On behalf of my constituents who have been so horribly affected by the AIDS epidemic, I would like to thank Senator Specter for holding this hearing in San Francisco to focus on HIV prevention. I would also like to thank Senator Specter for his important leadership in providing funding for HIV/AIDS care, including the AIDS Drug Assistance Program (ADAP), prevention, and research. We are joined today by Senator Boxer who is a national leader in the fight against HIV/AIDS. I commend you both for your leadership and commitment to fighting this epidemic and look forward to hearing the testimony of our distinguished panelists.
Here in the San Francisco Eligible Metropolitan Area (EMA), the HIV/AIDS epidemic has taken a tremendous toll. According to a recent report by the San Francisco Department of Public Health's AIDS Office, we have the highest rate of total AIDS cases per 100,000 residents; the third highest number of total AIDS cases; the fourth largest number of living AIDS cases; and the third highest rate of new AIDS cases in the nation.
There are an estimated 20,000 people living with HIV infection in this EMA, 15,240 of whom live here in San Francisco. Over 8,284 San Franciscans are living with AIDS, an increase of 50% since 1991. Over 50% of People Living with HIV here are diagnosed with AIDS, a much higher proportion than most other EMAs, reflecting a population that has been infected longer, is sicker, and in need of more services per capita than many other areas.
The Health Department's AIDS Office reports that the demographics of the epidemic are changing here. Recent AIDS cases in San Francisco are more frequent in people of color (38% compared to 25% cumulative), in women (8% compared to 4%), and in injection drug users, including injection drug users who are also men who have sex with men. A disproportionate number of new AIDS cases are among African-Americans; African-Americans comprise 11% of San Francisco's population, yet make up 20% of the AIDS cases diagnosed in San Francisco since January, 1998. During this same time period, the proportion of cumulative cases among whites decreased from 75% to 62%.
San Francisco has been a model for responding to the epidemic, in our scientific community, in our neighborhoods, and in our local government. Because of the wide availability of quality HIV care, people with HIV/AIDS often move here, increasing the burden on our system of care. These people utilize CARE funded services, but are not counted in our case load numbers since they were diagnosed elsewhere. While we do not want to deny services to anyone, we are bearing the cost of delivering these services because formula funds do not count these individuals.
The focus of today's hearing is on prevention. I am pleased to note that President Clinton has finally requested new money for HIV prevention in his budget and hope that the Labor-Health and Human Services Subcommittee, which Senator Specter chairs in the Senate and on which I serve in the House, will provide funding at at least the President's requested level. It is essential to dedicate more resources to prevention.
Recent studies have given us some cause for hope, as well as raising new concerns. There is new evidence that people with very low levels of HIV in their blood are less likely to be infectious. The good news is that more treatment could aid with prevention efforts. The danger is that people will think they can forget about safer sex if they are in treatment. We must adequately fund education and outreach that helps people understand this and other new and complex research and maintain safer behavior.
Of concern is a recent study which has found that young HIV positive people were more than twice as likely as adults to continue engaging in risky behaviors after HIV infection. We need to provide funding to reach out to HIV positive people, including youth, to help them practice safer sex and we must do this in a way that does not stigmatize people who have HIV infection.
Also of concern is a recent study, presented at the Retrovirus conference here in San Francisco last week, which found that oral sex may be riskier than long thought. The study reported that 8% of 102 cases surveyed of HIV infection among gay and bisexual men were likely due to receptive oral sex without a condom. We must provide the funding to help people understand this complex and new research.
At the same Retrovirus conference, findings demonstrated a resurgence of unsafe sex among gay men. People are exhausted from years of worrying about AIDS. We cannot afford to slip in the progress that we have made in fighting this epidemic. We need to redouble our commitment to providing the needed resources and focus on prevention to help people maintain safer behavior. I again thank Senator Specter for holding today's hearing and for his leadership in the fight against HIV/AIDS.
