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Prevention: Changing Focus in San Francisco

August 18, 2000

HIV infection in San Francisco is increasing among men who have sex with men, and there are now about 750-900 new infections per year in the city. At the same time, the number of new HIV infections in IV drug users who do not have sex with men has gone down substantially -- as has the number of heterosexual HIV transmissions (which are usually cases of a woman infected by a man who acquired the virus from IV drug use with a contaminated needle). San Francisco health director Mitchell Katz explained the new data to a hearing at the Board of Supervisors on August 9, and recommended an 11-point plan of action based on current knowledge. For example, he said that many gay men are not responding to the campaigns to use a condom every time -- and noted that if condoms were used whenever there is sex between an HIV-positive top and an HIV-negative bottom, HIV transmissions in San Francisco would be cut by 95%.

The IV and heterosexual transmission statistics are very different for San Francisco than for many other areas, due in substantial part to needle exchange. Dr. Katz noted that every two weeks, for years, the San Francisco Board of Supervisors has passed an emergency resolution which allows the local needle exchange program to continue without being shut down by the State of California.

In much of the country needle exchange is banned, and there is a major epidemic of HIV transmission to IV drug users, and to women who are their sexual partners, whether the women use needles or not.



ISSN # 1052-4207

Copyright 2000 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.


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