California: San Francisco Fails to Cut HIV in Gay Men by 50 Percent

New estimates indicate that San Francisco health officials fell well short of the goal they set five years ago for a 50 percent reduction by 2008 in new HIV infections among city men who have sex with men (MSM).

Officials now estimate San Francisco achieved a reduction in overall HIV rates of about 10 percent, allowing them to downgrade their assessment of the city's HIV situation from epidemic to endemic - meaning growth is expected to be flat.

The 2004 San Francisco HIV Prevention Plan estimated there were 1,082 new HIV infections annually, of which MSM accounted for 835. The revised figures estimate 975 new HIV infections each year, of which MSM account for 772 cases.

The city had also set a goal of eliminating HIV transmission among heterosexuals by 2008, but this population is expected to see 12 to 15 new infections this year.

There was better news to report for injecting drug users (IDUs), whose estimated number of HIV infections fell from 220 cases per year to 144, almost reaching the city's 50 percent goal. The prevention plan also called for eliminating mother-to-baby transmission by 2008. While the city expects two such transmissions, the actual number may in fact be zero.

The city also achieved the hoped-for 50 percent reduction in new HIV cases among male-to-female transgender persons: Estimated annual new cases among this population, excluding IDUs, dropped from 102 in 2004 to 42.

The city's HIV Prevention Planning Council is due to issue its revised HIV prevention plan in 2010. It is not known at present whether the plan will include the same goals set in the 2004 document. "For the 2010 plan, we need to determine how do we address an endemic situation and set goals to deal with an endemic situation," said Dr. Grant Colfax, San Francisco's HIV prevention director. "I am supportive of having goals to reduce HIV infections."

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