HIV rate jumps in San Francisco

Saturday, July 1st 2000, 12:00 am
By: News On 6

SAN FRANCISCO – Alarming health officials, the rate of new HIV infections among gay and bisexual men in San Francisco nearly tripled during the last two years.

Health experts said powerful AIDS drugs were making people complacent and the safe-sex message was no longer getting through.

"We think this needs to be a wake-up call for the rest of the nation," said Dr. Ronald Valdiserri, deputy director of the National Center for HIV, STD and TB Prevention at the Centers for Disease Control and Prevention.

In 1997, 1.3 percent of all gay and bisexual men who were anonymously tested at San Francisco clinics that year were diagnosed as HIV positive. That rose to 2.6 percent in 1998 and 3.7 percent last year, according to the San Francisco Department of Public Health. In 1996, it was 2.0 percent.

Powerful AIDS drug cocktails that can knock down the virus to almost undetectable levels and make AIDS a manageable disease went into wide use in the mid-1990s.

"I think there's a sense that the drugs have taken care of the problem," said Dr. Tom Coates, director of the AIDS Research Institute at the University of California at San Francisco. "Second, I think people believe the disease is slowing. I used to go to a memorial service every week. I've only been to two in the last year.

"And I think within the community itself there has been an erosion of the safe-sex norm. I think all of that has eroded the community's resolve for prevention."

San Francisco generally has been ground zero for trends in the AIDS epidemic, so experts worry that that they soon may start seeing the same phenomenon among gay and bisexual men elsewhere.

"Obviously we want to be careful about extrapolating what's happening in one city. But the CDC considers this an important and serious finding," Dr. Valdiserri said.

The figures come from a network of sites around San Francisco that provide free, anonymous HIV testing. They were released in advance of the International AIDS Conference, set for July 9-14 in Durban, South Africa.

Dr. Willi McFarland, an epidemiologist with San Francisco's Public Health Department, said the research involved only gay and bisexual men, and "we really haven't seen a change in other groups."

Researchers were tipped to a possible rise in infection rates when they started seeing a number of well-recognized warning signs, including a higher incidence of rectal gonorrhea and increases in high-risk sexual behavior with multiple partners.

For example, the proportion of gay men reporting that they always use a condom fell from 70 percent in 1994 to 54 percent last year.

Researchers went back to blood samples they have kept for the past four years to determine with much more accuracy the trend in infections. They used technology that can show from a blood test whether a person has been infected within the last 120 days.