MIDYEAR S.F. STD/HIV REPORT: GONORRHEA DECLINES, HIV FLAT

I simply adore being the bearer of good news.

This week, amid the clamor of alarm and fear emanating from the Center for Disease Control and Prevention's biennial HIV prevention conference, the San Francisco Department of Public Health quietly released its June monthly sexually transmitted disease report and the good news in it has been completely ignored by the media and AIDS groups. [1]

The best development in the report is the low, stable rate for overall HIV infections, especially for recent/new infections.

53 positive test results were reported at the midyear point in 2002, and 55 HIV positive results were recorded during the first six months of 2003. Sure, that's a slight increase, but, essentially this category is stable

For recent positives, using the STARHS, Serologic Testing Algorithm for Recent HIV Seroconversions, method, 21 results were documented for the first six months of 2002, and 21 results were reported for the first half of this year. Same number for the first six months, two years in row, is a level rate.

Number of HIV tests performed through the end of June 2002 was 1223, while there were 1273 tests through the end of June 2003.

The number of total gonorrhea diagnoses fell from 1127 cases in the first half of last year, while at the midyear point of 2003, the number was 835.

A key indicator of safe sex behavior among gay men, rectal gonorrhea cases, also declined. Total number through the end of June 2002: 161. For the first half of 2003, the number was 153 cases.

Both male oral gonorrhea and proctitis also dropped so far this year, compared to numbers from 2002, as did adult male shigellosis cases.

Syphilis cases rose from 291 during the first half of 2002, while so far for this year the number is 365.

So the number of new HIV infections in San Francisco is as flat as the state of Kansas and male gonorrhea continues to decline, particularly the male rectal rate, but these developments are not newsworthy and all HIV prevention groups remain silent about the drops.

And I have to wonder if the head of the San Francisco Department of Public Health, Dr. Mitch Katz, reads his own department's STD reports.

In the July 29 San Francisco Chronicle story about CDC claims of increasing HIV infections among gay men in 24 states, Katz stated: "We don't think new (HIV) infections are low, however. That's due to many things, including the increasing use of methamphetamines, Viagra and people recognizing that AIDS is no longer a death sentence." [2]

How Katz can say he doesn't believe new HIV infections are low, when the health department he runs reports flat new HIV infections, is beyond my comprehension.

As far as I am concerned, the new monthly STD report for America's AIDS model city, should be page one news and widely disseminated.

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

[If this link is broken, go to http://www.dph.sf.ca.us/Reports/HlthAssess.htm, then scroll down to the monthly STD reports.]

2. http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2003/07/29/MN272065.DTL

GAGGING FROM THE ENDOSCOPY, WAITING FOR BIOPSY RESULTS

I used to think my big, fat Greek mouth could handle anything, that is until today's endoscopy at the California Pacific Medical Center was performed.

For two-plus months my stomach has been experiencing weird, unexplained painful knots that my regular doctor couldn't figure out what was causing the trouble.

In June, I had stomach x-rays performed, which showed mild diverticulitis in the intestines. To alleviate some of the problem, I started a regimen of acupuncture treatments and Chinese herbs that greatly relieved some of the pain. However, this didn't cure the cramps so my doctor had me see a GI specialist who ordered up this morning's endoscopy.

Groggy from little sleep late night, and no food, I registered for the procedure. My mind flashed on to gay French director's Patrice Chereau's latest film, "His Brother," which is about a gay brother who helps his straight brother die after he's diagnosed with a platelet deficiency disease. Getting prepped for the procedure brought back images of the dying brother's grueling visits to a Paris hospital and the concerned nurses who tend to him.

Laying on the gurney, a nurse injected two painkillers into the IV hose in my right arm and I got high. Even under the influence of the drugs, the GI specialist still had difficulty getting the tube with the miniature camera down my throat. Gagging, I took a deep breath and the tube finally slid past my throat and down into my stomach.

When the painkillers wore off slightly, the GI specialist came to talk to me.

"We found some polyps that were removed and will be biopsied," he explained. "Avoid aspirin, Advil and Motrin until we get the results back."

Not the news I wanted to hear.

