According to a San Francisco Department of Public Health presentation at the January 9 meeting of the HIV Prevention Planning Council, 8,303 residents are living with AIDS and nearly 14 percent are homeless. "It is problematic that we have that many homeless people with AIDS," said Sandra Schwarcz, the city's director of HIV/AIDS statistics. Officials estimate between 8,000 and 9,000 San Franciscans are HIV-positive, but estimate only 6,000 people know their status. Since 1998, the city has seen a steady rise in HIV incidence among gay men, as well as the number of men reporting they have engaged in unprotected anal intercourse.

"The average age of seroconversions in gay men is mid-20s to mid-30s ... not younger gay men," said Schwarcz.

Syphilis also continues to be a problem among gay men, with 93 percent of the city's cases in 2002 attributed to men who have sex with men, according to Schwarcz. In 2002, the health department documented 300 syphilis cases in gay men, compared to less than 50 cases in 1996.

In 2001, the city continued to see higher rates of AIDS among African-American men and women than their white counterparts, with more than 1,300 African Americans living with AIDS. Less than 70 percent of HIV-positive blacks survive more than five years after being diagnosed, and only 61 percent use highly active antiretroviral therapy. "What accounts for it is care," said Schwarcz. "They don't have access to treatment."

City health officials attribute methamphetamine use to the increased incidence of HIV among gay men, yet their statistics currently only track injection drug users. Some see crack use implicated in the epidemic. "Crack is an important part of the equation," within the black community, HIV Prevention Planning Council member Hank Wilson, of the Tenderloin AIDS Resource Center, told officials.

Impending federal, state and local budget cuts make "our work here all the more challenging," said council member Mike Discepola of the AIDS Health Project's REACH Program.

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