San Francisco’s Sexually Transmitted Infection Rates Lower than Southern Cities

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While many cities have seen escalating numbers of sexually transmitted infections (STIs) over the past few years, San Francisco has experienced only modest increases. According to Centers for Disease Control and Prevention (CDC) data, in 2020 San Francisco was ranked third highest among major U.S. cities in reported STI rates per 100,000 residences. By 2021, the City had dropped to 15th, as public health efforts successfully muffled transmission while elsewhere STI rates rose rapidly.  

Due to the extensive work involved in data collection there’s typically a year and a half lag in issuance of CDC data. However, statistics released by the San Francisco Department of Health (SFDH) in February 2023, indicate that the number of STI cases was somewhat higher in 2022 compared to 2021, though December 2022 was slightly lower than December 2021. 

SFDH data also shows an uptick in the number of HIV tests between 2021 and 2022, with 3,488 checks in 2021 compared to 3,859 in 2022, a 1.1 percent increase for the year. Fifty-five of those tested were HIV positive in 2022 compared to 39 positives in 2021, a 1.4 percent rise. The San Francisco Department of Health didn’t respond to interview requests.

According to Eric Rodriguez, Chief Executive Officer and Co-Founder of Innerbody, a health and wellness company, “the CDC has noticed a concerning upward trend in the amounts of STD’s nationwide over the past eight years. At the tail end of the pandemic cities have been dealing with a multitude of issues that have contributed to their rising number of STD infections.” 

Southern cities have experienced the greatest increases in STI rates, particularly in states with little healthcare spending. The national average for healthcare expenditures is $10,191 per person. The states with the highest STI rates – Mississippi, Tennessee, and South Carolina – are ranked among the lowest in healthcare spending in the country. In 2021 Memphis, Tennessee had the uppermost STI rate, 1,460 cases per 100,000 residents, significantly greater than San Francisco’s 1,002 cases per 100,000 residents that year. 

The San Francisco “Department of Health has made it a priority to increase public awareness through education in its neighborhood clinics and hospitals,” said Rodriguez. “There has also been an increase in access to treatment and testing throughout the City…Although San Francisco does a pretty good job with reporting, there are some issues with the homeless population and the accuracy of documented infections, because they are not always seeking regular testing or treatment.” 

SFDH recently issued a study that found ”doxycycline post-exposure prophylaxis (doxy-PEP) significantly reduces the acquisition of chlamydia, gonorrhea, and syphilis.”  The report, which detailed the results of a random trial conducted by SFDH, Zuckerberg San Francisco General Hospital, and the University of Washington, focused on men having sex with men and transgender women. It recommended a 200 milligram dose of doxycycline taken between 24 and 72 hours after sex to prevent STIs. 

According to the SFDH “this is the first biomedical tool to be shown effective and well-tolerated…community awareness is growing, and many SF providers are prescribing doxy-PEP frothier at risk patients.