"What's causing the trouble? HIV? The meds for HIV, or something else entirely?" I asked.

"I don't know," he replied. "I'll call your doctor and talk to him. You should see him this week, and I want you back in my office in August."

He prescribed a new medicine to add to my already large daily cocktail.

Am I worried about this latest physical ailment and what the biopsies may reveal? Yes, and with good reason.

My t-cells haven't been above 100 in over a year. They fell down to two this spring. I named them Ringo and Paul and told them to multiply, which they did recently. I now have 73 t-cells, according to my latest blood tests. My viral load, which has been over 250,000 all year, is at 500,000.

All these numbers floated around my head as I waited for my boyfriend Mike to come pick me up and take me home. He embraced me in the waiting room, kissed my lips and asked how it went. His response to my gagging problem?

"You are the last man I'd expect to have trouble opening wide enough for that little tube," he said, and both of us laughed.

We took a cab home. What did I find waiting for me in the kitchen? A big bowl of fruit, fresh filtered water and a wedge of a marijuana-laced brownie, to help ease the stomach knots.

"Now, remember today is the last day for the Sarunas Bartas retrospective at the Pacific Film Archives in Berkeley, and after you take a nap, I want you to get on BART and go see the film tonight," Mike said. "It would do you good to catch a Lithuanian film at the PFA."

He went off to work and I thanked God for blessing my life with Mike as my partner, of eight years and counting, and for making sure a Sarunas Bartas film is playing tonight. Small stuff in the grand scheme of things, but despite the low t-cells, a viral load that won't decline, continuing intestinal troubles, I'm grateful for the good people in my life and true happiness.

Let's hope the biopsies are benign. And that Ringo and Paul continue to clone themselves into new t-cells for me.

S.F. EXAMINER MISTAKES IN MIKE SALINAS OBIT


July 17, 2003

[This email sent to: jdineen@examiner.com, letters@examiner.com, newstips@examiner.com.]


Editor
San Francisco Examiner
San Francisco, CA

Dear Editor:

I am deeply saddened by the news that Mike Salinas, former editor for the Bay Area Reporter, has passed away in New York. I knew Salinas from when he was a reporter at the New York Native and viewed him as a fine writer, editor and, at times, a friend.

However, in your July 17 story about his death, several mistakes are made in regard to the death of gay sailor Allan Schindler that demand correcting.

You reported that Schindler was murdered in Yokosuka, Japan, which is not true. He was killed in Sasebo, Japan, which is where his ship was stationed.

Here is an excerpt from Karen Ocamb's March 1999 article in Genre magazine about Schindler's death and the larger controversy of gays in the military, that should clear up your confusion about where his death took place.

"Schindler's story, a kind of naval Matthew Shepard murder, bears recalling since his convicted killer is up for regular clemency reviews and the made-for-TV movie left out the hard work of gay activists such as Michael Petrelis. Schindler was a closeted sailor aboard USS Belleau Wood who was being harassed by homophobic shipmates. In late October 1992, he was found murdered in a public restroom near his base in Sasebo, Japan. His head and face were so bashed in his mother couldn't recognize him. Sailors Charles Vins and Terry Helvey were arrested. In early November 'the Navy cut a sweetheart deal with Vins. In exchange for testimony against Helvey, Vins was quietly sentenced to four months in jail,' Petrelis recalls.

"As Schindler's mother, Dorothy Hadjys, became suspicious of the Navy, Petrelis started asking questions. In December he held a news conference on the steps of the Pentagon to condemn Secretary of Defense Dick Cheney for covering up the gay aspects of the case. That led to media coverage. On the eve of Clinton's inauguration Petrelis organized a candlelight vigil for Schindler at the Sailor's Memorial in Washington, D.C., with other vigils held elsewhere.

"As the gays-in-the-military debate heated up in early March of 1993, the Pentagon leaked rumors that Schindler was in the restroom cruising for sex and that he and Helvey were jealous gay lovers. Fearing the cruising angle, many gay leaders refrained from speaking out. In late May, the trial finally concluded.

