New HIV cases decline, CDC report says

by Liz Highleyman

Annual new HIV infections in the U.S. fell by 12% in recent years, with the greatest declines seen among young gay and bisexual men and people in the South, according to the latest HIV surveillance report from the Centers for Disease Control and Prevention. Increased PrEP use played a role in this decline, experts say.

While everyone did not benefit equally, all groups saw some improvement.

“We see some bright spots in the data – our nation’s HIV prevention efforts are working, especially for young people,” Dr. Jonathan Mermin, director of the CDC’s National Center for HIV, Viral Hepatitis, STD, and TB Prevention, said during a May 23 media briefing. “While we are on the right track, progress is not happening quickly enough or equitably among all people or in all areas of the country.”

The CDC estimates that HIV incidence fell from about 36,500 new infections in 2017 to about 32,100 in 2021. But at this rate, “at least three people in the U.S. get HIV every hour,” according to Dr. Robyn Neblett Fanfair, acting director of the CDC’s Division of HIV Prevention.

About two-thirds of people with new infections were gay or bisexual men and more than half lived in the South. According to the CDC, 87% of the estimated 1.2 million people living with HIV have been tested and know their status.

The decline in incidence was driven by a 34% drop among people ages 13 to 24, from about 9,300 new infections in 2017 to about 6,100 in 2021.

Banko Brown

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Giants

This age group accounts for the second largest number of HIV cases, after people ages 25 to 34, of which 80% are among young gay and bisexual men. While HIV incidence dropped by 45% among young white gay and bi men, the declines were smaller – 36% and 27%, respectively – for young Latino and Black men.

Just under 20% of new HIV infections in 2021 were among women, more than half of whom were Black.

The good news is that the United States has met its goals for eliminating perinatal HIV, with the mother-tochild transmission rate falling below 1% for the first time in 2019 and continuing to decline.

In 2021, the South saw more new infections (16,700) than the West (6,600), Midwest (4,400) and Northeast (4,400) put together, but it was the only region to see a statistically significant decrease, falling by 12%.

Turning to HIV care, the portion of people with diagnosed HIV who were on antiretroviral treatment with an tions are the San Francisco Board of Supervisors, which voted unanimously Tuesday for a resolution asking Bonta as well as the United States Department of Justice to investigate. The resolution was introduced last week by board President Aaron Peskin and co-sponsored by District undetectable viral load rose slightly, from 63% in 2017 to 66% in 2021. But here, too, everyone did not benefit equally: Viral suppression rates ranged from 62% for Black people to 72% for white people.

The drop in HIV incidence and the rise in the proportion of people on treatment in the United States pales in comparison with some other highincome countries such as the United Kingdom and Australia. In the U.K., efforts to curb HIV among gay and bi men have been so successful that they now account for fewer new cases than heterosexuals. The differences can be attributed to “deeply entrenched social determinants of health that drive disparities and make progress elusive,” Mermin said.

Treatment

The most successful countries have gotten more people with HIV on treatment, which reduces onward transmission. According to Neblett Fanfair, people who receive care through the federal Ryan White HIV/AIDS program have outcomes rivaling those of other countries, showing that lack of health insurance and access to care is contributing to disparities.

SF data

Some American cities have done better than the nation as a whole but still face challenges. San Francisco, for example, is struggling with HIV among people experiencing homelessness, who accounted for 24% of new diagnoses in 2021.

New diagnoses in San Francisco fell from 240 in 2017 to 138 in 2020, before rising to 160 in 2021, according

10 Supervisor Shamann Walton, District 9 Supervisor Hillary Ronen, and District 5 Supervisor Dean Preston.

“I am heartened that the state attorney general has agreed to investigate whether District Attorney Jenkins abused her discretion,” Pe- to the Department of Public Health’s most recent HIV epidemiology annual report. But health officials say the uptick could have been due to changes in testing in the wake of the COVID-19 pandemic. Preliminary year-end numbers from 2022 suggest new diagnoses are again on the decline, DPH said in a statement to the Bay Area Reporter.

The role of PrEP

The nationwide decline in HIV incidence mirrors an increase in PrEP use. Among the 1.2 million people the CDC estimates could benefit from prevention pills or shots, about 30% had a prescription in 2021, up from 13% in 2017. But Black and Latino people are less likely to use PrEP even though they account for a majority of people at risk for HIV. According to the new report, 78% of white people at risk were taking PrEP in 2021, compared with 21% of Latinos and 11% of Black people.

President Joe Biden’s FY2024 budget proposal includes $850 million to accelerate efforts to end the HIV epidemic, and he has also proposed $237 million for a national PrEP program. But these requests may not be met as some legislators have called for deep cuts in federal spending to balance the national budget.

“It appears that our investments in HIV prevention are providing some positive results, but the persistent high number of new diagnoses and the low usage of PrEP among the communities most impacted by HIV point to the need for increased resources, particularly for a national PrEP program,” Carl Schmid, executive director of the skin told the B.A.R. “The fair and equitable dispensation of justice will make San Francisco safer.”

Mayor London Breed said during a downtown news conference last week that she supports Jenkins’ decision and also that “I don’t think that there’s anything wrong with

HIV+Hepatitis Policy Institute, said in a statement. “While there have been some increases, they have not been at the level needed to put the U.S. on a path to end HIV.”

The availability of generic versions of Truvada has helped increase PrEP access, Mermin noted. More people are now insured than in 2017, thanks in part to the Affordable Care Act and Medicaid expansion during the pandemic. But these gains could be reversed now that the national COVID-19 public health emergency has ended. Likewise, mandatory insurance coverage of PrEP is also in jeopardy due to a Texas judge’s ruling in March that is currently on hold pending appeal.

