AEGiS-BAR: SF AIDS cases continue to decline... sort of

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

SF AIDS cases continue to decline... sort of

The Bay Area Reporter - July 23, 1999
Cynthia Laird

Midway through 1999, the rate of newly-diagnosed AIDS cases in San Francisco continues to be less than in previous years, according to a Department of Public Health (DPH) quarterly AIDS surveillance report covering January 1 to June 30. The number of reported AIDS cases among all transmission categories for those six months was 181, compared with 219 reported cases for the same period in 1998, and 287 for the same period in 1997.

Although the overall rate is down from last year, the numbers suggest many more cases were reported among gay and bisexual non-injection drug users (IDUs) in the second quarter of 1999, compared with the numbers reported in the first three months of this year. The new report lists 121 total new AIDS cases among that group from January to June; the last quarterly report, which covered January through March, listed 39 reported AIDS cases in that sub-set. If those figures are correct, the rate has jumped from 13 cases per month to more than 26 per month.

The June 1999 report identified 20 AIDS cases among gay or bisexual men IDUs since the beginning of the year, and 20 cases among non-gay IDUs. The figures are cumulative from the beginning of the year. That rate appears to be holding steady, and is in line with the last quarterly report, which listed nine reported cases among gay and bisexual IDUs and nine reported cases among non-gay IDUs.

So far this year, there have been 115 AIDS deaths reported. In June 1998, there were 134 reported deaths. The number of people currently living with AIDS in the city is reported at 8,284. The figures are incomplete due to delay in cases/deaths reporting, according to the report, but they do provide a snapshot of how AIDS is progressing in San Francisco.

DPH officials emphasized that the AIDS reporting figures do not include people living with HIV, which is not required to be reported. "We expect a substantial drop in AIDS, but we don't really think there's any substantial change in HIV cases," Sandy Schwarcz, surveillance unit chief with DPH, told the Bay Area Reporter. DPH estimates of seroconversion vary, but are generally reported at 500 cases annually, according to the HIV Consensus Report. DPH estimates some 15,000 San Franciscans are living with HIV.

"Basically, this is the same trend we've seen. AIDS cases here peaked in 1992," Schwarcz said, referring to the latest quarterly report.

Of the 181 reported AIDS cases so far this year, 100 of them, or 55.2 percent, are among whites; 35 cases, 19.3 percent, are among Latinos; 34 cases, 18.8 percent, are among African-Americans; 10 cases, 5.5 percent, are among Asian/Pacific Islanders; and two cases, 1.1 percent, are among Native Americans.

Over 90 percent of the 181 reported cases -- 164 -- are among men, compared with 17 reported cases, or 9.4 percent, among women, the report stated.

Schwarcz said health officials are not surprised by the recent data. Although she could not say precisely why the decline is occurring, she credited improved treatment as one factor. New medical treatments are allowing people to live longer with HIV before they're diagnosed with full-blown AIDS.

And, the lower reported AIDS cases does not mean HIV prevention efforts should be lessened; if anything, the opposite is true, and prevention efforts should be expanded. Schwarcz said the AIDS data should be interpreted cautiously.

Since July 1981 there have been 26,171 reported AIDS cases in San Francisco and 17,887 reported deaths. Statewide during the same period, there have been 112,930 reported cases and 69,791 reported deaths. Nationally, cumulative reported cases during the same period are 688,200, with reported deaths listed at 410,800.
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