San Francisco Records All-Time Low Hiv Infections, Deaths

[fskn]

I'm posting this one level above the PrEP subforum and the HIV risk reduction subforum, because it also implicates testing and (prompt) treatment, and highlights community-level initiatives. Please move if necessary.

From the July 7, 2015 San Francisco Examiner:

"New HIV infections and deaths of HIV-infected people in [san Francisco] dropped more than 17 percent from 2013 to 2014, according to the Department of Public Health. There were 302 new HIV diagnoses last year, and 177 deaths of HIV-infected people, according to the department. That's down from 371 and 209, respectively, the year before.

"Since the HIV/AIDS epidemic began in the 1980s, those numbers are the lowest ever recorded [...]

"The most telling statistic may be this: Since 2012, when the drug Truvada was approved by the U.S. Food and Drug Administration as an HIV/AIDS prevention drug, new infections have dropped by 30 percent [...]

"In addition to increasing awareness and access to PreP [sic] as a prevention tool, public health officials tout the wide availability of HIV/AIDS testing and rapid access to antiretroviral treatment via UC San Francisco as key to the significant drop in new infections."

www.sfexaminer.com/sf-records-all-time-low-in-hiv-infections-deaths

Here are some of the unique initiatives and conditions in San Francisco that help make this possible:

• Well-funded public health system, including clinics and hospital

• Shame-free City Clinic offering STI testing and treatment, rapid initiation of anti-retroviral therapy in newly-diagnosed HIV patients, and counselors to help PrEP patients tap their insurance plans and Gilead's assistance programs

• Pooled PCR RNA HIV viral load testing standard in public health facilities. Patients with risky exposures receive a test that tells them several weeks sooner whether they have HIV. Pooling (some blood from every patient is mixed, and only if this pool tests positive are the samples tested individually) reduces cost.

• Rapid HIV antibody tests standard in public health facilities, for routine (no recent risky exposure) testing. No risk that patients will fail to return for results.

• Immediate microscopy performed on urine and discharge samples, at City Clinic, when symptoms indicate an STI. No risk that patients will fail to return for antibiotics. (HIV transmission is more likely when other STIs are present.)

• Provision of antibiotic "partner packs" and instructions, consistent with Centers for Disease Control guidelines, when an STI is diagnosed. Reaches sex partners who might not have access to health care.

• Well-organized HIV care module and PrEP program from the largest private medical provider and insurer, Kaiser Permanente

Despite all these measures, almost every day someone still gets HIV, and almost every other day, someone still dies of it, in San Francisco.

If your local community lacks some of these measures, speak up!

[Bottomhole]

That's great to hear that things are improving, always wanted to visit San Fran. 

[tboyer]

I sort of thought SF would have a low HIV infection rate, I know guys who have gone to cumunion parties and not have been infected

Of course they may be genetically resistant or what is more likely is that so many guys are on treatment or prep that one is much less likely to become infected

[fillmyholeftl]

I sort of thought SF would have a low HIV infection rate, I know guys who have gone to cumunion parties and not have been infected

Of course they may be genetically resistant or what is more likely is that so many guys are on treatment or prep that one is much less likely to become infected

I tend to believe its the later... more undetectable or PReP guys in SF

[Bttm2go]

Shows you what good outreach can do.

[fskn]

I sort of thought SF would have a low HIV infection rate, I know guys who have gone to cumunion parties and not have been infected

Of course they may be genetically resistant or what is more likely is that so many guys are on treatment or prep that one is much less likely to become infected

The City does have high treatment and PrEP rates, but it also has a small population (about 800,000 people in the City proper), high HIV prevalence and a particularly active sex scene, mostly bareback (as it should be!).

Locally, the infection rate is considered high. It would be interesting to compare infection rates in other cities, and to assess whether the variations stem from different levels of sexual activity and barebacking, or different health initiatives.

Increases in infections among youths and people color are worrisome.

Shows you what good outreach can do.

As a top on PrEP, I like to help with outreach by inseminating bottoms. It's a serious responsibility. :-)