"'Helvey received life in military jail and tearfully apologized to Dorothy in court for killing her son. It was a wrenching thing to witness, and it still gives me goosebumps,' Petrelis recalls." [Source: http://www.davidclemens.com/gaymilitary/0399genre.htm ]

Also, you incorrectly claim that "Salinas sent a reporter to Japan to cover the story." I was the only gay American who traveled to Japan to investigate the death of Schindler, demand justice for him, and attend the court martial of his killer. My role in helping bring attention to the Schindler case was that of an activist, and one of the editors who paid attention to my concerns about the case was Salinas, who gave the story the coverage it deserved.

The Bay Area Reporter did not send a reporter to cover the trial, and anyone who knows the paper's owner, Bob Ross, knows he is tightwad who would never have footed the bill to send a reporter to Japan.

The loss of Salinas is tragic. He will be remembered by me and many others as decent, upstanding man who righted wrongs in his capacity as an editor and reporter.

I will miss him. May Salinas rest in peace.

Sincerely,
Michael Petrelis
2215-R Market Street, #413
San Francisco, CA 94114
Ph: 415-621-6267

-


San Francisco Examiner
17-JUL-03

Gay activist-journalist dies
By J.K. Dineen
Of The Examiner Staff
jdineen@examiner.com

Mike Salinas, a former hard-charging Bay Area Reporter writer and editor
who was a central player in many of the San Francisco gay community's
great controversies of the 1990s, died Tuesday in New York City. He was
46.

Police ruled the death an accidental heroin overdose, but a preliminary
coroner's report suggests he may have died of a heart attack, family
members said. His partner, Brian Carmichael, found him at 7:30 in the
morning at his apartment on East 28th Street, curled up on the floor
next to his bed.

For more than two decades, Salinas stirred things up on the vanguard of
the nation's gay politics. In the early 1980s he wrote for the New York
Native and the Village Voice and was first writer to do a major piece on
the radical group Act Up.

At the Bay Area Reporter, he was probably best known for a stark
front-page above-the-fold August 13, 1998, headline, which read, "No
Obits." The story explained that for the first time in 17 years, the
newspaper did not have a single AIDS-related obituary that week.

"It doesn't mean that there is no AIDS," Salinas told the Associated
Press at the time. "What it does mean is that people with AIDS are
living longer and that we're smarter about the human immune system."

"That was really powerful," said current editor Cynthia Laird. "I
remember waiting until our final deadline at 5 o'clock to make sure none
came in."

Ironically, it is Salinas' obituary that will run on the front page of
today's B.A.R., Laird said.

"Everyone has just been stunned here," said Laird on Wednesday evening.

Throughout his career, Salinas investigated AIDS organizations he
thought were corrupt and took on nonprofit executives he felt were
overpaid. As an editor, he directed his reporters to explore the
finances of the AIDS Ride and the AIDS Foundation, organizations he felt
we mismanaged and top-heavy.

"That is something that he really pushed for, mainly because he wanted
to money to go to client services," said Laird.

Salinas believed in a crusading brand of advocacy journalism. In the
early 1990s, he pushed aggressive coverage of the murder of Allen
Schindler, a gay sailor killed in Yokosuka, Japan. The case received
national attention because it coincided with debate over President
Clinton's "don't ask, don't tell" policy about gays in the military.
Salinas sent a reporter to Japan to cover the story.

Eight years ago, he wrote a story on sexual abuse in the church. The
headline was "Catholic Church Fails to Finger Fondlers."

"So many time Mike has stood up and taken unpopular stand and withstood
the heat and time would go by and he was right on the money," said
Carmichael.

His relationship with Carmichael, whom he lived with during his final
years, started out as professional one. Carmichael was one of several
prisoners with AIDS at the California Medical Facility in Vacaville who
went on a hunger strike in 1992 to protest the lack of medical services
there. The hunger strike lead to the first-ever hospice inside a state
prison and forced prisons across the nation to confront HIV/AIDS.

Carmichael credited Salinas with keeping the story in the public eye.

"When I got out of prison, I went to the B.A.R. in San Francisco because
it was the paper that kept the story moving," he said. "I wanted to
thank the editor on behalf of thousands of prisoners."

