Tuesday, February 10, 2004

S.F. DPH: NEW HIV/AIDS/STD STATS EITHER STABLE OR DROPPING

The latest report on sexually transmitted diseases from the San Francisco Department of Public Health was released last week, and even though it shows either significant declines or stability for all infections, including HIV, the report has failed to generate any news coverage or mention from STD and HIV prevention groups on their web sites.

The following editorial note accompanies the data for 2003 from a staff member of the DPH’s STD control branch.

“While all statistics are provisional until the annual report is released for the year, preliminary data presented in the tables above suggest that gonorrhea and chlamydia were relative stable or declined in 2003 compared to 2002 among San Francisco residents.

“Overall, the number of gonorrhea cases declined about 15% between 2003 and 2002, and the number of [male] rectal and pharyngeal gonococcal infections was relatively stable. The number of reported chlamydial infections was also stable between 2002 and 2003.

“2003 did not see the continued rapid escalation of the syphilis epidemic. From figure 1, it is possible to see that there has been a relatively steady decline in the number of reported early syphilis cases (primary, secondary and early latent cases) since April 2003.

“Rather than syphilis cases doubling between 2002 and 2003, as was the case each year between 1999 and 2000, there was less than a 10% increase in the number of early syphilis cases in 2003. While it is good news that the epidemic has not continued to escalate, San Francisco will still be a metropolitan area with one of the highest syphilis rates in the country.”

Interestingly, the editorial note omits any reference to Table 2 of the report, which is for confidential HIV testing among clients at City Clinic, where nearly all of HIV testing for the city is done.

Table 2 shows 2,432 HIV antibody tests were performed in 2002, while in 2003 the number of tests was 2,776, an increase of 14%.

However, the actual number of HIV antibody positive test results remained remarkably stable. In 2002 the figure was 103, during 2003 it was 109.

Percentage-wise, the HIV positive rate for 2002 was 4.2%, while in 2003 it was 3.9%, which is a 0.3% reduction. Granted, a 0.3% drop is incredibly small, but nonetheless, given that San Francisco, according to DPH HIV researchers, is in the midst of sub-Saharan levels of HIV transmission, any drop in the HIV rate is a commendable development.

Why the editorial note ignores the HIV testing statistics and slight drop is unknown at this point.

Also, the number of recent HIV positive test results, using the STAHRS method, reveals 40 for 2002 and 41 for 2003. For the month of December 2002, there were 5 recent positives, and in December 2003 the number fell to zero. [1]

This new monthly STD report is not the only good news about HIV and AIDS in San Francisco.

In case you don’t believe that HIV infections have stabilized, allow me to share an excerpt from the minutes of the San Francisco HIV Prevention Planning Council’s January 8, 2004, meeting, at which an HIV surveillance expert from DPH presented a detailed update on the epidemic.

The DPH researcher stated the city has reached “[a] ‘Plateau’ phase (2001-07) in which new [HIV] infections are level or decline slightly. The rate is still higher than the ‘Nadir’ years [1989-95]. There are indications that some prevention efforts are effective.” [2]

There are also excellent advances regarding AIDS statistics. The quarterly AIDS surveillance report for 2003, published and released in early January, showed continuing declines of full-blown AIDS cases and deaths. [3] (See below)

The quarterly AIDS report also shows four transmission categories with zero new cases; lesbian or bisexual females, hemophiliacs, transfusion recipients and pediatrics.

Given all these fantastic drops of new STD and HIV infections, along with AIDS cases and deaths still plummeting, and with DPH HIV experts declaring San Francisco in the plateau years of the epidemic, it seems to me, as a longtime critic of HIV prevention programs, especially ones funded by the Centers for Disease Control and Prevention, that these programs would jump at the chance to use the data to claim their efforts are succeeding.

Yet, HIV organizations remain silent about all of this.

And not a single news story has appeared, but that could change, if the DPH and HIV nonprofits decided gay men should be informed of the new STD/HIV/AIDS rates and statistics.

I hope it happens before Valentine’s Day.



Sources:

1. http://www.dph.sf.ca.us/Reports/STD/STDMONTH.pdf

2. http://www.dph.sf.ca.us/HIVPrevPlan/Minutes/FullCouncil/2004FullM/minutes%200108.pdf , Page 3.


3. http://www.dph.sf.ca.us/PHP/RptsHIVAIDS/qrtrpt122003.pdf , Pages 2, 5 and 7.



# # #

Here are the most current annual AIDS caseload numbers for the city:


<1993
17,370

1993
2,361

1994
2,033

1995
1,760

1996
1,221

1997
927

1998
744

1999
636

2000
607

2001
549

2002
479

2003
293


For number of AIDS deaths per year, this is the breakdown:

1980
0

1981
9

1982
37

1983
136

1984
309

1985
602

1986
907

1987
981

1988
1,166

1989
1,441

1990
1,581

1991
1,734

1992
1,820

1993
1,791

1994
1,811

1995
1,683

1996
1,122

1997
465

1998
455

1999
410

2000
383

2001
239

2002
237

2003
189