Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
San Francisco Chronicle - Sunday, July 27, 2003
Christopher Heredia, Chronicle Staff Writer
"This will give us the clearest picture yet of the magnitude of the U.S. HIV epidemic, the true incidence, telling us where it is occurring so we can improve the effectiveness of prevention programs," said Dr. Robert Janssen, director of HIV prevention at the Centers for Disease Control and Prevention.
In 1998, San Francisco health officials began using the blood test STARHS -- Serologic Testing Algorithm for Recent HIV Seroconversion -- that enables experts to pinpoint infections that occurred in the previous six months. Older HIV tests captured all infections, including those that occurred many years ago.
In the early years of the AIDS epidemic, the CDC and state health officials made estimates of where HIV was spreading based on the length of time between HIV infection and the onset of AIDS. With the advent of antiviral therapy, fewer people have developed full-blown AIDS, creating a significant gap in information about which groups are contracting HIV at the highest rates.
The CDC estimates that 40,000 people in the United States a year become infected with HIV.
"No one knows that for sure," said Dr. Tom Coates, director of the UCSF AIDS Research Institute. "San Francisco is the only place in the country that knows at any given time what percentage of the uninfected population is (contracting HIV) and how rapidly the infection is spreading."
Coates said the newer test results can also be helpful in determining a patient's treatment if the test is positive.
In San Francisco, the test has shown the highest rates of infection among gay and bisexual men, especially gay men of color, followed by the male-to- female transgender community.
"Using the test we've been able to determine those people who are at highest risk, and this is where we're spending most of our money in prevention, " said Mitch Katz, San Francisco's director of public health.
E-mail Christopher Heredia at cheredia@sfchronicle.com.
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