Wednesday, October 05, 2011

DPH: 42% HIV Positivity Drop
from 2006 to 2010 at S.F. City Clinic

During the last week in September, the San Francisco Department of Public Health released the latest annual sexually transmitted disease report, for 2010, and some startling and good numbers were presented for HIV seropositivity at City Clinic.

That municipal health facility sees a tremendously high number of very sexually active individuals, an overwhelmingly majority of whom are gay and bisexual men, and its statistics are a key surrogate marker for STDs in the city. While the City Clinic's HIV figures are just one slice of the overall picture for HIV transmissions and infections, it's mighty large indicator of local rates especially among the most at-risk populations that receive services at the clinic.

Here are excerpts, bolding added, from the HIV testing and results stats presented on page 115 of the STD summary:

Overall HIV seropositivity (2010) = 1.9%

Change in HIV seropositivity from 2006 = 42.4% decline

Change in HIV seropositivity from 2009 = 5.0% decline

Total HIV tests performed (2010) = 4,545

Change in HIV test volume from 2006 = 46.4% increase

Change in HIV test volume from 2009 = 2.0% increase

That's some drop in number of poz results over a five-year period, and in and of itself is quite remarkable, and came about while the volume of tests performed was skyrocketing. More testing didn't equal more HIV detection. This is a key step forward in controlling the spread of HIV.

By the way, a lot of folks received HIV tests at City Clinic in the past five years. Here's the breakdown of years and number of patients tested, from page 116:
2006/3,104, 2007/5,292, 2008/5,404, 2009/4,456, 2010/5,545.

Also presented in the summary are citywide figures for male rectal gonorrhea and chlamydia, the former used to serve the surrogate marker in the for SF DPH, but that is no longer the case due to California finally creating a names-based surveillance system for HIV.

That is not to undervalue these infections and rates of high detection, but it is crucial to bear in mind SF DPH's explicit admission that greatly expanded testing services play a vital role in why these numbers are up. This data, bolding added, is excerpted from page 76:

Number of reported rectal chlamydia cases (2010) = 921

Change in chlamydia cases from 2009 = 22.5% increase

Number of reported rectal gonorrhea cases (2010) = 482

Change in rectal gonorrhea cases from 2009 = 6.5% increase

Rectal and pharyngeal screening for gonorrhea and chlamydia for men who have sex with men began in 2003 and has expanded beyond 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.

If you're the least bit interested in HIV in America's AIDS model city and a small look into gay male health, you should read the report.

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