Background:  Prior to the implementation of regulations in June 2000 requiring  New York health care providers and laboratories to report newly diagnosed HIV infection (non-AIDS), the HIV epidemic in New York City was  monitored primarily through AIDS-case reporting. We report on the descriptive epidemiology of HIV/AIDS in New York City, including newly available population-based epidemiologic data on persons diagnosed with HIV (non-AIDS).

Methods:  The study population included New York City residents diagnosed with HIV (non-AIDS) and AIDS during 2001, and persons living with HIV/AIDS (PLWHA) as of December 31, 2001. Rates of incident HIV diagnoses, prevalence of diagnosed PLWHA, and HIV-related and all-cause death rates among PLWHA were estimated using 2000 census data.

Results:  During 2001, 6478 persons in New York City (81/100,000) had incident HIV diagnoses.  Among these, 4207 (65%) were male and 2271 (35%) were female. Rates of incident HIV diagnoses were significantly higher in non-Hispanic blacks (rate ratio [RR] = 5.0; 95% CI = 4.7 - 5.4) and Hispanics (RR = 2.5; 95% CI = 2.3 - 2.7) compared with non-Hispanic whites. Among those with incident HIV diagnoses in 2001, 1770 (27%) persons were concurrently diagnosed with AIDS.  As of December 31, 2001, 75,550 persons were diagnosed, reported, and known to be living with HIV/AIDS.  This includes an estimated 3.9% of all males aged 40 to 49 years, 2.8% of males residing in Manhattan, and 2.3% of non-Hispanic black males.  The age-adjusted, all-cause mortality rate among diagnosed PLWHA was 4.1 (95% CI = 3.9 - 4.3) times higher than that of the general population of New York City in 2001. The population distribution of persons diagnosed with HIV in 2001 differs from that of PLWHA; specifically, a higher proportion of persons diagnosed in 2001 are female (35% versus 30%), non-Hispanic black (53% versus 44%), and aged 30 to 39 years (36% versus 29%) compared with PLWHA.

Conclusions:  Newly available population-based surveillance data on persons diagnosed with HIV (non-AIDS) are an important adjunct to AIDS surveillance data. These data can be used to more accurately describe the current status of the HIV epidemic and to redirect HIV prevention efforts to better target persons at greatest risk of acquiring HIV infection.  The large proportion of persons diagnosed concurrently with HIV and AIDS represent missed opportunities to reduce the transmission of HIV and the morbidity associated with HIV infection.

Keywords: surveillance; HIV infection; New York City