San Francisco’s HIV Infection Rate Doubles
The rate of newly reported HIV cases among San Francisco's gay men has "more than doubled" since 1997 and is "climbing steeply," according to a "comprehensive analysis" by a panel of two dozen researchers and AIDS experts released yesterday. According to the draft report, the city's estimated infection rate is now at 2.2%, up from the 1997 rate of 1.04%. The San Francisco Chronicle calls the increase an "alarming reversal," as the city's HIV infection rate has remained stable in previous years due to "strong prevention programs" and a "safer-sex ethic among the gay population." Willi McFarland, an epidemiologist for the San Francisco Department of Public Health, explained, "We're now on the upswing of a rebound epidemic, although it's not nearly what we were seeing in the late 1970s and 1980s." The researchers estimated the most recent infection rate by incorporating new data on STDs contracted by HIV-positive men (an indicator of unsafe sex); HIV rates recorded at the city's anonymous testing sites; and an ongoing study of a group of San Francisco gay men. The Chronicle reports that all indicators point toward "a substantial increase in infection and risky sexual behavior." Researchers also took into account studies of "high-risk" HIV-negative men enrolled in AIDS vaccine trials and a study indicating that 9% of HIV-positive men report having "the highest-risk kind of anal sex" with an HIV-negative partner. According to the Chronicle, the first signs of the "new wave" of infections occurred this summer, when studies showed increases in unsafe sex and new HIV infections.
Several factors may have contributed to the increase in infections, the Chronicle reports. Antiviral drugs have extended the lives of people living with HIV, yielding more opportunity to pass the virus on to others. New drugs also have decreased the "gruesome" symptoms that were once associated with AIDS, thus there are "people out there who have never seen anyone waste away from HIV," James Columbo, a University of California-San Francisco counselor who works with newly infected HIV-positive men, said. "That played a really huge role in motivating people to stay HIV-negative," Columbo added. He noted that illegal drugs also may have contributed to the rise in infections. The draft report found that the rate of new infections among gay men who also inject drugs (4.6%) is more than twice as high as the rate among non-drug using gay men (2.2%).
Not Just a Local Issue
Mike Shriver, special adviser on HIV/AIDS to Mayor Willie Brown (D), said he was "profoundly, profoundly troubled" by the panel's findings. "It's unequivocal that these numbers, even in their preliminary form, are showing an alarming trend in this city, and it's a trend that has got to be turned around," Shriver said. He indicated that local prevention programs that once proved effective need a "radical overhaul." Federal officials also are alarmed by the data, as San Francisco has traditionally served as an HIV/AIDS "bellwether" for the rest of the country, the Chronicle reports. Robert Janssen, director of the division of HIV/AIDS prevention at the CDC, said that the news is "very concerning," and that federal officials will convene next month to "discuss how to respond to the new trends." Currently, more than 25% of San Francisco's gay men are HIV-positive, and about 80% of the city's HIV infections are among gay men (Torassa, San Francisco Chronicle, 1/24).