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In cities like San Francisco, where I sit, a relentless focus on increasing the number of HIV-positive people taking anti-retroviral medications early in infection has been primarily responsible for improvements in their health outcomes, and reducing HIV incidence. With new HIV cases numbering some 1,200 a year a decade ago, San Francisco now estimates that there will have been some 330 new cases in 2013. As a group of agencies develop a strategy for “Getting to Zero” in San Francisco, the plan’s architects firmly believe that PrEP could have an important effect on incidence, too.
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