AIDS Main Killer of Men in San Francisco

Despite the 1996 advent of highly active antiretroviral therapy, 2003 data from the San Francisco Department of Public Health show that AIDS remained the number-one cause of death for men ages 15-54 in the city. A DPH epidemiologist believes it is most likely also the leading cause of mortality among gay men ages 15-64. That assessment was shared by some AIDS advocates, who said nearly 90 percent of the city's AIDS cases are gay and bisexual men.

Ling Hsu, co-director of DPH's HIV/AIDS Statistics and Epidemiology section, said the numbers translate to 52 HIV/AIDS deaths per 100,000 male residents in the 15-54 age group. In the state and nationally, HIV/AIDS is about the sixth-ranking cause of death for males ages 15-54, said Hsu. The high HIV/AIDS prevalence among gay men in the city makes it "reasonable to assume that HIV/AIDS would be the #1 cause of death among gay men ages 15-64 ... ." But Hsu emphasized that while the city has an estimate of its gay population, it does not have mortality figures grouped by sexuality.

HIV/AIDS decreased as an underlying cause of death among those infected from 88 percent between 1992-1995 to 72 percent in 2000-2003, according to the DPH 2005 HIV/AIDS report. During 2000-2003, non-AIDS cancers (6.7 percent), and heart and liver disease (5.2 percent and 2.3 percent, respectively) increased as a proportion of causes of mortality among those with AIDS. Cumulatively, most AIDS deaths were in those ages 30-39. In recent years, however, most AIDS deaths occurred among those ages 40-49.

"I think people haven't made a newsworthy piece of it because people assumed it was true," said Steven Tierney, San Francisco AIDS Foundation's executive director. "I think people have a right to know that; it might have some impact in people's decision-making."

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