HIV infections drop to record low in San Francisco

The San Francisco Health Commission received a report Tuesday that shows San Francisco is making progress on the "Getting to Zero" goal of ending new HIV infections by the year 2030.

The annual report by the San Francisco Public Health Department found the number of new HIV cases dropped 16 percent to 223, a record low. That is a dramatic change from the record high in 1992 of more than 2,332 HIV cases.

The glaring challenge is that 13 percent of new cases are homeless people.

Dr. Monica Gandhi is a veteran in the war against AIDS and works at the San Francisco General's Ward 86.

She's been treating HIV patients since 1996 when she arrived as an internal medicine intern.

"At that time 40 percent of the people who were admitted to our service had HIV," Gandhi said, "it was dramatic.  It was incredibly sad. It was heart-rending."

What's heartening now is the progress.

Tracey Packer, a director with the San Francisco Department of Public Health says new medicines such as PrEP, a pre-exposure prophylaxis pill that prevents people from getting HIV, have helped.

But homeless patients raise different challenges.

"We want to understand how our system can improve?  How can we run our clinics and our systems to meet the needs that people have that we might be missing now?" asked Tracey Packer, SF Dept. of Public Health spokeswoman.

"We document in their charts, where they are, what color their tent is, which encampment they are, how we can find them, who are the people next to them in the tents so we can try to find them are around them

Gandhi says another big challenge is administering medicines.

"Where do you put that medication if you're homeless? Where do you stash it? Where is your place that's safe where you can put it?" said Gandhi.

Gandhi says her team is trying new approaches. Last Thursday, they decided to have one homeless patient, come in to the clinic daily for her medicine, instead of sending her out with medications she might not take.

"These are actually infectious diseases. They can be transmitted, and decreasing rates of new infections is good for the entire population," said Gandhi.

Funding could be another big challenge. Packer says the Department of Public Health has applied to the CDC for grant money that could bring in hundreds of thousands of dollars to help with homeless HIV outreach. Packer says they will learn by the end of the year if they will receive that funding.