Sunday, January 01, 2006

Up, Down, Stable?: S.F.'s New HIV/STD Stats Released

The penultimate 2005 monthly sexually transmitted disease report for San Francisco was released in the last week of December and it is worth calling attention to, especially the syphilis and HIV stats.

Data through November shows a 27% reduction in syphilis, compared with this time last year, 461 cases in 2005 and 630 for 2004.

Looking at the number of HIV antibody tests performed and positive reactions, 2004/3482/120 versus 2005/3014/140, it is essentially a stable rate we're seeing.

Also worth mentioning is that the 120 and 140 poz test result stats includes repeat testers. Once the state of California begins HIV names reporting, we'll have a better sense of the current and recent infection rates because repeat testers will be weeded out, among other benefits of names reporting.

The lack of names reporting over the years has allowed HIV and public health advocates to use the syphilis rate as a surrogate marker for rates of HIV infections. I have always found that argument suspect because syphilis is much easier to contract than HIV, so when alleged syphilis surges were being tracked by the experts, they also sounded the alarm about a possible corresponding increase in HIV. Who can forget the page one scary stories in the San Francisco Chronicle and New York Times?

Well, syphilis is a names reportable disease, has been for decades, and it is clearly and abundantly decreasing in San Francisco, which for all intents and purposes means the "gay syphilis rate" is continuing to drop, but no one from the public health community is speaking out either about the falling numbers or what the decline may mean related to HIV infections. No stories are hitting the papers about the new stats.

One last thing. Let's examine the latest male rectal gonorrhea stats, 2004/425 and 2005/372. Yes, that is a rise in numbers, but it may be due to the public health department dramatically increasing the number of tests administered as part of a wide surveillance plan.

You can read about that expanded gonorrhea testing program at this link, on page 73.

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