PHONY HIV STATISTICS

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* Health and Healing *

Thursday, April 25, 2002 8:40 AM

PHONY HIV STATISTICS

 

 

- http://www.redflagsweekly.com/Thursday_report/hiv_statistics.html -

 

PHONY HIV STATISTICS

 

HOW THE SAN FRANCISCO DEPARTMENT OF HEALTH TURNED A DECLINE IN HIV INFECTIONS

AMONG GAY MEN INTO A TWO-FOLD INCREASE

 

By David Rasnick, Ph.d

 

David Rasnick is a visiting scientist in the Department of Molecular and Cell

Biology at the University of California at Berkeley

 

 

 

April 25, 2002 - I have examined a relatively minor study from the San Francisco

Department of Public Health, which was carried out in collaboration with the

UCSF AIDS Health Project and the Stop AIDS Project (1), to see if one of its

conclusions is consistent with the Department’s own statistics. The March 2002

study states that the fraction of gay men who have antibodies to HIV doubled

since 1996 (from 2.1% to 4.2%) (1). However, the Health Department’s own

statistics show that there has been a decline in newer HIV infections.

Unfortunately, the abuse of statistics at the department is not unique. It is

just the latest example of researchers, health officials and community

representatives manipulating their own data to make alarming points.

 

The 4.2% HIV infection rate for gay men at anonymous testing sites in 1999,

cited by the researchers is indeed true and can be located in the HIV testing

and counseling document, which is compiled and published by the SF DPH, with

funding provided by the Centers for Disease Control and Prevention (2). The HIV

Counseling, Testing, Referral and Partner Counseling and Referral Services

(CTR/PCRS) report for 1999 noted that there were 4,118 anonymous visits, and

that a total of 2,439 HIV tests were performed, of which 102 were HIV positive

(4.2%) (2). However, in the CTR/PCRS report for 2000 the researchers state that

there were 4,526 anonymous visits, and 2,791 tests for antibodies to HIV were

administered, of which 83 were HIV positive ( 3.0%) (3).

 

So even though there was a surge in the number of visits (up 10%) and the number

of tests (up 14%) in 2000, the HIV rate in fact fell from 4.2% in 1999 to 3.0%

in 2000. But if you only relied on the study by Katz and his colleagues or news

accounts you would never learn about the drop of the HIV infection rate. Why

isn't the drop of the rate of HIV infections acknowledged and discussed?

 

The release of the SF DPH study generated fairly typical stories at gay online

media sites. There were no challenges to the allegations being put forward by

the Katz study. In print (at Gay.com) the only community comment came from the

CDC-funded, Stop AIDS Project, headlined: " Study: Drug advances propel unsafe

sex. " And what evidence does Gay.com share with readers to back up the claim by

Katz that unsafe sex is rising? Gay.com offers this:

 

" At least one other sexually transmitted disease is on the rise. According to

the study, the number of cases of rectal gonorrhea in the city rose from 72 in

1994 to 160 in 1999. The disease generally hits bottoms -- men who are on the

receiving end of anal sex. "

 

Annual STD statistics are among the easiest things to locate at the SF DPH web

site, and should be read by all reporters who cover AIDS issues, if only because

the health department’s HIV programs are constantly making news. One would

expect Gay.com to check out the latest annual STD report for San Francisco (4)

and either verify or debunk the increases of male rectal gonorrhea, and to

inform readers of any mitigating reasons behind the upsurge in cases.

 

These critical facts and numbers from the SF DPH annual STD report for 2000 were

left out of the Gay.com story: In response to the city-wide increases seen in

1996, we began testing more men who have sex with men (MSM) seen at City Clinic

for rectal gonorrhea. Much of the increase in cases since 1996 is due to this

increased screening: the number of cultures increased from 571 to 1399, while

the proportion of cases found decreased from 8.9 percent to 8.4 percent (4).

There was actually a slight reduction in gonorrhea among gay men in San

Francisco.

 

San Francisco health officials have an extra special responsibility to be

accurate and fully informative on the latest statistics, when they present their

numbers in a study, which may have far reaching influence beyond the city’s

borders. And gay news outlets, online and in print, should look upon it as a

duty to look at every study from the San Francisco health department in the

larger context of all available data from the department that is at one’s

fingertips on the agency’s web site.

 

What legitimate reasons could the health department have for concealing a drop

in HIV infections in gay men at select testing sites? The answer may lie in the

minutes from the San Francisco Health Commission’s meeting on December 18, 2001.

The head of the health department’s AIDS Office presented an annual report to

the commission. According to the minutes, the AIDS Office budget is more than

$78 million, coming from the General Fund, federal funds and grants, state funds

and private foundation grants. (5)

 

Thus, there are at least 78 million reasons why the health department may need

to be creative with its studies and findings. While it is understandable that

the city wants to keep up its AIDS and healthcare budget, the desire for that

funding should not be a license to turn a decline in HIV infection among gay men

into a two-fold increase.

 

 

References:

 

1. Katz MH, Schwarcz SK, Kellogg TA, Klausner JD, Dilley JW, Gibson S, McFarland

W (2002): Impact of highly active antiretroviral treatment on HIV seroincidence

among men who have sex with men: San Francisco. Am J Public Health 92: 388-94.

2. Source: CTR/PCRS Reports,Data for 1999 by Behavioral Risk Population, page 11

3. Source: CTR/PCRS Reports,Data for 2000 by Behavioral Risk Population, page 11

4. Source: San Francisco Transmitted Disease Annual Summary, 2000

5. Source

 

 

 

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