply Chain, Marketing or Sales, Others

Distribution channels5 records

Marketing channels4 records

Core offering

St. James Infirmary provided free, peer-based, non-judgmental healthcare and social services for sex workers and allied communities in San Francisco. Core services included weekly medical clinics (including HIV/STI testing and STRIDE hormone therapy), mental health counseling, harm reduction and syringe access, street- and venue-based outreach, peer-led trans housing programs, and community gatherings such as Mujeres TransLatinas en Acción.

Product overview

St. James Infirmary was a peer-based healthcare organization providing comprehensive services to sex workers, trans, drug user, and unhoused communities in San Francisco from 1999 to 2023. The organization operated multiple interconnected programs including the Outreach Program, Harm Reduction Program with Secondary Syringe Exchange, medical services with HIV/STI testing and STRIDE hormone therapy, mental health services, and trans-led housing programs (Our Trans Home Subsidy Program and Taimon Booton Navigation Center). The organization also hosted community programs like Mujeres TransLatinas en Acción and operated the Naughty Nurse Mobile. Upon closure on December 29, 2023, programs were transferred to partner organizations: Lyon-Martin Community Health Services took over the Outreach Program and Naughty Nurse Mobile; TGI Justice Project assumed the Our Trans Home Subsidy Program; and San Francisco Community Health Clinic oversees the Taimon Booton Navigation Center.

Differentiator

Problem solved

Functional benefit

Brands

• Naughty Nurse Mobile: Mobile healthcare service providing medical, gynecological, and mental health care services.
• Our Trans Home (OTH)
• Taimon Booton Navigation Center (TBNC)
• Mujeres TransLatinas en Acción

Products and services

• Outreach Program Peer-based street- and venue-based outreach providing safer working condition supplies, harm reduction materials, and resource connection for sex workers. Transferred to Lyon-Martin Community Health Services upon SJI's December 2023 closure.
• Harm Reduction Program San Francisco DPH-sanctioned syringe access and harm reduction services including overdose prevention education, Narcan distribution, safer sex supplies, hygiene kits, first aid supplies, food, clothing, and basic needs supplies. Conducted approximately 9,000 encounters annually on average. Dissolved December 29, 2023.
• Secondary Syringe Exchange (SSE)
• Medical Services Weekly drop-in clinic providing medical care, HIV/STI testing, STRIDE hormone therapy for trans participants, holistic services, food, and clothing for sex workers. Service usage declined from 300+ visits in 2015 to 8 visits in 2022; no longer operating as of December 2023 closure.
• STRIDE (Hormone Therapy) Hormone therapy program for trans participants provided during SJI's weekly clinics.
• Mental Health Services Mental health counseling and support groups funded under the Mental Health Services program, including holistic care services; concluded in November 2023 due to inability to offer competitive salaries.
• Naughty Nurse Mobile Mobile healthcare unit providing medical, gynecological, and mental health care services to trans, non-binary, gender non-conforming, intersex communities and cis-gender women. Operated by Lyon-Martin Community Health Services following SJI's December 2023 closure.
• Our Trans Home (OTH) Subsidy Program Trans-led housing subsidy program for transgender, non-binary, gender non-conforming, and intersex people. Transferred to TGI Justice Project upon SJI's December 2023 closure.
• Taimon Booton Navigation Center (TBNC) Peer-led housing program for trans/GNC and sex worker communities, SJI's largest housing initiative. Oversight transferred to San Francisco Community Health Clinic upon SJI's December 2023 closure.
• Mujeres TransLatinas en Acción Weekly gathering for Transgender Latinas, a well-attended community support and connection event organized by St. James Infirmary.

Quantifiable outcome

• Conducted approximately 9,000 encounters annually through Harm Reduction Program
• +2 more outcomes

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Partnerships

Eight partnerships are on record, tiered core, foundational, key and supporting.

