Uptick in HIV Cases Worries SF Officials
After six years of steady decreases in new HIV cases in San Francisco, the end of that trend in 2012 is causing concern among local health officials.
The city registered 413 new HIV diagnoses in 2012, a slight increase from the 406 reported in 2011.
While that may not appear significant, it is a troubling sign that the city’s HIV prevention efforts may have reached a plateau. And it could prove problematic for reaching the city’s goal of reducing new HIV infections among gay and bisexual men, as well as transgender persons, by 50 percent in 2015.
"We cannot say new infections are going up," said Tracey Packer, the health department’s director of community health equity and promotion who oversees the city’s HIV prevention efforts. "We can say we think the trend is going down and it is not."
The city will have a clearer picture of where the trend in HIV cases is headed later this year when the 2013 data is released.
Based on the most recent HIV/AIDS surveillance report, released in June 2013, there is some evidence to suggest that new HIV diagnoses either remained stable or decreased last year.
The quarterly report indicated that during the first half of the year the city recorded 159 new HIV diagnoses. That was down from the 176 new cases recorded in the June 2012 quarterly surveillance report.
"I think it is a really good time to look closely at all the data we have in combination. I don’t think we have enough information yet to say it is not decreasing significantly," said Packer.
Nor do health officials know "what is causing the potential uptick," she added.
Presenting the most recent year-to-date figures to the city’s HIV Prevention Planning Council last week, Henry Fisher Raymond, an epidemiologist with the Department of Public Health’s Center for Public Health Research Branch, said the number of new HIV diagnoses in 2012 should have been below 400 for the data to indicate ongoing declines in HIV cases.
Instead, the uptick in cases "is really disconcerting," Raymond told the council, which prioritizes what HIV prevention strategies the city should be funding.
Raymond also pointed to an increase seen in the number of HIV cases among men who have sex with men between 2010 and 2011 as another troubling indicator. The city recorded 279 such cases in 2010 and 307 in 2011. In 2004 the number was 630 cases among gay and bisexual men.
"The overall trend from 2004 to 2011 is promisingly headed down. The question is whether the slight uptick from 2010 to 2011 is due to more infections or a result of more work being done to identify HIV cases through testing initiatives," Raymond told the Bay Area Reporter in an emailed response to questions following his presentation.
During the HPPC meeting Raymond was quick to emphasize that it remains unclear if "things are on the upswing again" or if the increased efforts to test people at risk of contracting HIV are behind the numbers.
"We are paying very much attention to if this is a welcome artifact of increased testing," he said.