At the current rate, the country is not on track to meet the goals of Ending the HIV Epidemic initiative, which calls for a 90% decrease in new infections and for 95% of people diagnosed with HIV to be on treatment with viral suppression by 2030.

To get there, CDC officials stress the need for increased investment in proven prevention programs, maximizing innovation—such as expanding self-testing, greater use of long-acting injectable treatment and PrEP, and offering services in more settings—and centering equity to better reach people disproportionately affected by HIV.

“In prevention, patience is not a virtue,” Mermin said. “A challenging task that once seemed impossible –to end the HIV epidemic in America – is possible. We need the will, the resources, and the resolve to make it happen.” t welcoming our California attorney general, or anyone else, to review the case.”

United States Attorney for the Northern District of California Ismail J. “Izzy” Ramsey has not commented on the case. t

SF archbishop joins row over drag nuns

The Dodgers have been the subject of controversy for the past week after the team decided to invite the LA chapter of the Sisters to be honored with a Community Hero Award at its June 16 Pride Night game. The Southern California National League team then disinvited the drag nun group after criticism from conservatives, who accused the group of being anti-Catholic.

The Sisters have poked fun at religion ever since first publicly appearing in San Francisco on Easter Sunday in 1979. Since then, the group has established orders in other cities with members raising funds for charitable groups and elevating awareness about LGBTQ rights.

Baseball Commissioner Rob Manfred asking, “Do you believe that the Los Angeles Dodgers are being ‘inclusive and welcoming to everyone’ by giving an award to a group of gay and transgender drag performers that intentionally mocks and degrades Christians –and not only Christians, but nuns, who devote their lives to serving others?”

The Sisters, for their part, denied being anti-Catholic, and highlighted their charitable causes.

“The Sisters were among the first to raise money to help care for people with AIDS and to create and distribute safer-sex information,” the San Francisco chapter stated. “They support other groups, including several mainstream churches, in their work. Sisters are regularly called upon to minister to the sick, the dying, and the mourning.”

Sister Unity of the LA chapter tweeted the group’s statement after being reinvited by the Dodgers.

“We, the Los Angeles Sisters of Perpetual Indulgence, are proud to accept the Community Hero Award from the Los Angeles Dodgers for our 27 years of service to the LGBTQIA2S community,” they tweeted.

In a statement issued May 22 Los Angeles LGBT Center CEO Joe Hollendoner called the Pride Night controversy a “debacle” that also highlighted the need for the LGBTQ community to remain united as drag queens and transgender individuals come under attack.

“The Dodgers’ course correction and the conversations we have had with the organization’s leadership since last week demonstrates the version of allyship we have come to expect from the team over the years,” he added. “The center will always strive to hold our corporate partners accountable – which means so much more than waving a rainbow flag.”

The archdiocese did not return a request for comment about the Giants’ Pride Night by press time.

Gay softball league anniversary

Meanwhile, the San Francisco Gay Softball League – celebrating its 50th anniversary this year – had told the B.A.R. that it was expecting to be a part of this year’s Giants Pride festivities.

The Giants had no comment about the Dodgers imbroglio when asked by the B.A.R.

U.S. Senator Marco Rubio (R-Florida) wrote a letter to Major League

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The Dodgers’ decision to disinvite the Sisters led the Los Angeles LGBT Center and LA Pride to step away from the event. The Dodgers reinvited and apologized to the Sisters May 22 and the group accepted.

“Last week’s debacle underscores the dangerous impact of political tactics by those who seek to stoke the flames of anti-LGBTQ bias at a time when our rights are under attack. We must continue to stand together as a community in defense of the rights and recognition of LGBTQ+ people in Los Angeles and beyond,” stated Hollendoner, a gay man who formerly led the San Francisco AIDS Foundation.

After the Dodgers reinvited the Sisters, Rubio wrote on Twitter that “our great country is controlled by sociopolitical ruling elites who don’t just tolerate anti-Christian bigotry, they encourage & celebrate it.” He was followed by none other than Salvatore Cordileone, the Roman Catholic archbishop of San Francisco, who wrote on Twitter, “Our Catholic sisters devote themselves to serving others selflessly. Decent people would not mock & blaspheme them. So we now know what gods the Dodger admin worships. Open desecration & anti-Catholicism is not disqualifying. Disappointing but not surprising. Gird your loins.”

Orlando Diaz, a gay man who is the softball league’s director of business development, told the B.A.R. in a March report that while details were in the works, “we’re definitely going to be a big part of their [the Giants’] Pride night.”

Heklina

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Sister Roma and Peaches Christ will be celebrating Heklina again at the San Francisco Giants’ Pride Night June 10, Sister Roma told the B.A.R. (See related story.

Tom Temprano, a gay former City College trustee who was promoted this week to managing director of external affairs for the statewide LGBTQ rights group Equality Cali - fornia, reflected on the significance of the event, which saw a block of Castro Street closed to accommodate mourners.

According to Steven Bracco, a gay man who is the director of communications for the league’s board, the league hasn’t “received any more details from the Giants” as of May 23. Daum reiterated to the B.A.R. that more details will be announced soon.t next month during Pride, and that they’d be bringing in a portrait of Heklina.

“This is more than a memorial,” he said. “This is a fucking state funeral for drag royalty.”

In 2015, Heklina opened the Oasis nightclub with Drollinger. She also helped found “The Golden Girls Live!” holiday show, wherein she played Dorothy Zbornak.

In 2019, Heklina bought a home in Cathedral City, near Palm Springs, and sold her ownership stake in Oasis.

“In the last two hours, I’ve talked to so many people I haven’t seen in years,” Roma said. “Here she [Heklina] is, living through our community, living through everyone who’s watching outside.”

Added Lovestocking: “If she had known her memorial would be such a huge hit, she’d have died three times a month.”