Fourteen years after his death sentence, Randy Silva is in the best shape of his life.

Silva, 51, was diagnosed with HIV in September 2001. In 2007, after suffering a heart attack while hospitalized at San Francisco General Hospital with AIDS-related pneumocystis pneumonia, he was told he had 48 hours to live.
“I expected to die,” he said recently.

But he didn’t. He finished a doctorate in clinical psychology last year. He has an active romantic relationship with his partner, who is 24 — and HIV negative.
And throughout San Francisco, there are more and more people like him.

New HIV infections and deaths of HIV-infected people in The City dropped more than 17 percent from 2013 to 2014, according to the Department of Public Health.
There were 302 new HIV diagnoses last year, and 177 deaths of HIV-infected people, according to the department. That’s down from 371 and 209, respectively, the year before.

Since the HIV/AIDS epidemic began in the 1980s, those numbers are the lowest ever recorded in San Francisco.

The most telling statistic may be this: Since 2012, when the drug Truvada was approved by the U.S. Food and Drug Administration as an HIV/AIDS prevention drug, new infections have dropped by 30 percent in The City.

The success of Truvada-centered PrEP, or pre-exposure prophylaxis, is also proof positive for some public health officials that their goal of getting to zero new infections is realistic and achievable.

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