Salinas was born in Iowa and his parents broke up when his father
announced he was gay. Salinas lived in foster homes for a while before
moving to New York. His father, Rick Salinas, lives in San Francisco and
owns an art gallery in Hayes Valley.

Despite big-city aspirations and lifestyle, he remained proud of his
humble Iowa roots, wearing an Iowa Hawkeye jacket, chastising friends
for littering, and disdaining the affectations of the intellectual
circles he ran in.

"He was practically inseparable from that jacket," said Teddy
Witherington, the director of Pride and an old friend.

But Salinas was more than an activist-journalist. His other great love
was theater -- especially musicals -- and it was Broadway that lured him
back to New York in 1999, after seven years at the Reporter.

Erik Haagensen, a senior copy editor at Back Stage magazine in New York,
where Salinas worked in 1999 and 2000, said Salinas hoped to produce
musicals. During the 1980s, he had been a founding editor of Theater
Week magazine.

"Every theater queen, myself included, bought Theater Week every week to
read him," said Haagensen.

But regaining the prominence that he had enjoyed as a young man in New
York was not easy. He struggled with his writing and his job at the Back
Stage was short-lived.

"The return to New York was not all he had hoped it would be," said
Haagensen. "He felt he had not managed to re-establish himself in
theater journalism or gay journalism in ways he had previously
established himself."

Friend Jim Provenzano, who writes a sports column for the Bay Area
Reporter, said Salinas had recently admitted that he was experimenting
with heroin. Provenzano speculated that after 9/11 and a challenging
return to New York, Salinas was struggling.

"He was not as tough he people thought," he said. "You can make your
mark in New York, but as soon as you leave you are forgotten."

But others say his final days were in fact happy. He had recently been
editor of the 2003 Pride guide and was looking forward to editing again
next year.

"It's sometimes hard to remember, but we are the lucky ones," he wrote
in his Pride Guide editors letter.

GAY LEADER DONATES TO ANTI-GAY MARRIAGE POLITICIANS


[This email sent to: eb@hrc.org, david.smith@hrc.org, mark.shields@hrc.org.]


July 16, 2003

Elizabeth Birch
Human Rights Campaign
Washington, DC

Dear Ms. Birch:

One of the most important issues for your organization and the gay community is securing equal marriage rights for gays, lesbians, bisexuals and transgender individuals.

The Human Rights Campaign's survey of Democratic presidential hopefuls shows that two of the leading candidates, former Vermont Gov. Howard Dean and Sen. John Kerry of Massachusetts, oppose equal marriage rights for the gay community. [Source: http://www.hrc.org/campaigns/2004/candidates/quest_summary.pdf .]

So I was quite dismayed and shocked to learn that you have personally donated money to them.

According to Federal Election Commission records, on September 30, 2002, you donated $1,000 to Dean's presidential campaign, on April 25, 2002, you contributed $1,000 to Kerry's senatorial reelection bid. [Source: http://www.tray.com ]

When you write a check to presidential candidates who are against full access to the institution of marriage for our community, in my opinion, you send a message that it's acceptable to oppose our right to marry and still receive funds from the leader of America's largest political organization.

I ask that you request a refund from Dean and Kerry, to show them that until they come out and endorse equal marriage rights for our community, they won't receive any donations from you.

Anything less delivers a mixed message to candidates who aspire to the White House.

Please have Dean and Kerry immediately return your donation to their presidential and senatorial campaigns.

Regards,
Michael Petrelis
2215-R Market Street, #413
San Francisco, CA 94114
PH: 415-621-6267

CDC says IDU HIV rate "leveled;" Reuters says rate "rose"


A new HIV study from the Centers for Disease Control and Prevention was released on July 11, rife with findings about either declines or a leveling of new HIV infections detected among injection drug users (IDUs).

Published in the Morbidity and Mortality Weekly Report, the study’s “findings indicate that HIV diagnoses among IDUs have leveled in the majority of demographic groups during this period [1994—2000] in the 25 states for which HIV surveillance data are available.” [1]

The CDC study found that “IDU-related HIV diagnoses declined from 4,226 case in 1994 to 2,403 cases in 1999, and leveled to 2,514 …[in] 2000.”

