Anna Bauman | September 10, 2019
Photo: Gabrielle Lurie/The Chronicle
The number of new HIV diagnoses in San Francisco has fallen to a record low, but the news was grimr for four groups with a growing number of new cases: Black and Latino residents, as well as the homeless and intravenous drug users.
The overall improvement comes five years after a consortium of city health officials, UCSF, and local nonprofits launched an aggressive "Getting to Zero" campaign aimed at eliminating new HIV cases by expanding testing for diagnosis , treatment, and care.
In the last decade, the number of new cases fell by more than 58%, to 197 in 2018, from 472 in 2009, according to the city's latest annual HIV epidemiology report. New cases also dropped 13%, from 227, between 2017 and 2018. The report noted that approximately [number missing]. Not all the news about HIV was so encouraging.
Between 2017 and 2018, new HIV cases increased among residents of Latino and Black cities. • New cases among Latino residents rose from 55 to 75, a 36% increase. • New cases among Black residents rose from 38 to 41, an 8% increase. The report does not explain why cases increased among these two ethnic groups. On Tuesday, Dr. Hyman Scott, a clinical professor at the UCSF AIDS Research Center who was among those announcing the findings, hinted at discrimination. “We need to focus on ensuring that the system in which people receive care is a positive place and that we address some of the structural problems, including racism, that many of our San Franciscans are experiencing in the health care system,” Scott said. Health officials found it easier to explain why new cases emerged among the homeless and drug users: because they don’t always take their medications regularly. Between 2015 and 2018, new cases among people experiencing homelessness increased from 29 to 40, a 38% increase. Between 2016 and 2018, new cases among intravenous drug users increased from 21 to 27, nearly a 29% increase. “These disparities highlight the work we have to do to continue getting to zero and really try to remove the barriers, the stigma, and the discrimination so we can truly put an end to new infections,” Breed said. She said the Department of Public Health will begin a competitive process this week to allocate $8 million to community-based organizations that assist groups with rising case numbers.
Dr. Monica Gandhi, medical director at San Francisco General Hospital, which treats HIV, said it is especially difficult for those experiencing homelessness to manage their medications, practice safe sex, maintain a healthy diet, and keep regular doctor appointments—all necessary for successfully treating and preventing HIV. “All of these barriers to taking your medication every day are multiplied a hundredfold if you don’t have a home,” Gandhi said. Ward 86 at SF General launched a program called POP-UP in January that treats people experiencing homelessness living with HIV by offering a less formal pathway to care. People experiencing homelessness can visit Ward 86 any afternoon, where two or three doctors or nurses will provide on-site care, including vaccinations, STD testing, pillboxes for medication storage, food, clothing, hygiene kits, and other medical treatment. No appointment is necessary. “It doesn’t make sense to have a Tuesday at 3 p.m. appointment when you’re living in a camp,” Gandhi said. The goal of the Getting to Zero campaign was to see no more than 30 new infections annually by 2020, but with nearly 200 this year, consortium members weren't sure if that could happen. "We'll try," said Dr. Diane Havlir, a co-founder of the consortium. Anna Bauman is a staff writer for the San Francisco Chronicle. Email: anna.bauman@sfchronicle.com Twitter: @abauman2