Fourteen years after his death sentence, Randy Silva is in the best shape of his life.
Silva, 51, was diagnosed with HIV in September 2001. In 2007, after suffering a heart attack while hospitalized at San Francisco General Hospital with AIDS-related pneumocystis pneumonia, he was told he had 48 hours to live.
“I expected to die,” he said recently.
But he didn’t. He finished a doctorate in clinical psychology last year. He has an active romantic relationship with his partner, who is 24 — and HIV negative.
And throughout San Francisco, there are more and more people like him.
New HIV infections and deaths of HIV-infected people in The City dropped more than 17 percent from 2013 to 2014, according to the Department of Public Health.
There were 302 new HIV diagnoses last year, and 177 deaths of HIV-infected people, according to the department. That’s down from 371 and 209, respectively, the year before.
Since the HIV/AIDS epidemic began in the 1980s, those numbers are the lowest ever recorded in San Francisco.
The most telling statistic may be this: Since 2012, when the drug Truvada was approved by the U.S. Food and Drug Administration as an HIV/AIDS prevention drug, new infections have dropped by 30 percent in The City.
The success of Truvada-centered PrEP, or pre-exposure prophylaxis, is also proof positive for some public health officials that their goal of getting to zero new infections is realistic and achievable.
In addition to increasing awareness and access to PreP as a prevention tool, public health officials tout the wide availability of HIV/AIDS testing and rapid access to antiretroviral treatment via UC San Francisco as key to the significant drop in new infections.
“We are on our way to zero,” said Dr. Susan Buchbinder, director of the health department’s HIV prevention unit. “But we still have a lot to do.”
Specifically, black people have a lower survival rate than other ethnicities, and vulnerable populations like the poor or homeless have a tougher time entering and staying in treatment.
There has also been an increase in new transmissions among youths, “specifically young men of color,” Buchbinder said.
Still, the numbers present a strong message: the overall strategy is working.
“For a while, our infection rates were pretty stubborn,” said Supervisor Scott Wiener, who is openly gay and last year publicly announced he takes Truvada as an HIV-prevention measure. “But we’ve made significant advances in getting people tested and quickly into treatment. All of that together creates a very strong atmosphere for reducing new infections.”
Globally, about 7,000 people are infected with HIV every day, according to the United Nations.