Bay Area Reporter - August 3, 2006
Cynthia Laird, c.laird@ebar.com

According to the Department of Public Health's Quarterly AIDS Surveillance Report, the number of reported AIDS cases for the first six months of the year stands at 205. Of those, only 43 AIDS cases were actually diagnosed this year, according to the report. There have been 93 deaths reported so far this year.

The number of people in San Francisco living with AIDS is 8,670, according to the report.

Ling Hsu, MPH, co-director of the HIV/AIDS Statistics and Epidemiology Section of the health department, told the Bay Area Reporter last week that the numbers are preliminary and likely to increase as more reports make their way to the department. AIDS cases are reported by hospitals, physicians, and clinics and there often is a significant reporting delay, Hsu said.

"These are very preliminary numbers for 2006," Hsu said.

Nevertheless, the trend is showing a decrease. For 2005, according to the report, there were 519 AIDS cases reported and of those, 372 were diagnosed in that year. In 2004, there were 560 AIDS cases reported, 427 of which were diagnosed in that year. Figures for 2005 are still coming in, Hsu noted.

Officials at AIDS organizations and HIV prevention agencies reacted cautiously to the news.

"We're reluctant to make conclusions based on one report," said Robert McMullin, executive director of the Stop AIDS Project. "I think that given a choice between a quarterly report showing the numbers up and a quarterly report showing the numbers down, we prefer the down."

While McMullin added that he agreed with the health department that the significant reporting delay likely would affect future numbers, he did say that the downward trend is in keeping with "some of the things we've seen recently."

Among those factors are indications that crystal meth use among gay men in San Francisco is going down and the incidence of syphilis also is going down - two health issues often associated with HIV transmission.

Mark Cloutier, executive director of the San Francisco AIDS Foundation, also pointed to the downward trend, but was hesitant to read too much into the latest numbers.

"I think we need to see what happens when the health department has robust numbers," he said.

Gay city resident Michael Petrelis, who has been living with AIDS for many years, said on his Petrelis Files blog (www.mpetrelis.blogspot.com/) that he views the lower number of AIDS cases and diagnoses as good news. He attributed the decrease to several factors, including decreased viral loads, serosorting (when men have sex with men of the same serostatus), and safer sex behaviors.

"The recent and sustained decrease in AIDS diagnoses and new HIV infections, in my opinion, can only be viewed as positive developments in the fight against AIDS, an opinion at odds with a few people who work for 'AIDS Inc.' and sit on the [HIV Prevention] Planning Council," he wrote.

In fact, Petrelis's blog links to the HPPC minutes of July 13, where HIV consensus data was discussed at the meeting. "Some members expressed concern that as numbers go down, we lose funding accordingly," the minutes state.

But Jeff Sheehy, with the University of California, San Francisco's Center for AIDS Prevention Studies and who is Mayor Gavin Newsom's AIDS policy adviser, told the B.A.R. that he found the number of AIDS cases that were diagnosed this year about on course, given the city's estimate of around 976 new HIV cases per year.

"In general - not to cover every case - but in general every time an HIV case progresses to AIDS it represents a failure of the system," Sheehy said. "They don't have adequate access to healthcare or are not being treated. People who are HIV-positive and have healthcare shouldn't progress."

McMullin, who is openly gay and HIV-positive, also mentioned the importance of access to healthcare. The Board of Supervisors last month approved a Health Access Plan that is supposed to provide access for those city residents who are uninsured. It is scheduled to go into effect next July.

Sheehy, who is openly gay and HIV-positive, said that a small percentage of people infected with HIV are "rapid progressors" and develop AIDS sooner than others. But for most people, the new drug regimens keep viral load low or undetectable and keep opportunistic infections from developing. A person is defined as having AIDS if they develop one of several AIDS-defining conditions or if there T-cell count falls below 200.

"Most people should be put on therapy and not progress to AIDS," Sheehy said.

He added that access to healthcare and adequate housing are two key factors in keeping someone with HIV from developing full-blown AIDS.

"I always wonder if the number of AIDS cases is because of housing issues," he said.

Evictions can have a devastating impact on an HIV-positive person's ability to maintain daily compliance with their medications. And now, with the advent of the new once-a-day pill Atripla, compliance is even more important, he said.

Petrelis told the B.A.R. in an e-mail that health officials could help the community make sense of the new numbers by convening community meetings "about what the heck all this data adds up to, and how it decides programs and prevention messages."

060803
BR060801

Always watch for outdated information. This article first appeared in 2006. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2006. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .