Mr. Saklad,

You have probably seen this report in the New York Times.  

It is pasted below for your reference but I have extracted portions I
don't understand and you may be able to explain.

quote here:
Moreover, statistics released last week on syphilis, which researchers
say often tracks closely with H.I.V., show that the number of new
infections in San Francisco dropped 27 percent in the first six months
of this year, the first decline since 1998.
end quote here:

So if postive people are only having sex with positive people and HIV
and Syphilis tracks closely together, why isn't the syphilis rate just
as high except it is only among HIV positive people as opposed to the
rest of the population?  

If we accept that HIV positive for the most part can't reinfect other
HIV positive people, fine.  But you can have all the HIV positive people
in the world and those that have syphilis will certainly spread it to
other HIV positive people who do not have syphilis.  Is it because it is
hard to detect syphilis and since there is no reason for HIV positive
people to get tested as they have the disease everybody is looking for
and interested in, that the syphilis has been caught by them but has
gone unnoticed and sits quietly in their body from the last six months
yet to be tested for and treated thus affecting the above noted data?  

complete article pasted here:
 

A Good Report on AIDS, and Some Credit the Web

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By DEAN E. MURPHY
Published: August 18, 2005

SAN FRANCISCO, Aug. 17 - The conversation over tossed salad, dinner
rolls and iced tea was about dating. Mostly predictable stuff, like
where to meet guys and the hottest men-seeking-men Web sites.
Skip to next paragraph
Jim Wilson/The New York Times

A study has found that new H.I.V. infections in San Francisco are fewer
than local health officials thought.

But the gathering last week at a coffee shop in the largely gay Castro
district here was not a casual pickup session. The dozen or so men were
infected with the virus that causes AIDS, and the talk was of
"responsible sex," not through condoms, necessarily, but through
choosing sex partners who are already infected.

"I don't think I could sleep at night if I knew I had infected another
human being," said one of the men, Don Stewart, who tested positive for
the virus, H.I.V., five years ago.

The monthly social event, called Positive Space and organized by an AIDS
prevention group, is among the scores of educational meetings,
workshops, seminars and parties that health officials here say may be
contributing to a significant decline in the incidence of H.I.V. among
gay men in San Francisco.

The national Centers for Disease Control and Prevention estimated in a
report in June that new infections in San Francisco among men who have
sex with men were occurring at about half the rate previously calculated
by city health officials - 1.2 percent a year instead of 2.2 percent.
That is the lowest rate reported in San Francisco since 1997 and the
lowest among five cities with significant gay populations studied by the
disease control agency.

Since the report's release, health officials here, known for their
cautious approach to shifts in AIDS trends, have been scrambling to
confirm the results and offer an explanation. Some officials have said
that the decline has been fueled by conventional efforts like stepped-up
H.I.V. treatment programs, easier and more regular tests, and so-called
harm-reduction strategies like discouraging the use of crystal
methamphetamine, a drug blamed for helping to spread the disease by
lowering inhibitions.

But other signs, like the proliferation of matchmaking Web sites for men
infected with H.I.V. and the relatively high number of men here who know
their H.I.V. status, point to a growth in the number of men looking for
partners with the same status. The practice is known as sero-sorting,
which involves men choosing sex partners based on their common
serostatus, a term that refers to the presence of antibodies to a
particular infectious agent in the blood.

"Studies have shown when people have knowledge of their sero-status,
they take that knowledge and use it to protect their partners," said Dr.
Patrick S. Sullivan, chief of the behavioral and clinical surveillance
branch at the disease control centers. "Sero-sorting is one piece of
that whole benefit that arises from people learning their status through
H.I.V. testing."

Since the AIDS epidemic began nearly 25 years ago, San Francisco has
often been a laboratory of sorts, with many behavioral changes, both
good and bad, occurring here before spreading to other cities.

Though the disease control centers' report is just one in a sea of
statistical analyses and studies about H.I.V., containing the usual
caveats about possible reporting errors and potentially skewed sampling,
the emerging consensus in San Francisco is that the new numbers signal a
reversal in a sharp rise in infections that began about seven years ago.

The highest incidence of new infection among men who have sex with men,
8 percent, was found in Baltimore, followed by Miami with 2.6 percent,
New York with 2.3 percent and Los Angeles with 1.4 percent, according to
the report's preliminary estimates, which were based on H.I.V. tests
conducted among 1,767 men from June 2004 to April 2005.

"When I first saw the data, I was skeptical and had to be convinced,"
said Jeff Sheehy, an adviser on AIDS issues to Mayor Gavin Newsom of San
Francisco. "There's a lot of fortunate events coming together to drive
this. It's incredibly important to start people really looking at the
factors driving the downward trend and reinforce and encourage those
factors."

