Having previously been held for 14 years in San Francisco, the National HIV/AIDS Update Conference comes to Miami for the second consecutive year this weekend. "San Francisco still has a high rate of AIDS," said conference Chair Dr. Mervyn Silverman, "but New York and Miami have the equally dubious distinction of being right up at the top now."

Florida cities like Miami, Fort Lauderdale and West Palm Beach are now topping San Francisco in new per capita AIDS cases, according to CDC. One reason is that well-educated gay men in San Francisco responded well to treatment and prevention programs. But in New York and Florida, and to a lesser extent across the United States, HIV has increasingly spread to black and immigrant communities, where the issues of poverty, cultural differences and language have hindered the fight against AIDS.

In the United States, new AIDS patients are relatively more likely to be men who have sex with men (MSM); in Florida, they are relatively more likely to be female, heterosexual and black -- especially among immigrants from Haiti and elsewhere in the Caribbean. In 2002, MSM comprised 46 percent of new US AIDS cases, but only 40 percent in Florida. New cases stemming from heterosexual sex were 11 percent in the United States for 2002, but 20 percent in Florida.

Major themes of this weekend's conference include:

• The status of the AIDS crisis in the United States. Saturday speakers include CDC Director Dr. Julie Gerberding; Dr. Paolo Teixeria, HIV/AIDS director at the World Health Organization; and Kathleen Cravero, deputy executive director of UNAIDS.
• The development of HIV/AIDS drugs and HIV vaccines.
• The global fight against AIDS. Harvard medical anthropologist Dr. Paul Farmer and others will discuss how political chaos in Haiti -- home to 90 percent of the Caribbean's AIDS cases -- has impacted HIV/AIDS treatment there.

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