Subject: SF health dept.: "No major increase of any reportable STD" in 1999
From: [email-masked]
Date: Sat, 29 Jul 2000 21:06:21 EDT

[Dear friends:

The Journal of the American Medical Association, JAMA, last week printed a 
study from Drs. Jeff Klausner and Mitch Katz, et al., "Tracing a Syphilis 
Outbreak Through Cyberspace," in which the authors cited the preliminary 
annual STD rates for San Francisco from the SF STD unit's monthly report of 
January 27, 2000. (See note number 12, <A 
HREF="http://jama.ama-assn.org/issues/v284n4/full/joc00896.html">Tracing a 
Syphilis Outbreak Through Cyberspace</A> ).

I went back to my files to again read the full one page report and happily 
rediscovered the editorial note was full of data about stabilized STD cases. 
Including rectal gonorrhea cases, usually cited as an indicator associated 
with HIV transmission.

I bring this to your attention because allegations have been made by UCSF and 
DPH Aids researchers that HIV transmission levels in SF have tripled to 
almost 1,000 per year. Four long weeks after the SF Chronicle screamed about 
a "surge" of HIV here, minute data has been distributed proving the HIV rates.

Putting aside valid and ever-growing concerns about the DPH and UCSF 
allegations for a moment, and only looking at number of male rectal gonorrhea 
cases, along with 
total adult syphilis cases, there really is a statistically stable rate. 

With male rectal gonorrhea and adult syphilis stable, how can we then make 
the leap to HIV supposedly being transmitted to 1,000 new people this year? 

For argument's sake, let's say the rectal rate is 160 per year and adult 
syphilis is 125 per year. If these STD rates so relatively low, and basically 
stable, how can the HIV rate be so much higher? I would expect STD rates to 
be corresponding to HIV rates, not wildly unmatched.

I strongly encourage you to visit the SF DPH web site and download the 
January 27, 2000 report in PDF and examine the charts, which I can't share 
with you in an email. ( http://www.dph.sf.ca.us/Reports/HlthAssess.htm, or 
check out  <A HREF="http://www.dph.sf.ca.us/Reports/HlthAssess.htm">Health 
Assessments & Data</A> ). 

Pay particular attention to Table 1 and the non-gonococcal urethritis, or 
"dick drip," case line. In 1998 there were 719 cases, versus 489 cases in 
1999. Just one more indicator STD rates for males in SF, including gay males, 
are truly declining and/or stable? Yes, one of a number of factors that 
convince me the only way to probe recent unsubstantiated charges of HIV 
levels surging in a very large sexual health context.  --mp]

            *      *      *

San Francisco Monthly STD Report
Data Through December 1999
Report prepared on January 27, 2000

STD Control Unit
1360 Mission Street
San Francisco, CA 94102
Phone: 415-554-8450

Editorial Note:

This report includes provision annual totals for 1999. Until the 1999 annual 
report is released, these annual totals should be interpreted with care. 

There appears to have been a small increase, 2%, in the number of reported 
cases of  CT between 1998 and 1999. 

The total number of reported cases of gonorrhea has declined by about 15% 
since 1998.

With only two more cases of rectal gonorrhea reported than in 1998, rectal 
gonorrhea may be leveling in San Francisco.

Primary and secondary syphilis also appears to have been stable between 1998 
and 1999, with only 26 cases reported each year. 

Like in 1998, only one case of congenital syphilis was reported in 1999. 

There were also no cases of chancroid reported in 1999.

Overall, the provisional data suggest that STD rates in San Francisco were 
relatively stable in 1999, with no major increases of any reportable STD.

During 2000, San Francisco STD Services will continue to promote the primary 
prevention of and early identification and treatment of STDs in order to 
create a healthy sexually environment for San Francisco residents. 

Anyone can be evaluated for STDs at The City's municipal STD clinic. There 
were over 17,000 patients visits at the clinic during 1999. For more 
information about the City Clinic, please call 415-487-5500 or visit our web 
page at www.dph.sf.ca.us/sfcityclinic.

Report prepared by Charlotte Kent
Chief
Epidemiology and Research
STD Services
Phone: 415-554-8450
========================

Michael Petrelis
 <A HREF="http://www.aids-statistics.com/">Welcome to AIDS-STATISTICS</A>
www.AIDS-statistics.com 
2215-R Market Street, #413
San Francisco, CA 94114