From 2010 to 2017, the number of new HIV diagnoses in San Francisco decreased by 50%, while chlamydia increased by 98%, syphilis increased by 122%, and gonorrhea increased by 196%

San Francisco was one of the first urban centers to see declines in new HIV diagnoses, with new HIV diagnoses reduced by half from 462 in 2010 to 221 in 2017.¹ These decreases are due to citywide efforts to scale-up HIV testing and early and widespread HIV treatment, a strong linkage-to-HIV care program (provided by the SFDPH LINCS team), and access to syringes, condoms, and more recently PrEP (pre-exposure prophylaxis for HIV).

Across this same time-period, condom use has been declining among gay men and other men who have sex with men.  This decrease is likely because taking PrEP (if you’re HIV-negative) or maintaining an undetectable HIV viral load (if you’re living with HIV) can prevent HIV acquisition and transmission, respectively, during sex, regardless of whether or not condoms are used.

Declining rates of condom use² has likely contributed to rising rates of gonorrhea, syphilis and chlamydia in San Francisco. The San Francisco Department of Public Health is focused on reducing STI health disparities and preventing the most severe complications of STIs in San Francisco.  We prioritize our work with:

1. gay, bisexual, and other men who have sex with men (MSM)
2. adolescents and young adults, particularly those of color
3. transgender persons and
4. females of reproductive age who are at risk for syphilis infection (and therefore newborns with congenital syphilis).

Syphilis

• In 2017, San Francisco had the highest rate of early syphilis of any county in the U.S.³
• Over 95% of new early syphilis cases in San Francisco are among men
• There was a 122% increase in early syphilis diagnoses (764 to 1694) between 2010 and 2017
• There was a 144% increase in early syphilis in women in San Francisco from 2017 to 2018 ³

Chlamydia

• The number of chlamydia diagnoses nearly doubled (4599 to 9094) in San Francisco between 2010 and 2017.
• Adolescent and young adult women experience disproportionate rates of chlamydial infection, more so among black/African-American youth. There are multiple factors that contribute to these persistent disparities.

Gonorrhea

• Between 2010 and 2017, the number of gonorrhea cases increased by 196% (1942 to 5754) in San Francisco.
• In 2017, over 50% of gonorrhea cases among males in San Francisco were identified through rectal and pharyngeal (throat) infections, highlighting the importance of extra-genital testing in addition to urine/urethral testing.

SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH STI REPORTS

OTHER STI and HIV RELATED DATA

National (CDC) STI Data
California Department of Public Health STI Control Branch Data and Resources
San Francisco HIV Epidemiology Annual Reports