Petrelis Files

Five years ago around this time, AIDS experts in San Francisco, along with SF Chronicle and NY Times reporters, sounded a loud alarm about allegedly rising HIV and STD rates for gay men here.

About the only things that were supposed to be blowing on Castro Street were tumbleweeds and dust. We were at the dawn of gay San Francisco being wiped out, almost overnight, as infections climbed towards unseen heights.

Well, there's been a remarkable reversible of those dire predictions, and no one from the Department of Public Health is saying why this good news is happening or really congratulating sexually active gays for what appears to be a stunning flatness or decline of disease rates.

The director of STD control, according to recently web posted minutes from the May 3 S.F. Health Commission meeting, reported that "In general over the past five years gonorrhea rates have been level or have declined, most dramatically in young adults age 15-19. Importantly, these declines are most pronounced in high-risk groups, including African Americans."

I consider gonorrhea rates a better surrogate marker for HIV rates, which, as we all know thanks to Bay Area Reporter front page stories, are continuing to plateau.

Syphilis rates, which are on the upswing, in large part because of the massive numbers of tests for it performed by DPH, are not a good indicator of possible new gay HIV transmissions. And don't forget that syphilis is vastly easier to transmit and contract than HIV.

The STD director for DPH at the May 3 meeting also said, "San Francisco does a lot more testing than other areas, and this might be a factor in higher rates," in response to a question about testing rates influencing HIV/STD positivity rates. (Source: SF Health Commission)

If you want proof that another major American city is also seeing surging syphilis statistics, without a corresponding increase in HIV infections, look to Seattle, Washington.

The Emerald City's daily Post-Intelligencer reported on May 19 that Seattle's leading STD/HIV public health official, openly gay Dr. Robert Wood, said "There is no evidence to suggest that the rising rates of syphilis in the region are contributing to an increase in HIV infection rates as well." (Source: Seattle P-I )

The SF STD control and prevention head's contention that gonorrhea statistics are level or declining comes just two months after the DPH released its latest annual STD report, which was for 2003.

The report noted "Gonorrhea in San Francisco decreased by 15 percent from last year, and decreases were observed among both men and women.

"Male rectal gonorrhea cases were also stable between 2002 and 2003." (Source: Latest annual STD report for SF, page 4.)

But this plateau didn't generate a single story. Guess the DPH experts don't see much point in saying anything when STD infections are under control. You really can't generate more federal funding if you're succeeding at stabilizing diseases, so why call press attention to the success?

Since receptive male anal sex is one of the easiest ways to contract HIV, I consider male rectal gonorrhea figures indicative of potential new HIV infections, so having both the HIV infection rate and the level of male rectal gonorrhea flat, says the epidemic's wild fire has cooled.

Too bad our DPH is not holding any public meetings to discuss why this decline and flatness has occurred, much less how to keep the numbers either level or drive them down even further.