A tale of two futures: HIV and antiretroviral therapy in San Francisco

Science. 2000 Jan 28;287(5453):650-4. doi: 10.1126/science.287.5453.650.


The effect of antiretroviral therapy (ART) in preventing human immunodeficiency virus (HIV) infections and averting acquired immunodeficiency syndrome (AIDS) deaths in the San Francisco gay community over the next 10 years was predicted. A transmission model was coupled with a statistical approach that enabled inclusion of a high degree of uncertainty in the potential treatment effects of ART (in terms of infectivity and survival), increase in risky behavior, and rate of emergence of drug resistance. Increasing the usage of ART in San Francisco would decrease the AIDS death rate and could substantially reduce the incidence rate.

Publication types

  • Comment
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome / mortality
  • Anti-HIV Agents / therapeutic use*
  • Drug Resistance, Microbial
  • Drug Therapy, Combination
  • Forecasting*
  • HIV / drug effects
  • HIV Infections / drug therapy*
  • HIV Infections / prevention & control*
  • HIV Infections / transmission
  • HIV Infections / virology
  • Homosexuality
  • Humans
  • Models, Biological
  • Models, Statistical
  • Monte Carlo Method
  • Probability
  • Risk-Taking
  • San Francisco / epidemiology


  • Anti-HIV Agents