[David Rasnick is a researcher at the University of
California, Berkeley and expert on protease inhibitors, the new AIDS
drugs that have been hailed as the cause of the recent decline in AIDS
deaths. Rasnick is an outspoken critic of the HIV=AIDS hypothesis and an
advisor to South African president Thabo
How the San Francisco Department of Public Health turns
a 30 percent decline in HIV infections among gay men into a two-fold
David Rasnick, Ph.D.
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 evidence contained in 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 percent to 4.2 percent).1
However, the Health Department's own statistics show that there was
actually a decline in new HIV infections. Unfortunately, the abuse of
statistics by Katz et al. 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 percent 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 percent).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 percent).3
So even though there was a surge in the number of visits
(up 10 percent) and the number of tests (up 14 percent) in 2000, the HIV
rate in fact fell significantly, plummeting from 4.2 percent in 1999 to
3.0 percent in 2000, while at the same time the blinded HIV rate was not
going up. But if you only relied on the Katz et al. study 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
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 et al. study. The only
community voice in print is from the CDC-funded Stop AIDS Project
under the headline “Study: Drug advances propel unsafe sex,” that
appeared on Gay.com
February 27, 2002. What evidence does Gay.com share with readers to back
up the claim by Katz et al. 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 Francisco4
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 1,399, 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
The online gay press is also guilty of failing to tell
readers its one person quoted as a community representative, Steven
Gibson of the Stop AIDS Project is an author of the Katz et al. study,
which makes him a guilty party to this faulty research on the sex lives
of gay men and HIV rates. Gibson, as expected, does not raise any doubts
about the research.
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 significant 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 December 18, 2001, meeting. 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, and sources are 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 substantial decline in HIV infection among gay men into a
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.
Reports, Data for 1999 by Behavioral Risk Population,
page 11. [back]
Reports, Data for 2000 by Behavioral Risk Population,
page 11. [back]
San Francisco Transmitted Disease Annual Summary, 2000.
David Rasnick is a visiting scientist at the Dept.
Molecular & Cell Biology, University of California at Berkeley,
Berkeley, CA 94720; 408-857-3505 cell.