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HIV diagnoses fall in San Francisco even as gonorrhea, chlamydia and syphilis rise; health department outlines testing, outreach and lab improvements
Summary
San Francisco Department of Public Health officials told the Health Commission that HIV diagnoses are declining while cases of chlamydia, gonorrhea and early syphilis are increasing, concentrated among men who have sex with men and disproportionately affecting Black residents. The department described expanded testing, faster lab turnaround, targeted outreach and new behavioral strategies to reduce disparities.
Dr. Susan Phillips, director of the Disease Prevention and Control branch and the city's STD controller, told the commission on May 16 that "HIV diagnoses are going down," but that rates of chlamydia, gonorrhea and early syphilis "are going up." She framed the trend as a paradox tied to the success of HIV treatment and pre-exposure prophylaxis (PrEP) and said STD prevention must be integrated with HIV work.
The department presented surveillance and behavioral data showing declines in reported 100% condom use and rising self-reported gonorrhea and chlamydia among men who have sex with men (MSM). Dr. Phillips said these patterns predate widespread PrEP use and noted racial disparities: while case counts have been higher among white MSM, rates per 100,000 show substantially higher burdens among Black/African American MSM.
San Francisco's municipal City Clinic was highlighted as a central hub: nearly 18,000 visits last year, 53% of visits…
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