In terms of raw numbers, that’s an increase of diagnoses, but, for epidemiologic purposes, the researchers deem the statistics to have leveled.

Broken down by gender, male IDU diagnoses “declined 44%, from 2,819 in 1994 to 1,568 in 1999, and leveled to 1,628 in 2000,” while the rate for female IDU diagnoses “declined 41% from 1,407 in 1994 to 835 in 199, and leveled to 886 in 2000.”

I found it fascinating that the researchers qualified marginal increases as a leveling, not a rise, per se.

The editorial note accompanying the MMWR article said the “finding of overall declines in new HIV infections among IDUs in the 25 states with HIV infection reporting is consistent with studies that suggest a decline in new HIV infections among IDUs in other areas of the United States.”

The CDC study provided a citation for this claim, and I located the abstract from another study from which the citation came.

The earlier study, published in the American Journal of Public Health, titled “HIV incidence among injection drug users in New York City, 1992-1997: evidence for a declining epidemic,” made the following conclusion.

“The recent incidence rate in New York City is quite low for a high-seroprevalence population of injection drug users. The very large HIV epidemic among injection drug users in New York City appears to have entered a ‘declining phase,’ characterized by low incidence and declining prevalence. The data suggest that very large high-seroprevalence HIV epidemics may be ‘reversed,’” it noted. [2]

Many reasons are likely responsible for the drop reported in the CDC study.

“Because the peak of infections occurred in the early 1990s, the decline during the late 1990s might reflect the natural decline in the epidemiologic curve following the peak in the epidemic, which often is observed after the onset of a disease in a population,” and might be one of the factors behind the decreases, stated the MMWR.

In other words, HIV transmissions hit a high among injection-drug users a decade ago. This is good news in my estimation.

What could be responsible for the slight numerical increases in 2000? The answer may lie at the end of the following sentence from the study.

“The leveling of IDU-related HIV diagnoses during 1999—2000 for the majority of demographic groups might represent a plateau in IDU-related HIV diagnoses or changes in testing behavior among IDUs.”

Translation: more IDUs may have sought out HIV testing services and taken an HIV antibody test.

Indeed, the MMWR states: “Although testing patterns can change the number and trends of new diagnoses, surveillance methods being developed by CDC will enable estimation of patterns in HIV-infection incidence.”

Even taking into account variations in testing patterns, this new CDC study and the declines or level rates contained therein cannot be dismissed, and, in my opinion, should be characterized as a positive development in containing HIV.

But despite the repeated use of the words declines, decreases and leveled, it did not stop the Reuters news wire from putting out a story about the study with this headline: “HIV diagnoses rise among intravenous drug users in US.” [3]

Reuters reporter Paul Simao wrote, “The number of new HIV diagnoses among intravenous drug users in the United States rose in 2000, halting five years of steady declines, according to a federal study released on Thursday.”

Not once in his story did Simao note how the CDC study defined the incremental increases of HIV rates for IDUs as leveling.

Simao’s Reuters story did note one of the CDC researchers “said the increases in diagnoses could have resulted from expanded AIDS [sic] testing or a change in risk behavior among intravenous drug users.” However, Reuters should have provided a larger context in its wire story about the overall leveling of HIV diagnoses in this population.

This new study comes one year after the CDC released another study on overall HIV diagnoses in 25 states, in which the authors reported similar good news.

“The number of persons in whom HIV infection without AIDS was the initial diagnosis declined 21% (from 15,945 in 1994 to 12,612 in 2000), and the number of persons in whom HIV infection with AIDS was the initial diagnosis declined 31% (from 5,760 in 1994 to 3,987 in 2000). However, during 1998--2000, the number of diagnosed cases of HIV infection with and without AIDS remained constant,” stated the July 12, 2002, article in the MMWR. [4]

Last year’s study also found that data “from national surveys and publicly funded counseling and testing sites indicate that testing rates have remained relatively unchanged during the late 1990s.”

This means that the number of initial HIV diagnoses declined, while the number of tests performed stayed constant, so the HIV rate didn’t drop because of a decrease in antibody tests administered.

