San Francisco, CA – The San Francisco Department of Public Health (SFDPH) today released its 2023 HIV Epidemiology Annual Report, which shows that the number of new HIV diagnoses have declined in San Francisco.
In 2023, there were 133 new HIV diagnoses, a 20% decrease from 2022 when 167 diagnoses were reported. Since 2014, the number of new HIV diagnoses in San Francisco has declined by 59%, while nationally, new HIV diagnoses have only declined by 3% in the past decade.
Declines in new diagnoses were specifically reported among Latino individuals living in the City. In 2023, there were 40 new HIV diagnoses among Latino individuals, a 46 % decrease from the previous year when 74 new diagnoses were reported, and a 59% decrease since 2014. Importantly, there has been an overall decline in the number of new HIV diagnoses for all racial and ethnic groups from 2014 through 2023.
“San Francisco has long been a national leader in HIV research, epidemiology, prevention, testing, and care. We are thrilled to see that HIV diagnoses in our City continue to go down,” said Mayor London Breed. “Today’s report underscores just how important it is to have trusted, world-class public health facilities such as SFDPH’s San Francisco City Clinic and Zuckerberg San Francisco General Hospital, as well as incredible community partners, whose ongoing work in providing critical HIV services to our community have helped make these declines possible.”
Levels of linkage to care and viral suppression after diagnoses have returned to or exceeded the pre-COVID-19 pandemic levels. In 2023, 95% of individuals diagnosed in San Francisco were linked to care within one month and 84% of people diagnosed the first nine months of 2023 were virally suppressed within six months.
“This report gives us many reasons to be encouraged and shows that our efforts are making a difference,” said Director of Health Dr. Grant Colfax. “Incredible advancements have been made in HIV prevention and care, and we must continue to make sure that communities across San Francisco have access to high-quality, culturally competent services so that this report is part of a sustained trend that marches us towards a day when there will be no new HIV infections.”
SFDPH’s expanded services in 2023 include the HIV/STI home testing program Take Me Home, which reported an increase in participation from 533 HIV test kits ordered in 2022 compared to 843 in 2023. In a testament to the effectiveness of public awareness efforts through many years, an estimated 97% of people living with HIV in San Francsico are aware of their status, compared with 87% in the United States.
Pre-exposure prophylaxis (PrEP) also became more widely available, including an injectable form of PrEP. The medication’s use among men who have sex with men (MSM) living without HIV has increased for all race/ethnicities from 2015 to 2023 among San Francisco City Clinic patients who were San Francisco residents. In 2015, PrEP use ranged from 22% to 27% among MSM living without HIV across all race/ethnicities; by 2023, it increased to between 71% to 78%.
While much progress has been made, challenges remain. Nationally and in San Francisco, Black/African American MSM have lower PrEP use compared with MSM of other race/ethnicities. A key priority of Getting to Zero San Francisco, a consortium of over 300 members including SFDPH, is to scale-up efforts in providing access to HIV PrEP and to ensure linkage to and engagement in HIV care for Latino, and Black/African American communities, as well as to people experiencing homelessness (PEH) and people who use drugs.
PEH comprise an elevated proportion of new diagnoses each year, accounting for 23% of 2023 diagnoses. Among PEH who were last unhoused in San Francisco, only two-thirds were virally suppressed in 2023. Additionally, while people living with HIV continue to live longer, drug overdoses accounted for 19% of deaths among that population in between the years 2019 and 2022.
To address these challenges, SFDPH’s Community Equity Health and Promotion Branch coordinated with community partners to open seven Health Access Points (HAPs). The HAPs provide equity-focused, stigma-free, and low barrier HIV prevention, care and treatment services, as well as for other sexually transmitted infections, Hepatitis C, and overdose prevention. While everyone is welcome at the HAPs, each HAP is designed to address the specific health needs of priority populations, including Latinos, people who use drugs, Trans Women, and Black/African Americans. In addition, SFDPH’s renowned San Francisco City Clinic provides comprehensive prevention and care HIV services with bilingual staff.
SFDPH also manages a robust network of programs to help ensure that PEH get and remain connected with their care, such as LINCS (Linkage, Integration, Navigation and Comprehensive Services), Whole Person Integrated Care, and Zuckerberg San Francisco General Hospital’s Ward 86 POP-UP clinic and new HAP, “The Lobby”.
“To ultimately succeed in our fight against HIV, it is critical for people to know and understand the many services that are available to them, and that services continue to evolve and improve, which cannot be done without continued planning and coordination with community, academic, and health system partners,” said Dr. Susan Philip, Health Officer, City and County of San Francisco and Director of Population Health Division, San Francisco Department of Public Health. “The tools both inside and outside of traditional medical settings are there, and the more we connect with and hear from our communities, the better chance we will have in tackling the challenges in front of us.”
The 2023 HIV Epidemiology Report Annual and can be accessed here.
###