The annual report shows a slight decline in HIV infections in San Francisco, though disparities exist. The City continues to be a leader in linkage to care, pre-exposure prophylaxis (PrEP) uptake, and HIV status awareness.
December 05, 2023

San Francisco, CA – The San Francisco Department of Public Health (SFDPH) today released the 2022 HIV Epidemiology Annual Report that outlines San Francisco’s progress towards the City’s goal of “Getting to Zero” new HIV infections, while highlighting challenges faced by communities of color, as well as people experiencing homelessness.

The report shows the number of new HIV diagnoses was 157 in 2022, a slight decrease from 166 in 2021, and an overall 12% decrease since 2019. While this reduction is larger than the nation as a whole, it is not as rapid as the 56% decrease seen in the pre-pandemic years from 2013 to 2019. There continues to be no reported cases of children born with HIV in San Francisco, nor reported cases of people living with HIV under the age of 18. In addition, the population of people living with HIV is aging, with 73% aged 50 and over.  

The report also shows San Francisco has been successful in linking people to care. In 2022, 90% of persons were linked to care within one month of their HIV diagnosis, and on average, people newly diagnosed began treatment on the same day.

“We are pleased to see that HIV diagnosis have declined substantially since “Getting to Zero” was launched in 2013, and that many people are receiving the immediate care they need. However, we will not be satisfied until we get to zero new infections, and more must be done,” said Director of Health, Dr. Grant Colfax. “Breaking down barriers to provide stigma-free care that reaches the community is key, and working together across San Francisco’s robust HIV care and prevention infrastructure we will do just that.”

Community-Based Care to Address Disparities

In 2022, there were higher rates of new HIV infections in Latino men than Black men for the first time, and infection rates for both groups were substantially higher than in White or Asian/Pacific Islander men, respectively. In addition, people experiencing homelessness accounted for nearly one in five new HIV diagnoses, although this proportion has declined in the last two years. While only 52% of people experiencing homelessness who were living with HIV were virally suppressed in 2022, it marks a 32% increase from 2019. Furthermore, while HIV-related deaths continue to decline, 18% of deaths among people with HIV were from drug overdoses from 2018 to 2021.

Recognizing that these disparities must be eliminated, in July 2023 SFDPH collaborated with community partners to open Health Access Points (HAPs) that focus on priority populations, including Black/African Americans, Latinx persons, people who use drugs, and people experiencing homelessness. The goal of the HAPs is to provide equity-focused, stigma-free, and low barrier access to person-centered, comprehensive HIV services, including access to PrEP, as well as overdose prevention services.

Additionally, SFDPH manages a robust network of programs to help ensure that people experiencing homelessness get and remain connected with their care. These programs include LINCS (Linkage, Integration, Navigation and Comprehensive Services), Whole Person Integrated Care and Zuckerberg San Francisco General Hospital’s Ward 86 POP-UP clinic.

“We are excited to see the recent launch of the HAPs, which provide equitable access to HIV prevention, care and treatment services, as well as care for other sexually transmitted infections (STIs), Hepatitis C (HCV), and overdose prevention,” said Health Officer Dr. Susan Philip. “Providing comprehensive, whole-person care delivered by expert community service providers to those who have traditionally experienced barriers will help us address disparities and reduce new HIV diagnoses.”

PrEP Uptake and HIV Status Awareness

In another significant achievement following years of community engagement, an estimated 76% of people who are recommended to take PrEP, a highly effective HIV prevention method, were doing so in San Francisco, compared to the national rate of 30%.

At SFDPH’s San Francisco City Clinic, 72% of Latino men who have sex with men were on PrEP, which is also ahead of the national rate of 20%. PrEP uptake among African Americans at the clinic was 67%, substantially higher than national rate of 11%.

The report also estimates that 97% of people living with HIV in San Francisco know their status. Recognizing that not everyone can travel to a site to get tested, SFDPH partnered with community and health organizations to launch the “Take Me Home” program, which offers HIV and STI home test kits online and delivers them to San Francisco residents. This low-barrier, and confidential program was launched in 2020, and participation has grown, with 249 test kits ordered in 2021, and 621 test kits ordered in 2022.

“To get to zero new HIV infections, accessibility and engagement is key. We must be innovative in our approach to providing low-barrier, and judgement free services such as injectable PrEP and testing,” said Dr. Susan Buchbinder, co-chair of the Getting to Zero Steering Committee. “We also must follow-up to ensure that people on PrEP continue to have access to PrEP, removing barriers that can arise.”

For more information about the 2022 HIV Epidemiology Report, read the full version here.

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