Bolstering The City's annual spending on HIV-related services and prevention measures, a consortium fighting the disease is calling for increased investment in a new strategy it says will end HIV infections in San Francisco before any other city does. The initial goal is a 90 percent reduction of new cases within five years.
The strategy was developed by the Getting to Zero consortium, a large coalition established last year of those fighting HIV/AIDS in San Francisco, and would initially require more than $2 million of city funding this year.
The investment would fund three initiatives: One would increase use of pre-exposure prophylaxis, or PrEP — the brand-name drug Truvada manufactured by Gilead Sciences is the only one on the market — which can reduce the risk of transmission by more than 95 percent, and is being called a game-changer in the fight against AIDS. Another would expand UC San Francisco's Rapid ART (antiretroviral therapy) program, which provides immediate treatment and counseling to anyone who tests positive. A third initiative aims to keep those with HIV under care by preventing treatment gaps, such as if someone loses health insurance or housing.
San Francisco has had success in its battle against HIV, with a decrease in new transmissions from 530 in 2007 to 359 in 2013. But Neil Giuliano, CEO of the San Francisco AIDS Foundation and a member of the consortium, said that there has been an increase in diagnoses of people aged 25 to 29 and disparities remain with blacks and Latinos having the highest number of the new infections.
Still, Guiliano argued that if The City supports the strategy, it “will enable San Francisco to be the first city that ends HIV transmission.” Part of that optimism may be due to the fact that 63 percent of HIV-infected patients are virally suppressed, while nationally the number is 25 percent.
“When people are virally suppressed they will not be infectious and the virus cannot be spread,” Guiliano said. “That's a very important part of why we believe we can be successful.”
The effort has the support of supervisors Scott Wiener and David Campos, who held a board Budget and Finance Committee hearing Wednesday on the issue. The exact amount and spending details remain under discussion, Wiener said.
“We do have a path to ending new HIV infections,” Wiener said. “If we can do it here, it will spread to other parts of the country, it will spread to other parts of the world. In order to make this successful, we have to put the resources behind the effort.”
There are 15,901 San Francisco residents with HIV, according to the most recent data from 2013, of which 92 percent are male and more than half are over the age of 50.
The hearing comes as Mayor Ed Lee and city departments have started working on the mayor's budget proposal, which must be submitted by June 1. In the current fiscal year, The City will spend $57 million on the battle against HIV, about $36 million for services, $15 million for prevention and $5 million for research. The share of the total funding that comes from state and federal sources continues to decrease.