Wednesday, July 23, 2008

SF DPH: New HIV Stats for 2007 Fall to 467 Cases,
44% Drop in Diagnoses

In keeping with unofficial Department of Public Health rules to remain silent about newly published HIV/AIDS/STD reports, especially when the number of new infections is dropping, the DPH published and web-posted the latest annual HIV/AIDS epi report this week, and HIV infections continue to dramatically drop, but DPH is doing nothing to call attention to the report.

Let's look at the just-released 2007 stats, as presented in Table 1.3 of the report, on page 17:

The number of persons newly diagnosed with HIV declined between 2003 and 2007. However, the lower numbers in recent may also reflect delays in reporting of persons newly diagnosed with HIV. Overall, the characteristics of persons newly diagnosed with HIV remained relatively stable with the majority of cases being male, white, aged 25-49 years, and MSM.

Characteristics of persons newly diagnosed with HIV between 2003 and 2007, San Francisco:






Granted, the plummeting number may be due to tardy lab reports submitted to DPH, but the falling figures may also be due to a genuine decrease in new infections and even taking into account the reporting delays, I'm not sure the 2007 stats are going to climb to anywhere near the 2003 numbers.

There has been a 44% drop in new annual infections over a five-year period, it should be discussed widely among sexually-adventuresome gay men, so we can keep the numbers going down.

In short, I believe the decline in new HIV diagnoses, and infections, began several years ago and continues. But the DPH, as we vividly saw when full-blown AIDS cases were dropping in the late 1990s, was loathe to come out and inform the gay community and the general public that AIDS diagnoses were going down, and the same mentality of "we can't tell the fags any good news about HIV in San Francisco" permeates how DPH disseminates and discusses emerging data.

Actually, regarding discussion by DPH on these matters, I should qualify that because there is no discussion taking place about the stats. Whether the issue is this annual HIV/AIDS report, or the quarterly AIDS surveillance reports, or the monthly STD stats, which include some HIV numbers, DPH does its damnedest to keep silent about the numbers. I believe this is because the experts just don't know how to talk about declining stats and they can't peddle their alarmist and crisis-driven rhetoric with falling stats.

If there is one thing the HIV and gay communities in San Francisco need, it is a frank public series of discussions with DPH epi experts about the new annual report and other data more than suggesting a sustained decline is here.

On the flip side, when very sketchy preliminary data shows alleged increases, SF DPH goes all out to generate attention and media coverage, as happened in June 2000, right before the start of that year's international AIDS conference in Durban, South Africa.

The SF Chronicle, in a front-page above-the-fold story, with the headline "S.F. HIV Rate Surges", played up those 2000 prelim numbers, and got the requisite alarmist quote from a DPH expert:

"We are very concerned, and we are very worried,'' said San Francisco Department of Public Health epidemiologist Dr. Willi McFarland. "These are sub-Saharan African levels of transmission.''

Then in November 2006, in an article published in Nature magazine, about the scaling down of HIV rates in African countries and India, that same San Francisco researcher gave an interesting quote about blowing up numbers:

"Many of us in the field have suspected that the standard methods of estimation have resulted in overestimates," says Willi McFarland, director of HIV/AIDS Statistics and Epidemiology for the San Francisco Department of Public Health.

That quote can easily apply to scary projections of HIV/AIDS/STD stats here. In any event, the latest HIV/AIDS epi report for America's AIDS model city should generate some media coverage and community debate.

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