Not only do we have two CDC studies documenting significant decreases or a leveling of new HIV diagnoses nationally, we also have the San Francisco Department of Public Health’s recent monthly sexually transmitted disease report showing declines of new HIV diagnoses. [5]

Too bad these developments aren’t widely reported in either the mainstream or gay press, but that lack of press coverage won’t deter me from sharing the good news about declining HIV diagnoses, if and when I find it.

Sources:

1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5227a2.htm
2. http://www.ajph.org/cgi/content/abstract/90/3/352
3. http://www.alertnet.org/thenews/newsdesk/N10174862.htm
4. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5127a3.htm
5. http://www.dph.sf.ca.us/Reports/STD/STDMONTH.pdf

MAY S.F. STD REPORT: HIV, GONORRHEA RATES FALL; SYPHILIS UP


Three years ago this week, San Francisco Department of Public Health HIV experts exclaimed with alarm to the New York Times that the AIDS plague was resurgent, not just here, but possibly in many other urban areas, and all the fears were based on slender increases in HIV antibody testing, especially the rates involving a new test to detect recent HIV transmissions.

On July 1, 2000, Lawrence K. Altman reported in a page one, above-the-fold story that 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 . . . [and that the] rise was detected by using a new test developed by the C.D.C. that allows health workers to distinguish between recent H.I.V. infections and those that were acquired months to years ago.”

Altman explained to readers that the new test “strategy involves testing the infected blood twice, using both a sensitive and less sensitive method . . . [and that the] test is becoming a powerful new tool for epidemiologists tracking the AIDS epidemic, health officials said.” [1]

Three years on, that “powerful new tool” shows incredibly low levels of recent HIV infections in America’s AIDS model city, and Altman and editors at the Times yawn. If Altman were to revisit the story he wrote in 2000, particularly his first sentence about the “sharp rise,” his opening this year might be, “A small but sharp drop in new infections with the virus that causes AIDS has been detected among gay men in San Francisco over the last two years.”

By the way, the test Altman refers to is known as STARHS, the Serologic Testing Algorithm for Recent HIV Seroconversions, and when the SF DPH monthly STD reports cite recent new HIV infections, the department is referring to this testing method.


CURRENT HIV STATS

The latest monthly sexually transmitted disease summary from the SF DPH, for May, reports essentially flat or slightly declining rates of new HIV infections.

Let’s start with what I consider to be the most noteworthy numbers, for the two categories of HIV tests performed.

Total number of regular HIV antibody positive test results at City Clinic at the end of May 2002 was 48, while for this year the figure thus far is 45. I consider this a minor decrease, while many statisticians would characterize it as stable. In any case, it’s good news.

The statistics for recent HIV positive infections, using the STARHS method, are even better. Last May there were 20 for the year; while so far this year the number has gone up to only 16. [2]

And bear in mind that these drops come at a time when the number of HIV tests performed is going up. Last year for this period, 1047 tests were administered, while so far for this year there have been 1072 performed.

Furthermore, if you want to look at the monthly HIV infection rates in a larger context, take a gander at this slide, http://hivinsite.ucsf.edu/InSite?page=md-rr-17-sl&ss=xsl/sl-doc&slide=7, which is from the SF DPH, and presented on a University of California at San Francisco web site.

You’ll see that at anonymous testing sites, for gay males, the incidence rate was at a high of 4.2% in 1999, and fell to 3.9% during 2000, the year San Francisco was allegedly going through sub-Saharan levels of new HIV transmissions.

So we have hints of declines of overall HIV tests results and recent HIV infections detected with STAHRS, in a city supposedly in the throes of sub-Saharan levels of new HIV transmissions, and what do health advocacy groups have to say? Literally nothing.

The SF DPH and HIV/AIDS organizations have a responsibility to analyze the monthly STD reports and offer reasons why there appears to be a small, but sustained decline underway, but no one in the AIDS industry in this town is speaking about the most recent summaries and what they may mean for controlling and preventing new infections.

The silence from SF DPH and AIDS groups is, I believe, an indication of how they don’t use epidemiologic reports and data in more honestly communicating with the public, and they should utilize such data with a wide audience concerns about sexually transmitted infections.

