New HIV cases are declining in San Francisco, except among Latinos

San Fransisco Chronicle
December 5, 2023
By Catherine Ho

Shocking new trend: Nearly 1 in 5 deaths of people living with HIV is due to a drug overdose.

New HIV cases in San Francisco declined about 5% in 2022 compared with 2021 — an encouraging trend that was somewhat dampened by a notable and worrisome rise in HIV among the city’s Latino population, particularly Latino men.

There were 157 new cases of HIV diagnosed in 2022, down from 166 in 2021, according to an annual HIV epidemiology report released by the San Francisco Department of Public Health on Tuesday morning.

This marks a continuation of the headway public health officials have made in lowering new HIV infections over the last decade — but also reflects a recent slowdown in the progress. Between 2013 and 2019, new cases declined 56%, but between 2019 and 2022 they fell just 12%, according to city data.

“We’ve continued to see a decline in new HIV infections, which is great, but the rate of decline has slowed the last few years,” said Dr. Susan Buchbinder, director of Bridge HIV, the HIV prevention research unit of the San Francisco Department of Public Health.

Buchbinder said the reasons behind the slowdown are not entirely clear. One partial explanation could be that while new HIV infections are falling in most racial and ethnic groups, they are increasing in the Latino community.

Even as new HIV infections have declined 12% overall since 2019, they rose 10% among Latino residents, the only racial and ethnic group that saw an increase during the period.

And for the first time, the rate of new HIV diagnoses is higher among Latino men than in any other racial and ethnic groups — 84 per 100,000 for Latino men, compared with 68 for Black men, 19 for white men, and 9 for Asian American and Pacific Islander men. This marks a change from the last several years, when the rate had been highest among Black men.

Buchbinder said health officials are looking into whether Latino men newly diagnosed with HIV are foreign-born or U.S.-born so they can better understand how to tailor their services for prevention of HIV and other sexually transmitted infections.

The number of deaths among people with HIV rose about 12% in 2022 to 312, compared with 279 in 2021. That marks a roughly 19% increase since 2019. Part of this is to be expected, since the population of people living with HIV is aging. About 73% of people living with HIV in San Francisco are 50 older, and about 40% are 60 and older.

People living with HIV are applauded during the annual World AIDS Day observance held at the National AIDS Memorial Grove in Golden Gate Park in San Francisco on Friday, Dec. 1.
Jessica Christian/The Chronicle

“We expect there may be age-related deaths, but we have some other concerns,” Buchbinder said.

One of them is the uptick in drug overdoses as the cause of death among people living with HIV. Between 2010 and 2013, drug overdoses accounted for 10% of deaths among people living with HIV. That has since jumped to 18%.

“That is really high,” Buchbinder said. “Nearly 1 in 5 deaths of people living with HIV is due to an overdose. I think this is a microcosm of a larger problem we have with overdose deaths in the city.”


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