Since 2012, new cases of HIV infection in San Francisco have decreased by more than 50%. Moreover, almost three-fourths of people living with HIV in San Francisco are virally suppressed. Despite these gains, sizable disparities exist for people experiencing homelessness, who make up 1% of the city’s population, yet accounted for 14% of new HIV diagnoses in 2017.
People experiencing homelessness in San Francisco also have a lower rate of viral suppression compared to the city average at 32%. In 2016-2017, enhanced mortality surveillance of 50 people without stable housing revealed that 68% of HIV-associated deaths occurred among people who experienced homelessness, used substances, and/or had mental health diagnoses.
Previous studies have focused on the broad success of HIV prevention and control in San Francisco, but in an oral abstract presented at the Association of Nurses in AIDS Care Conference (ANAC 2019) a team of investigators provided examples of clinic-based, community-delivered, and public health-level HIV care models recently implemented in San Francisco, focusing on their impact for people experiencing homelessness.