The federal report did not delve into possible causes, and there is no
specific evidence to support any definitive conclusion. Dr. Sullivan
said that the report was a "snapshot in time," and that there would not
be directly comparable data available until another survey was conducted
in 2007.

He said there was a variety of possible contributors to the lower
incidence of infection in San Francisco. But some of the men gathered at
the coffee shop in the Castro, the H-Cafe, suggested that sero-sorting -
while imperfect because it relies on men being truthful about their
H.I.V. status and gives some an excuse to avoid using condoms - was
among the most important reasons for the decline.

"I very rarely date a negative person," said Stan Pugh, a massage
therapist who said he had been H.I.V. positive since the early 1980's.
"If I do, it is only safe sex. But when you have two positives together,
we tend to have sex any way we want to."

The surge in recent years in men turning to the Internet to find casual
sex partners has made sero-sorting easier. Web dating often eliminates
the awkward and too often skipped face-to-face discussion just before
sexual relations about who is infected with what.

"Everything is going well and you dread finding the right moment to come
out with that," said Matt Kennedy, who tested positive for H.I.V. a year
ago and who works for the Stop AIDS Project, the nonprofit group that
organizes the meetings at the H-Cafe.

Matchmaking Web sites for men who are H.I.V. positive have flourished,
and many personal ads on more general sites, like Craigslist.com, also
include details and demands from prospective sex partners about H.I.V.
status.

In the shorthand of the sexually explicit personals, "POZ UB2" indicates
a man who is H.I.V positive seeking the same. In a recent Craigslist
item under the headline "Long Party Sessions Wanted," one San Francisco
man asked to meet "sometime today" and posted his age, height, hair and
eye colors, and the message "neg (u2 plz)."

Though San Francisco has a high percentage of men who are H.I.V.
positive - about a quarter of the roughly 60,000 gay men here, according
to city estimates - health officials said sero-sorting was easier here
than in many other cities because the men were relatively well informed
about their status. The disease control centers estimated in June that
77 percent of the city's infected men knew they were infected, compared
with estimates of 48 percent in New York and 38 percent in Baltimore.

J. Jeff McConnell, who directs a study of about 300 people who are
H.I.V. positive at the Gladstone Institute of Virology and Immunology at
the University of California, San Francisco, said recent data showed
that sero-sorting patterns were "becoming stronger" among the study's
gay participants.

Data from three recent months showed that the 176 gay participants
engaged in 5,500 acts of sexual intercourse with other men, with about
80 percent of the acts occurring with men known to be H.I.V. positive.

Despite concerns that the Internet facilitates high-risk sex, Mr.
McConnell said, "Ultimately, sex that occurs from the Internet is no
more risky than sex from any other venues because of sero-sorting."

Yet there are drawbacks. Herb Topping, another of the H-cafe patrons,
said that many men who are H.I.V. positive worried about the possibility
of becoming infected with a new strain of the virus. Mr. Topping said he
insisted on safe-sex practices, like use of condoms, even when having
sex with a positive partner, but that other worried positive men seek
out willing negative partners.

"I think that is a struggle in the community right now," said Mr.
Topping, who tested positive for H.I.V. five years ago.

Health officials recommend safe-sex practices regardless of the partner.
But Dr. Jeffrey D. Klausner, who oversees sexually transmitted disease
prevention at the San Francisco Department of Public Health, said
worries about acquiring a second strain were mostly unfounded.

Dr. Klausner said research had shown that the risk was low, particularly
after the first year or two of infection, and paled in comparison with
the risks associated with men who are H.I.V. positive having sex with
men who are not.

"From a public health perspective," he said, "it is much more important
that people have sexual contacts of the same status."

Though it will take months for health officials to come up with firm
numbers of their own, preliminary reviews of some data collected at city
health clinics and in surveys by the Stop AIDS Project indicate a trend
similar to that reported by the disease control centers.

Moreover, statistics released last week on syphilis, which researchers
say often tracks closely with H.I.V., show that the number of new
infections in San Francisco dropped 27 percent in the first six months
of this year, the first decline since 1998.

"We interpret this C.D.C. report as good news, and there are some other
encouraging trends and results of other studies," Dr. Willi McFarland,
director of the H.I.V. seroepidemiology unit at the San Francisco health
department, said in an e-mail message. "But we definitely do need to
corroborate and independently confirm any decrease in H.I.V. incidence
by carefully examining other data. We also need to figure out if this is
true, then why."