On World AIDS Day, San Francisco has much to be proud of, but much work still left to do

SAN FRANCISCO – Nations throughout the globe commemorated World AIDS Day on Thursday, marking simply over 40 years of struggles and triumphs surrounding the virus that has claimed over 40 million lives. In San Francisco, AIDS has taken the lives of over 21,196 individuals because it emerged within the early Eighties. 

Although San Franciscans have a lot to be glad about within the wake of latest preventions and coverings for HIV an infection, HIV continues to be a problem in San Francisco, in response to the San Francisco Division of Public Well being.   

As of 2021, there have been 15,631 San Francisco residents recognized and residing with HIV. Eleven % of Californians who’re residing with HIV reside in San Francisco, although lower than two % of individuals residing in america with HIV resided within the metropolis. 

“Whereas the brand new an infection fee is down 90 % from its zenith, we nonetheless have new infections,” mentioned SFDPH Director of HIV Well being Providers Invoice Blum. “Whereas for these with entry and sources to take care of common healthcare HIV has change into a power sickness that may be managed, there are nonetheless many with private and structural challenges that forestall them from getting and staying in care.”  

The much less steady an HIV optimistic particular person’s housing, for instance, the extra possible they’re to have an energetic virus that isn’t managed by medicine, Blum mentioned. There are additionally disparities in well being outcomes within the Black/African American neighborhood, although these disparities have “decreased considerably,” he mentioned.  

One other virus — COVID-19 — can also have had an impact on San Francisco’s HIV numbers. In 2021, 160 new diagnoses have been reported at a rise of 16 % from the earlier yr, in response to a report revealed by SFDPH in 2021. Nevertheless, researchers are unclear if the rise is because of extra individuals changing into contaminated or if diagnoses merely elevated on account of some individuals delaying testing throughout 2020 as a result of pandemic.  

For individuals experiencing homelessness, the report discovered that the proportion of latest diagnoses amongst individuals experiencing homelessness has elevated within the final decade, accounting for a excessive 24 % of diagnoses in San Francisco in 2021– that is one out of each 4 diagnoses. 

Researchers and medical professionals look to what they name “care indicators” after they look at total trends– measuring an individual’s linkage to care (whether or not they moved into medical care after analysis), their retention in care (are they sustaining their medical care?), and viral suppression therapies.  

In San Francisco, all three care indicators have been decrease in 2021 amongst Black/African People, individuals who inject medicine and other people experiencing homelessness.  

Blum mentioned he is hopeful that new therapies that might make it simpler for individuals with unstable housing or different challenges affecting their retention of care to handle their HIV and stay on a sustained therapy plan. The therapy is named “long-term injectables,” that are intramuscular shot drugs that final for 2 months.  

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“And there is hope on the horizon that this may go to each six months to a yr,” he mentioned.  

San Francisco was sadly on the forefront of the epidemic however has additionally been on the forefront of doing one thing about it.  

“San Francisco has been a pacesetter in responding to the AIDS Disaster and has garnered worldwide consideration and respect,” mentioned Blum. “Provided that we have been one of many early epicenters of the epidemic within the U.S. and as there may be world-class analysis and medical care in addition to a big community of service organizations, SF has developed maybe probably the most complete and inclusive system of HIV care which many different jurisdictions have sought to emulate.”  

In accordance with the SFDPH report, San Franciscans have an extremely excessive consciousness of their HIV status–97 percent– in comparison with California total at 88 % and the U.S. at 87 %. Use of pre-exposure prophylaxis can be very excessive in SF, at 75 %, in comparison with the state’s 26 % and the U.S.’s 25 %. Late-diagnosis of HIV can be decrease in SF than within the state and the nation, at 17 % in comparison with California’s 21 % and the nation’s 22 %.  

Nevertheless, persons are nonetheless dying of AIDS in San Francisco. The 2020 demise fee per 1,000 individuals with HIV was 17.5, greater than the state’s variety of 13.1 and about the identical because the nation’s 17 %.  

Nonetheless, there may be a lot to be glad about.  

“Individuals are residing with HIV and may lead comfortable, healthful lives,” mentioned Blum. “Should you get examined and discover out you’re optimistic and get handled, you possibly can stay near a really regular lifespan.”