For years, Latinos accounted for the largest share of new HIV cases in this city, but testing data suggests the tide may be turning.
The number of Latinos newly testing positive for HIV dropped 46% between 2022 and 2023, according to a preliminary report released in July by the San Francisco Department of Public Health.
The decrease could mark the first time in five years that Latinos do not account for the largest number of new cases, leading to cautious optimism that the millions of dollars the city is spending to address this worrying disparity are working . But outreach workers and health care providers say more needs to be done to prevent and test for HIV, especially among new immigrants.
“I’m hopeful, but that doesn’t mean we’re going to let up on our efforts,” said Stephanie Cohen, who oversees the city’s HIV program.
Public health experts said the city’s latest report may be encouraging, but more data is needed to know whether San Francisco has addressed inequities in its HIV services. For example, it remains unclear how many Latinos have been tested or whether the number of Latinos exposed to the virus has also declined — key health indicators that the public health department declined to provide to KFF Health News. Testing rates are also below pre-pandemic levels, according to the city.
“If there are fewer Latinos reached by testing efforts despite a need, that indicates a serious challenge in the fight against HIV,” said Lindsey Dawson, associate director of HIV policy and director of policy LGBTQ health news at KFF, a nonprofit health news organization that includes KFF Health News.
San Francisco, like the rest of the country, suffers from significant disparities in diagnosis rates between Latinos and people of color. Outreach workers say recent immigrants are more vulnerable to infectious diseases because they don’t know where to get tested or because they have difficulty navigating the health care system.
In 2022, Latinos accounted for 44% of new HIV cases in San Francisco, despite making up only 15% of the population. Latinos’ share of new cases fell to 30% last year, while whites made up the largest share of new cases at 36%, according to the new report.
Cohen acknowledged that a one-year decline is not enough to chart a trend, but she said targeted funding toward community organizations could have helped reduce HIV cases among Latinos. A final report is expected in the fall.
Most cities rely primarily on federal dollars to fund HIV services, but San Francisco has an ambitious goal of being the first U.S. city to eliminate HIV, and about half of its $44 million HIV/AIDS budget dollars last year came from city coffers. By comparison, New Orleans, which has similar HIV rates, has invested only $22,000 of its overall $13 million HIV/AIDS budget, according to that city’s health department.
As part of an effort to address HIV disparities among LGBTQ+ communities and people of color, San Francisco last year gave $2.1 million to three nonprofits — l Instituto Familiar de la Raza, the Mission Neighborhood Health Center and the San Francisco AIDS Foundation – to increase awareness and testing. , and the treatment of Latinos, according to the city’s 2023 budget.
At the Instituto Familiar de la Raza, which administers the contract, the funding helped fund HIV testing, prevention, treatment, awareness events, counseling and immigration-related legal services, said Claudia Cabrera-Lara, director of the HIV program at Sí a la. Vida. But continued funding is not guaranteed.
“We live with the anxiety of not knowing what will happen,” she said.
The public health department commissioned a $150,000 project from the Instituto Familiar de la Raza to determine how Latinos contract HIV, who is most at risk and what health gaps remain. Results are expected in September.
“This could help us shape, pivot and grow our programs in a way that makes them as effective as possible,” Cohen said.
The center of the HIV epidemic in the mid-1980s, San Francisco established a national model for responding to the disease after building a network of HIV services allowing residents to obtain free or low-cost HIV testing, as well as than treatment, whatever their state of health. insurance or immigration status.
Although city testing data showed that new cases among Latinos declined last year, outreach workers are seeing the opposite. They say they are encountering more and more Latinos diagnosed with HIV as they struggle to get information about testing and prevention – such as taking preventative medications like PrEP – particularly among young people and communities in gay immigrants.
San Francisco epidemiological data for 2022 shows that 95 of the 213 people diagnosed with late-stage virus were foreign-born. And the diagnosis rate among Latino men was four times that of white men and 1.2 times that of black men.
“It’s a tragedy,” said Carina Marquez, associate professor of medicine in the Division of HIV, Infectious Diseases and Global Medicine at Zuckerberg San Francisco General Hospital, the city’s largest HIV care provider. “We have tremendous tools to prevent and treat HIV, but we see a big disparity.”
With Latinos being the least likely ethnicity to receive care in San Francisco, outreach workers want the city to increase funding to continue reducing HIV disparities.
The San Francisco AIDS Foundation, for example, would like more bilingual sexual health outreach workers; it currently has four, to cover areas where Latinos have recently settled, said Jorge Zepeda, its director of Latino health services.
At Mission Neighborhood Health Center, which operates Clinica Esperanza, one of the largest providers of HIV care to Latinos and immigrants, the number of patients seeking treatment has increased from about two per month to about 16 per month .
One challenge is connecting patients to bilingual mental health and substance abuse services, key to retaining them in HIV care, said Luis Carlos Ruiz Perez, medical manager of the clinic’s HIV records. The clinic wants to advertise its testing and treatment services more, but is short of money.
“A lot of people don’t know what resources are available. Period,” said Liz Oates, health systems navigator for the Glide Foundation, which works on HIV prevention and testing. “So where do you start when no one is hiring you?” »
This article was produced by KFF Health News, which publishes California Healthline, an independent editorial arm of the California Health Care Foundation.
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