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San Francisco, Calif., Program Pushes Immediate HIV Treatment

December 18, 2013

This article was reported by SFGate.com (San Francisco).

SFGate reported that the San Francisco General Hospital (SFGH) launched an early intervention program that connected newly diagnosed people to HIV treatment on the day of diagnosis. The program's prime target was people with acute HIV infections -- high virus levels in the blood, "but almost no immune reaction from the body." With rapid treatment, HIV drugs could reduce the virus to undetectable levels quickly, benefitting the patient and preventing the spread of HIV to the patient's sexual partners.

Dr. Hiroyu Hatano explained that city health clinics and the hospital coordinated to implement the program. When a person received an HIV diagnosis at a city clinic, health workers determined whether the infection was acute and alerted Hatano or another HIV specialist. The patient went directly to SFGH's HIV clinic, where patients received counseling, and a social worker assisted them with paperwork to pay for HIV drugs. Doctors also observed the patients taking their first dose of HIV drugs and provided enough drugs to last until the patients secured insurance coverage or federal aid.

Hatano believed early intervention was essential to San Francisco's goal of eradicating HIV from the city. She hoped to expand the program to every newly diagnosed HIV patient by the end of 2014. In addition to the "treatment as prevention" strategy, the city had other advantages in addressing HIV/AIDS. The HIV-infected population was composed largely of gay men, which made highly targeted interventions possible. San Francisco also had a "large and active support network." In contrast, the population of HIV-infected people was much more diverse and hard to reach in communities such as Oakland, Calif., other cities, and other nations.

Public health officials estimated that only 7 percent of HIV-infected persons in San Francisco were unaware of their status. HIV diagnoses declined from 534 in 2007 to 413 in 2012.

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