“Treat All” Policy Proves Effective in San Francisco

In 2010, the San Francisco Department of Health and the HIV/AIDS Division at San Francisco General Hospital issued a recommendation that all HIV-infected individuals receive antiretroviral therapy (ART), regardless of CD4-cell count. Since then, both the U.S. Department of Health and Human Services and the International AIDS Society–USA have followed suit — but how did the San Francisco experience play out?

Researchers evaluated temporal trends in viral loads among 2245 patients who received care at a publicly funded HIV clinic in San Francisco between 2001 and 2011 and were not receiving ART at the time of clinic entry. The patients were predominantly male (87%) and white (54%), and 21% had a history of injection-drug use.

During the study p…