Charting the epidemic: the case study of HIV screening of injecting drug users in San Francisco, 1985-1990.

HIV screening for drug users in treatment began in San Francisco in 1985, and was followed by street screening, community outreach, bleach distribution and other intervention programs. The HIV seroconversion rate fell from 4.5% per year in 1985-86 to 1.7% per year in 1987-88 and has remained stable at about 2% per year since 1988. While this decline cannot be attributed to specific programs, the broad spectrum of interventions in San Francisco appears to be keeping the new infection rate low. Future programs should aim at reducing heterosexual HIV transmission, at intervening with multiply-diagnosed drug users, and at providing service to homeless and other very poor drug-using groups.