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HIV & Hep C Statistics

An overview of the state of HIV and hepatitis C in San Francisco, California and the U.S., updated annually.

San Francisco

Note: HIV testing capacity in 2020 was greatly affected by the COVID-19 pandemic especially during the period of San Francisco’s shelter-in-place order that was in effect from March 16, 2020 through May 2020. Overall, the average number of monthly HIV tests at medical sites in 2020 (N=3,514) was 18% lower than the 2019 monthly average.

People Living with HIV

San Francisco has one of the largest populations of people living with HIV in the United States with an estimated 15,811 people living with HIV (“HIV Epidemiology Annual Report” 1).

Of the total number of San Franciscans living with HIV/AIDS at the end of 2020, 8,950 were living with HIV ever classified as AIDS. AIDS is a late-stage HIV disease defined by a low count of CD4 cells or an opportunistic infection (“HIV Epidemiology Annual Report” 2).

As of December 2020, 71% of people living with HIV (11,207) in San Francisco were over age 50 (“HIV Epidemiology Annual Report” 66).

New Diagnoses

The number of new HIV infections occurring in San Francisco continues to decrease every year. There were 131 new HIV diagnoses in 2020, down from 168 in 2019 (“HIV Epidemiology Annual Report” xi).

Of those newly diagnosed with HIV in 2019, 82% identified as male and 61% were men who have sex with men (“HIV Epidemiology Annual Report” 1).

Among men who have sex with men newly diagnosed in 2020, Latinos accounted for the highest proportion at 41% followed by 26% Whites, 15% Black/African Americans, and 15% APIs. Diagnoses among African Americans and Latinx people decreased slightly between 2019 t0 2020 (“HIV Epidemiology Annual Report” 55).

Due to the impact of the COVID-19 pandemic, in 2020 all racial/ethnic groups experienced declines in the absolute number of new diagnoses, with Whites experiencing the largest decline from 2019 to 2020 (59 cases to 37 cases) (“HIV Epidemiology Annual Report” 11).

The percentage of people diagnosed with HIV who are experiencing homelessness is showing a slightly increasing trend to 21% in 2018 and leveling to 18% in both 2019 and 2020. In 2020, 18% of people diagnosed with HIV (24 people) did not have housing at the time of their diagnosis (compared to 21%, 43 people, in 2018) (“HIV Epidemiology Annual Report” 73).

Compared to persons who were not homeless and diagnosed with HIV in 2011 to 2020, persons who experienced homelessness at time of HIV diagnosis were more likely to be women or trans women, Black/ African American, trans women who have sex with men (TWSM), and PWID (including non-MSM, MSM, and TWSM) (“HIV Epidemiology Annual Report” 74).

As with California new diagnoses, by racial/ethnic group, Latinx persons accounted for the largest proportion of 2020 diagnoses in San Francisco (37%). Compared to newly diagnosed persons nationally, San Francisco new diagnoses were more likely to be men and trans women, and White, Latinx or Asian/ Pacific Islander (API) (“HIV Epidemiology Annual Report” 1).

HIV Care & Viral Suppression

92% of people newly diagnosed with HIV in 2019 entered care within one month of their diagnosis (“HIV Epidemiology Annual Report” 15).

Between January and June 2020, 77% of persons diagnosed (61) were virally suppressed within six months (“HIV Epidemiology Annual Report” 15).

Among all people living with HIV in San Francisco, 67% have their virus under control (are virally suppressed) in 2020. (“HIV Epidemiology Annual Report” 17). People who are virally suppressed have better health outcomes and do not transmit HIV to other people.

The proportions of persons with HIV who received care and were virally suppressed in 2019 were higher in San Francisco than in California and the U.S. (“HIV Epidemiology Annual Report” 22).

Black/African Americans had a lower proportion of linkage to care and viral suppression. Trans women, persons aged 30-39 years, MSM-PWID, and persons experiencing homelessness at diagnosis had a lower proportion of viral suppression. (“HIV Epidemiology Annual Report” 19).

Among persons diagnosed with AIDS in the years 2012-2019, survival probability at 36 months (three years) was lower among Black/African Americans and Whites compared to Latinx and Asians/ Pacific Islanders. (“HIV Epidemiology Annual Report” 35).

In San Francisco...

0

People were diagnosed with HIV in 2020

0

of people diagnosed with HIV were younger than 30

0

of newly diagnosed people become virally suppressed within six months of 2020

In California

In California, 137,785 people were living with diagnosed HIV in 2019 (“California HIV Surveillance Report” 9). Of those people, 75% were in HIV care and 65.3% achieved viral suppression (“California HIV Surveillance Report” 12).

Hispanic/Latinx people in California made up the greatest proportion of new diagnoses (49.7%), followed by people who are white (24.7%), Black/African American people (17.4%) and Asian people (5.5%) (“California HIV Surveillance Report” 6).

In the United States

In the United States, approximately 1.2 million people are living with HIV today. About 13 percent of them (1 in 7) don’t know it and need testing (“CDC Statistics Overview”).

There were 36,740 HIV diagnoses in 2019. From 2015 – 2019, the annual number of HIV diagnoses decreased (“CDC HIV Surveillance Report” 10).

Hepatitis C

Hepatitis causes inflammation of the liver and can lead to cirrhosis (scarring), liver cancer, liver failure and death. The most common types are hepatitis A, hepatitis B and hepatitis C. The hepatitis C virus (HCV) infects and can severely damage the liver. It is the most common chronic blood borne disease in the United States; approximately 4-6 million persons are infected (“About Hepatitis C”).

The End Hep C SF initiative estimates that approximately 12,000 people in San Francisco are living with active HCV infection, despite the existence of an easy-to-complete, highly effective cure. Additionally, San Francisco has the highest liver cancer rate in the nation, most of which is attributed to high rates of hepatitis B and hepatitis C virus infections (“About Hep C SF”).

People living with HIV are at higher risk for contracting HCV, and approximately 8% of PLWH are co-infected with HCV. People who inject drugs are the vast majority of those diagnosed with HCV infection, and are least likely to access treatment. Men who have sex with men (MSM) and baby boomers are also disproportionately affected by HCV. While trans women make up a small percentage of the total population of San Francisco overall (0.1%), End Hep C SF estimates that more than 1 out of every 6 trans women is currently living with HCV (“About Hep C SF”).

Sources

California Department of Public Health, Center for Infectious Diseases, Office of AIDS. California HIV Surveillance Report, 2019. California HIV Surveillance Report, 2019.

Centers for Disease Control and Prevention. HIV Surveillance Report: Diagnoses of HIV Infection in the United States and Dependent Areas, 2019.
Centers for Disease Control and Prevention. Statistics Overview. Accessed September, 2021.

San Francisco Department of Public Health Population Health Division. HIV Epidemiology Annual Report. 2020.

End Help C SF. About Hep C SF. Accessed January, 2021.

San Francisco Hepatitis C Task Force. About Hepatitis C. Accessed December, 2020.

Last updated: 9/21/2021