GONORRHEA

According to the latest STD report, the rates for gonorrhea are falling even more dramatically. Through May of last year, total number of all gonorrhea cases was 951. The number for the comparable period this year is only 701.

Male rectal and oral gonorrhea infections, along with male proctitis, until the end of May 2003, are all slumping, when stacked up against last year’s numbers through May.

All of the San Francisco gonorrhea declines come amid similar drops elsewhere across the country.

The latest national gonorrhea statistics from the Centers for Disease Control and Prevention reveal there were 164,409 cumulative cases at this point in time in 2003, and the number for the current year shows just 144,073 diagnoses. [3]

Let’s do a little math here on the San Francisco numbers. Adding up all the male cases of assorted gonorrhea infections so far this year, it comes to 328. That’s out of 701 total cases for the city.

The remaining infections, 623, were among females. More than half of all gonorrhea cases here are in the female population, yet no breakdown of gonorrhea cases among women is presented in the May STD report and such information has never been presented in the monthly summaries.

Which makes me wonder: Why does the SF DPH omit data on female gonorrhea infections broken down vaginally, orally and anally?

It boggles my mind that in politically correct San Francisco, the health department has for years gotten away with focusing only on the male cases of gonorrhea in monthly reports, even though women have been contracting the infection in far greater numbers than men. This must change, and the department should contain a table about female gonorrhea infections in monthly STD summaries.

The reason behind the omission may be that there’s simply more of emphasis on men, particularly gay men, in the monthly reports, because we keep the department in federal grants worth millions annually, and in the news with never-ending studies and stories on our sex lives and the STDs that afflict us. But I also can’t overlook how sexism could be the root reason why SF DPH simply fails to provide any hard numbers on female gonorrhea diagnoses.


SHIGELLA AND SYPHILIS

Remember the alarming stories about the outbreak of adult male shigellosis among gay men in San Francisco back in 2000? The rise in shigella cases was all over the news, as were SF DPH officials, sounding the alarm about this new health problem for gay men. There was also an article in the CDC’s Morbidity and Mortality Weekly Report in October 2001 about this problem. “During June--December 2000, 230 cases of culture-confirmed [shigella] infection were reported to the San Francisco Department of Public Health,” noted the MMWR. [4]

Number of adult male shigellosis diagnoses last year through May was 58. This year, so far, cases have plummeted to 40.

Might be too much trouble to congratulate the gay male community for containing and reducing shigella rates. Same goes for widely informing us of this healthy decline.

Need I add that there’s no data on female cases of shigella in the monthly summary? Even if there are zero such cases, I think the SF DPH has a responsibility to report zeros, if and when they exist.

Syphilis is surging, according to the newest raw numbers. By the conclusion of May 2002, 238 cases were reported. Through May of this year, it’s jumped to 313.

Yes, reported syphilis cases are up. However, I do wonder if the increase in cases has anything to do with the widespread upswing in number of syphilis tests performed on more populations. Unfortunately, the SF DPH does not release the number of syphilis tests performed, so we don’t know if increased testing has contributed to more infections being detected.


CONCLUSION

Accept, just for argument’s sake, that public health officials at the local and federal levels must and will sound an alarm over shigella outbreaks, syphilis increases and indications of an HIV surge, bringing about tremendous news media coverage.

But that shouldn’t preclude the health experts from publicizing drops in infections, explaining decreases and devising plans with the gay community to keep the rates going downward.

Superior and effective public health policies require an ongoing discussion of STD and HIV, preferably without so much alarm, and a full acknowledgment from health officials and private sector groups when the numbers show decreases or stabilization.

And the press, most particularly the New York Times, should be reporting on new STD and HIV data from San Francisco, now that certain numbers are down.


Sources:


1. http://www.nytimes.com/library/national/science/health/070100hth-sf-aids.html
2. http://www.dph.sf.ca.us/Reports/STD/STDMONTH.pdf
3. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5225md.htm
4. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5042a3.htm

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Donations, large and small, to support my work are gratefully accepted. Send checks to:
Michael Petrelis, 2215-R Market Street, #413, San Francisco, CA 94114.