Testing and Treatment Tied to Fewer New HIV Cases in San Francisco


The real personal benefit of HIV testing and care for those found to be positive—delayed progression to AIDS and death—is well established. Less understood is the public health benefit of “test and treat” initiatives, namely whether or not having more people know their positive status and then take treatment to lower their viral loads affects transmission rates in communities with high rates of HIV.  Evidence has certainly suggested this is possible. Studies have shown that HIV-positive people who know their status are likely to take steps to prevent ongoing transmission of the virus.

Moupali Das-Douglas, MD, of the San Francisco Department of Health and the University of California at San Francisco, reported her team’s data on Wednesday, February 17. The study evaluated HIV testing practices and the relationship between average viral loads and the number of newly reported HIV cases and the number of new HIV infections between 2004 and 2008.

Das-Douglas reported an enormous reduction in the number of people living with HIV but unaware of their HIV status. In 2004, about 24 percent of people living with HIV did not know they were infected and, in turn, weren’t accessing care or likely engaging in safer practices to reduce the risk of transmitting their infection to others. By 2008, the rate was about 14 percent—a tremendous improvement.

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