Bay Area Reporter - April 20, 2001
David Fraser

In its quarterly AIDS surveillance report covering January-March 2001, DPH noted 81 deaths in the past three months, compared with 62 in the year-ago period, or a 30.6 percent increase.

But new cases reported totaled 162, a 25 percent drop from the 216 cases a year ago.

Dr. Sandra Schwarcz, the AIDS surveillance unit director at DPH who compiled the report, pointed out in a statement to the Bay Area Reporter that delays in reporting cases average one to two months.

Reporting delays for AIDS diagnoses and deaths can skew the picture. Schwarcz said that the quarterly report thus also presents data by dates of diagnosis or death.

Shift toward women

Broken out by gender, there were 50 cases of AIDS diagnosed in the first quarter of this year among men, or 89.3 percent of total cases, versus five cases among women (8.9 percent). One transgender person was diagnosed (1.8 percent).

In January-March 2000, the diagnosed case totals were men, 43 (87.8 percent) and women, six (12.2 percent).

Overall in 2000, there were 531 cases diagnosed, 464 among men (87.4 percent), 57 among women (10.7 percent), and 10 among transgenders (1.9 percent), the DPH report said.

Comparing the most recent complete annual figures, Schwarcz said researchers found that "although the number of new AIDS cases declined between 1999 and 2000, the proportion of cases diagnosed among women increased.

"The HIV epidemic hit women later than men and so we expect to see an increase in women diagnosed with AIDS relative to men.

"Also," Schwarcz added, "the proportion of women on HAART [highly active antiretroviral therapy] has been less than the proportion of men on HAART so there may also be some differences in progression from HIV to AIDS."

Ethnicity differences

DPH's breakdown of AIDS cases by race and ethnicity for this quarter compared with the year-ago quarter was: white, 32 versus 27 (57.1 versus 55.1 percent); African American, 16 versus 13 (28.6 versus 26.5 percent); Latino, four versus seven (7.1 versus 14.3 percent); Asian/Pacific Islander, three versus two (5.4 versus 4.1 percent); Native American, one versus zero (1.8 versus 0 percent).

In terms of racial and ethnic differences, Schwarcz said, "There has been a decline in the proportion of AIDS cases among whites and an increase in the proportion among non-whites. This is also probably a reflection both of the HIV epidemic, where the first cases were among white men, as well as access to care and use of HAART. Note that we find less HAART use among African Americans but all other race/ethnic groups are similar in HAART use to whites."

Cumulative cases

Cumulative reported AIDS cases in San Francisco for the past 20 years (July 1981 through March 2001) totaled 27,484. A year ago the figure was 26,823. Cumulative deaths went from 18,225 in 2000 to 18,605 so far this year.

The total number of people living with AIDS in San Francisco through last year was 8,879, the report noted.

Schwarcz said, "What is most important is to note that San Francisco AIDS cases accounted for 23 percent of cumulative California cases (120,802) and 4 percent of U.S. cases (753,907). That's substantial if you compare the population size of San Francisco relative to the state and the country. In terms of our trends in AIDS diagnoses and deaths, we see continued declines in both."

She added that San Francisco has a higher case fatality compared with California and the entire country. "However," she said, "this is most likely a reflection of more complete and timely reporting of deaths. In our survival analyses we find that survival continues to improve for persons with AIDS."

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