Tuesday, July 01, 2003


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.


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.


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.


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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