Standing at the vanguard of HIV prevention and treatment efforts, San Francisco has seen numerous measures of its local epidemic improve dramatically since kick-starting a multifaceted campaign known as “Getting to Zero” in 2010, Healio reports.
Publishing their findings in Clinical Infectious Diseases, local researchers analyzed the San Francisco epidemic before and after the introduction of the Getting to Zero interventions, which have included: providing HIV treatment regardless of CD4 count (started in 2010); increasing HIV testing rates and better targeting those at high risk of the virus for testing (2011); finding those who have dropped out of medical care for HIV and reintegrating them into such care (2011); providing antiretroviral (ARV) treatment the day of an HIV diagnosis (2012); expanding access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) (2013).
The annual number of HIV diagnoses in San Francisco declined from 473 in 2009 to 329 in 2014. (Recently, the city reported that 2016 saw a record low of 223 diagnoses, along with troubling racial disparities within key measures of the epidemic.)
The rate of those linked to HIV-related medical care within three months of diagnosis rose from 85.8 percent in 2009 to 91.8 percent in 2014. During this period, the rate of those starting ARV treatment within one year of diagnosis rose from 63.2 percent to 90.7 percent. The rate of those who had a fully suppressed virus within one year of their HIV diagnosis increased from 49.2 percent to 82.3 percent. The proportion of those who were diagnosed with AIDS within three months of an HIV diagnosis (indicating that they likely tested very late in the course of their infection) decreased from 26.9 percent to 16.4 percent.
Between 2009 and 2014, the average time between an individual’s HIV diagnosis and his or her initiation of ARV treatment declined from nine months to just one month, while the time between diagnosis and the achievement of full viral suppression narrowed from 11 months to three months. During this period, the proportion of those who remained in HIV care six to 12 months after being linked to such care remained stable at about 70 percent. The proportion of those who died within one year of diagnosis also did not change significantly, remaining below 4 percent.
To read the Healio article, click here.
To read the study abstract, click here.