Monday, November 22, 2004

The 2003 HIV/AIDS epidemiology report from the San Francisco Department of Public Health was recently released, showing a dramatic leveling of new HIV infections, and once and for all proving a July 1, 2000, front-page story in the New York Times about HIV rates here was wrong.

The executive summary of the new report states the "HIV/AIDS epidemic has taken another turn in San Francisco. Previously, we reported that HIV transmission was resurgent among men who have sex with men (MSM) in the late 1990s. Our conclusion was based on rising trends in sexual risk behavior, sexually transmitted diseases (STDs), and, in several studies, HIV incidence itself. We now detect a more complex pattern in the HIV epidemic.

"New data suggest HIV incidence has leveled off in the past few years. Application of the Serological Testing Algorithm for Recent HIV Seroconversion (STARHS) to specimens collected at the anonymous and the STD clinic testing sites finds that recent infection peaked in 1999. From 1999 to 2003, HIV incidence has stabilized."

Here's what the Times' chief medical correspondent, Lawrence K. Altman, reported back in 2000.

"A small but sharp rise in new infections with the virus that causes AIDS has been detected among gay men in San Francisco over the last three years, San Francisco health officials said yesterday . . . [and that the] rise is deeply troubling because it was seen in San Francisco, one of the principal centers of the AIDS epidemic that was first detected in 1981. Thus, the rise could signal a new wave of infections there and elsewhere, San Francisco health officials said."

To drive a scary point home, Altman noted that "Dr. Ronald O. Valdiserri, an AIDS expert at the federal Centers for Disease Control and Prevention in Atlanta, said his agency had not reviewed the San Francisco findings. But, if confirmed, the findings 'are very serious and important,' Dr. Valdiserri said in an interview."

But, if the findings are not confirmed four years later, will the Times do the journalistically honorable thing and revisit and update the story, reflecting new data?

One of the reasons why HIV has stabilized among gay men in San Francisco, according to the new report, is because the "widespread use of [anti-AIDS drug cocktails] may also dampen HIV incidence as lower viral loads translate into lower risk of transmission."

So the drugs many of us AIDS patients are taking not only help keep us alive, prevent opportunistic infections, boost T-cell counts, reduce HIV viral loads, but they also appear to play a significant role in stopping new HIV transmissions. This is good news that simply has not been reported in the Times, other mainstream media and the gay and AIDS press.

This new HIV data comes at a time when the San Francisco health department has been waging social marketing campaigns about supposed increases in other STDs for gay men.

First, the 2003 report says the "data on male gonococcal proctitis suggest some of the increase in reported male rectal gonorrhea may be due to increased screening." In other words, more tests for STDs is probably a strong factor in why there are more cases being detected.

Second, even with a climb in the STD infection rates, it is not equaling an increase in HIV infections.

In my opinion, it says much about what is wrong with the San Francisco Department of Public Health, HIV prevention groups here, and the press.

When flimsy evidence was produced in 2000 to herald an alleged skyrocketing of HIV infections, those entities seized upon the questionable evidence for more government funding and bogus, alarming news accounts.

Now, new research is released documenting a stable HIV transmission rate, and public health officials along with their counterparts in the private sector, remain silent, while reporters ignore the latest findings.

Do yourself a favor and read the 2003 HIV report for San Francisco. It's at You might also read check out Altman's July 1, 2000, article at

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