Mayor London Breed Announces Another Year of Improvement in New HIV Diagnoses and Care Outcomes
San Francisco’s 2019 HIV Epidemiology Report includes promising trends, but more work is needed to support vulnerable populations that are still disproportionately affected. Health officials urge people to continue seeking HIV prevention and treatment services during the COVID-19 pandemic
San Francisco, CA — Mayor London N. Breed and Dr. Grant Colfax, Director of Health, today announced the results of the 2019 Annual HIV Epidemiology Report by the San Francisco Department of Public Health (DPH). The report shows another year of improvement in new HIV diagnoses and care outcomes and includes new data and analysis to further understand the disparities of some vulnerable populations disproportionately affected by higher HIV diagnosis rates and poorer health outcomes.
New HIV diagnoses in San Francisco declined to a record-low of 166 in 2019. The 19% decrease in new diagnoses since 2018 shows a positive trend towards achieving San Francisco’s goal of zero new HIV infections. This represents a 65% decline since 2012, compared with nearly level values nationally. Moreover, the City made significant headway with HIV care outcomes. Ninety five percent of new diagnoses were linked to care within one month, and 78% of new diagnoses were virally suppressed within six months after diagnosis. The recent declines in new diagnoses included declines among Black/African Americans, Latinx, people who inject drugs, and people experiencing homelessness.
“We are seeing encouraging trends on many fronts towards achieving San Francisco’s goal of zero new HIV infections, but we can’t let up on our efforts to address disparities and ensure people get the care and treatment they need,” said Mayor Breed. “San Francisco has always been and will continue to be the leader of HIV/AIDS care and prevention. The City’s health care experts and community partners are continuing their efforts to decrease disparities among populations and improve HIV care for everyone in our City.”
Despite the progress that San Francisco continues to make in reducing the number of new HIV diagnoses and improving care outcomes, disparities that were observed in previous years still exist. While the total number of new diagnoses and rates of diagnosis declined for Black/African Americans and Latinx people, the diagnosis rates for Black/African American and Latinx men and women were still higher than the rates for White and Asian and Pacific Islander men and women. Among people living with HIV, approximately 75% are virally suppressed, however viral suppression was lower for people experiencing homelessness (39%) and for people who inject drugs (66%).
The 2019 report features new data tables that display information about HIV diagnosis rates by poverty, income, and education level. The report reveals that HIV diagnosis rates were higher among persons living in census tracts that had high percentages of people below the federal poverty level, a higher percentage of people with less than a high school education, and lower median household incomes.
“San Francisco continues to make remarkable progress toward our goal of getting to zero new HIV infections,” said Supervisor Rafael Mandelman. “We should be proud of our Department of Public Health and our many incredible non-profit partners for their work to achieve this milestone. One new HIV diagnosis is still one too many and we must remain committed to addressing disparities in new infections and viral suppression among our most vulnerable communities.”
“While the 2019 numbers make our progress in eliminating new HIV diagnoses look promising, the ongoing disparities and gaps revealed by the data tells us much more work still needs to be done,” said Dr. Colfax. “We will do so by focusing on equity and by working together with our community partners, scientists, academics, providers and the City’s leaders. I am committed to combining our efforts to ensure that all San Francisco communities have access to HIV prevention and care that works for them and be the first city to Get to Zero.”
In 2014, San Francisco City agencies, researchers, providers, community-based organizations and activists came together in a collective impact initiative known as Getting to Zero. There are several efforts underway to address the disparities highlighted by race and ethnicity, age, gender, housing status, and risk group. In 2019, DPH received a grant from the Centers for Disease Control and Prevention (CDC) to develop a plan to achieve the goal of ending new HIV infections by 2030. In partnership with community-based organizations and existing initiatives, including the HIV Community Planning Council, the Getting to Zero Consortium, and End Hep C SF, DPH is developing the San Francisco Ending the HIV/HCV/STI Epidemics plan. The plan will address overlapping vulnerabilities, health disparities and inequities with all communities by integrating a person-centered, harm reduction-based, and low-barrier services approach. Under this collaborative effort, the plan will help San Francisco reach its goal of getting to and stay at zero new HIV infections, zero HIV-related deaths, and zero stigma.
In January 2019, Ward 86 at San Francisco General Hospital launched a new medical program that provides flexible, comprehensive and patient-centered care. The POP-UP (Positive-health Onsite Program for Unstably-housed Populations) program provides low-barrier care for patients who are not virally suppressed and require urgent care or other drop-in needs and has now provided services to about 100 patients with HIV and who are experiencing homelessness. DPH has funded community-based organizations to provide pre-exposure prophylaxis services to African Americans, Latinx, transgender persons, and youth.
“Getting to Zero is pleased, but not satisfied with the reduction in cases,” said Dr. Diane Havlir, co-chair of Getting to Zero. “We still had over 160 new HIV diagnosis and over 70 HIV-related deaths due to AIDS, which never should happen if persons are diagnosed and treated early. Innovative and multi-sector approaches are needed for HIV prevention and treatment that reach communities of color and youth.”
While the City focuses on further improving linkage and retention in care and enhanced patient outreach, health officials urge people to help make sure the City does not lose its momentum gained from the past few years by continuing to seek HIV prevention and treatment services. The COVID-19 pandemic in 2020 has added significant new challenges in managing the HIV epidemic due to reduced HIV testing and care utilization. DPH is working on guidance about how to conduct HIV and STI testing and services most safely for patients and providers. Meanwhile, as the City gradually reopens, HIV providers and services are dedicated to ensuring their adjusted protocols and procedures are in alignment with COVID-19 safety and prevention measures.
“It is more important now than ever to let people know they should still be seeking HIV prevention and care services,” said Dr. Susan Buchbinder, Director of Bridge HIV at the Department of Public Health. “These are essential services, and clinics and community-based organizations have built in safeguards to protect the health and well-being of clients and workers.”
The new 2019 HIV annual report can be found online here. The report will be presented to the San Francisco Health Commission on Tuesday, October 6 at 4:00pm.