Wednesday, September 24, 2008

(The broken line, on the downward slope, represents the HIV poz rate for all patients at SF City Clinic. [Page 114.])

SF DPH: HIV Down 33%,
Gay Gonorrhea -12%, Syphilis -16%

Maintaining their customary silence about the latest annual STD report showing remarkable and continuing significant declines of HIV infections and other diseases, the San Francisco Department of Health last week released the 2007 report without any fanfare or attempt to garner gay community or mainstream media attention.

Let's go over the important stats from the STD control and prevention unit of DPH.

The report notes that the HIV seropositivity rate at City Clinic, the municipal health facility where much HIV/STD testing is performed, experienced a 33.3% decline from 2006. This positivity rate is not the rate for the city, but it is a telling surrogate marker for HIV transmission. (Page 114.)

Total gonorrhea for the city fell 18.5%. Early syphilis dropped 16.3%, while primary and secondary syphilis fell 16.9%. Chlamydia infections fell 2.8%. (Page 6.)

Male rectal gonorrhea declined by 12.3%, another prime surrogate marker for determining San Francisco's HIV infection rate. However, male rectal chlamydia cases increased 15.1%. Here is the reason why:

Rectal and pharyngeal screening for gonorrhea and chlamydia for men who have sex with men began in 2003 and has expanded beyond the STD City Clinic to local providers serving MSM populations. As a result, increases in case detection may be a function of increased screening for this often asymptomatic infection. (Page 76.)

If the falling HIV, rectal gonorrhea and syphilis numbers are enough good news for you from the new report, here are more encouraging stats.

Non-gonococcal urethritis decreased 15.6%, while pelvic inflammatory disease fell by 7.0%. (Page 83.)

All these declines of HIV and STDs, in my opinion, are fantastic developments in the control and prevention of infections, and should be discussed at public forums held by the DPH. Sadly, DPH is resolutely silent about the new report and the declines. DPH has issued no press release about the report.

It strikes me as strange, to say to the least, that silence is the rule in San Francisco as sexually transmitted diseases continue to show decreases. Why can't the DPH herald the new report and praise sexually active gay men for acting responsibly to reduce and control new infections?

After years of closely observing the DPH and how it handles HIV/STD rates and new reports, I can honestly say the department is really only interesting in promoting the new stats when rates are climbing, even by the smallest margins.

But when annual reports document dramatic falling rates of HIV and STDs, the operative mode is to do nothing that calls attention to the declines, and we certainly never hear DPH offer any praise and positive reinforcement to gay man for bringing infection rates down.

I would think the DPH would welcome press and gay community attention for the new report. That the department would also explain how and why the rates fell, and town hall meetings would be held to disucss how to keep the stats going down. We might even get the DPH experts to say if the myriad social marketing ads were responsible for the drop, or other AIDS Inc-driven prevention programs, or community-created practices such as serosorting, played a role in the reduction.

In any case, the silence from DPH and AIDS Inc about the continuing decline of HIV and STDs is not healthy or beneficial to fighting AIDS.

1 comment:

Anonymous said...

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