• Lyon-Martin Community Health ServicescoreStrategic or Co-development Partner · 29 December 2023Lyon-Martin took over SJI's Outreach Program following closure. They have provided clinical care to trans, non-binary, gender non-conforming, and intersex (TGI) communities and cis-gender women for over 40 years. The program is led by Celestina Pearl. Founded by activists rooted in reproductive justice and self-determination, Lyon-Martin shares SJI's principles.
• TGI Justice Project (TGIJP)coreStrategic or Co-development Partner · 29 December 2023TGIJP took over the Our Trans Home (OTH) Subsidy Program following closure. They provide vital services to transgender, non-binary, gender non-conforming, and intersex communities. Janetta Johnson, Sharyn Grayson, and Stephany Ashley (SJI Board member) lead the transition. TGIJP found new homes for all Bobbie Jean Baker House residents.
• San Francisco Community Health Clinic (SFCHC)coreStrategic or Co-development Partner · 29 December 2023SFCHC is overseeing the Taimon Booton Navigation Center (TBNC), SJI's largest peer-led housing program for trans/GNC and sex worker communities. Founded in 1987 as Asian AIDS Project, SFCHC became a federally qualified health center (FQHC) providing comprehensive medical, mental health, education, and community services including Trans Thrive.
• COYOTE (Cast Off Their Yokes of Tyranny Everywhere)foundationalStrategic or Co-development PartnerSex worker organization that helped initiate St. James Infirmary in the mid-1990s. COYOTE members Carol Leigh (Scarlott Harlott) and others met with Dr. Jeff Klausner to develop the infirmary concept, bringing Priscilla Alexander's plan as a blueprint.
• Exotic Dancers Alliance (EDA)foundationalStrategic or Co-development PartnerCo-founded by Dawn Passar and Johanna Breyer, EDA partnered with COYOTE to help establish SJI. EDA founders had met Dr. Klausner after presenting at the San Francisco HIV Planning Council about substandard working conditions in adult entertainment theaters.
• San Francisco Department of Public HealthkeyStrategic or Co-development PartnerDr. Jeff Klausner, Director of STD Prevention & Control at SFDPH, partnered with COYOTE and EDA to establish SJI. Dr. Klausner provided first office space and CDC grant support. SFDPH later sanctioned SJI's syringe access program.
• Asian AIDS ProjectfoundationalStrategic or Co-development PartnerDawn Passar, who became SJI's first Outreach Coordinator, previously worked at the Asian AIDS Project. The organization later evolved into San Francisco Community Health Clinic, which took over SJI's housing programs upon closure.
• UCSF Medical SchoolsupportingOthersSJI provided training for medical students at UCSF, alongside training for community service providers and hundreds of sex workers themselves.

Scale indicators6 records

Recent moves7 records

Expansion highlights1 record

Broad incumbents

• Fenway Health: Boston-based LGBTQ+ health system providing primary care, behavioral health, and HIV/infectious disease services. Comparable as an established incumbent with overlapping clinical service lines and community health mission.
• Howard Brown Health: Large Chicago-based LGBTQ+ community health network operating multiple clinics with primary care, gender-affirming care, and HIV/STI services. Comparable as a broader incumbent offering overlapping clinical and harm-reduction services across the populations SJI served.
• Gay Men's Health Crisis (GMHC): Historic NYC HIV/AIDS service organization providing primary care, prevention, housing, and harm reduction. Comparable as a long-tenured incumbent in HIV/STI and sex-worker-adjacent health services with policy influence similar to SJI's WHO/UNAIDS engagements.

Direct peers

• Magnet at San Francisco AIDS Foundation: San Francisco sexual-health clinic and community center offering HIV/STI testing, PrEP, and trans-affirming care. Comparable because it delivers the sexual-health services that SJI clients increasingly migrated to, and competes for the same HIV-testing demand in the Bay Area.
• San Francisco Community Health Clinic (SFCHC): Federally qualified health center serving TGI, API, sex-worker, and unhoused communities in San Francisco. A direct comparable because it absorbed SJI's Taimon Booton Navigation Center and operates overlapping medical, mental-health, housing-navigation, and harm-reduction programming.
• Callen-Lorde Community Health Center: New York-based community health center dedicated to LGBTQ+ and TGI primary care, hormone therapy, and sexual-health services. Closely comparable peer-led clinical model serving sex workers, trans patients, and people who use drugs, with a similar mission profile.
• TGI Justice Project: San Francisco-based organization providing services, advocacy, and re-entry support to transgender, gender non-conforming, and intersex people impacted by incarceration. Took over SJI's Our Trans Home Subsidy Program and operates at the direct intersection of housing and TGI communities SJI served.
• Lyon-Martin Community Health Services: San Francisco community clinic providing primary care, mental-health, gynecological, and gender-affirming care to TGI communities and cis-gender women. Directly comparable because it assumed SJI's Outreach Program and Naughty Nurse Mobile at SJI's closure and serves overlapping patient populations through a peer-informed, trauma-informed model.
• APICHA Community Health Center: New York LGBTQ+ and immigrant-focused FQHC offering primary care, HIV/STI services, and gender-affirming care. Comparable as a peer community clinic serving overlapping TGI and sex-worker-affiliated populations via a mission-driven, culturally competent model.

Emerging players

• SWOP-USA (Sex Workers Outreach Project): National sex-worker advocacy and mutual-aid organization that complements clinical providers with peer support, harm reduction, and decriminalization advocacy. Comparable because it represents the activist/peer-led pillar that SJI integrated into clinical services.

Market position

Strengths2 records

Weaknesses4 records

Competitive moat3 records

Key risks6 records

Key highlights5 records

Customer concentration

• Xx.com/comebystjames
• Facebookfacebook.com/comebystjames
• Instagraminstagram.com/st.jamesinfirmary
• LinkedInlinkedin.com/company/st-james-infirmary

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

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M&A

Investments

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Frequently asked questions about St. James Infirmary