HIV INCIDENCE ESTIMATES
NEW YORK STATE, 2013
INTRODUCTION
HIV incidence data 1 estimate the number of persons who become newly infected in a given year. The overall
benchmark for New York State’s Ending the Epidemic initiative is a reduction in such cases to 750 by the end of 2020.
This document reports NYS incidence estimates and population rates for 2006-2013.
HIGHLIGHTS FROM 2013 INCIDENCE ESTIMATES
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NYS had an estimated 2,925 new HIV infections in 2013 or 17.6 infections per 100,000 population.
Non-Hispanic blacks and Hispanics made up almost 70% of estimated new infections, although their
combined population proportion was just 32% in 2013. The estimated rate for non-Hispanic blacks (41.6
per 100,000) was six times that of non-Hispanic whites (6.8 per 100,000), and the rate for Hispanics was
five times higher (34.0 per 100,000).
People ages 25-34 had the greatest estimated number of new infections of any age group (966) and the
highest rate (34.5 per 100,000). In 2013, one in every three estimated new infections was in persons aged
25-34 years, although only 16.9% of NYS residents were age 25-34 in 2013.
Men who have sex with men (MSM) comprised over two-thirds of estimated new infections (71%).
Estimated new infections among men (2,339) were four times higher than those among women (585).
NYS INCIDENCE ESTIMATES BY POPULATION GROUP, 2013
By Race/Ethnicity
By Age
9%
23%
8%
23%
14%
33%
22%
White
Black
Hispanic
35%
MR, NA/AN, A/PI*
* Multirace, Native American/Alaska Native, Asian/Pacific Islander
33%
13-24
25-34
35-44
45-54
55+
By Sex at Birth
By Risk
21%
20%
8%
71%
MSM
IDU
DEER | NYSDOH | December 2015
Other
Male
80%
Female
1
STATEWIDE INCIDENCE TREND 2006 – 2013
The new infection estimates for each year are shown in Figure 1a along with the 95% confidence interval. Between
2006 and 2013, estimated new HIV infections decreased 39%. The estimated incidence rates (i.e., the number of
new infections per 100,000 population) and 95% confidence intervals are shown in Figure 1b. Between 2006 and
2013, the estimated incidence rate decreased by 41%, a statistically significant decrease.
Figure 1a. NYS Incidence Estimates
6,125
Estimated New Infections
6,000
5,682
5,191
5,000
4,933
4,209
4,829
4,000
4,184
4,240
4,257
3,631
3,977
3,000
3,509
3,547
3,472
3,628
3,000
3,051
2,925
3,072
3,052
2,000
3,385
2,593
2,527
2,464
2012
2013
1,000
0
2006
2007
2008
2009
2010
2011
Figure 1b. NYS Estimated Incidence Rate
40
37.8
35.2
Rate (per 100,000)
35
32.0
30
29.9
25
20
24.6
30.1
25.9
22.1
26.3
21.5
18.6
18.7
15.9
10
22.1
21.0
20.4
18.1
21.6
15
25.5
25.6
17.6
18.7
15.3
14.8
5
0
2006 2007 2008 2009 2010 2011 2012 2013
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DEER | NYSDOH | December 2015
RACE/ETHNICITY INCIDENCE TREND 2006 – 2013
Incidence by race/ethnicity is shown in Figures 2a and 2b. Between 2006 and 2013, estimated new HIV infections
decreased by race/ethnicity as follows: non-Hispanic white – 47% decrease; non-Hispanic black – 46% decrease;
Hispanic – 30% decrease; and for the combined non-Hispanic multi-race (MR), Native American/Alaska Native
(NA/AN), and Asian/Pacific Islander (A/PI) category – 11% decrease. The NYSDOH is unable to assess incidence
individually for numerically smaller race/ethnicity groups using CDC’s incidence methodology.
2,500
Figure 2a. NYS Estimated New HIV Infections by
Race/Ethnicity
Incidence Estimate
2,000
1,500
1,000
500
0
2006
Population Rate (per 100,000)
90
2007
2008
White
Black
2009
2010
2011
2012
Hispanic
MR, NA/AN, A/PI
2013
Figure 2b. NYS Estimated Incidence Rate by
Race/Ethnicity
80
70
60
50
40
30
20
10
0
2006
White
2007
2008
Black
2009
2010
Hispanic
2011
2012
2013
MR, NA/AN, A/PI
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DEER | NYSDOH | December 2015
AGE INCIDENCE TREND 2006 – 2013
A decrease of 61% in estimated new HIV infections is seen for the age group 35-44 between 2006 and 2013. Although
a slight decrease is also seen in age group 25-34, in 2013 one out of every three new HIV infections was found to
occur in this age group.
Table 3a. NYS Estimated New HIV Infections by Age
1,800
1,600
Incidence Estimate
1,400
1,200
1,000
800
600
400
200
0
2006
2007
13-24
2008
25-34
2009
2010
35-44
2011
45-54
2012
2013
55+
Table 3b. NYS Estimated Incidence Rate by Age
Population Rate (per 100,000)
70
60
50
40
30
20
10
0
2006
13-24
2007
2008
25-34
2009
2010
35-44
2011
45-54
2012
2013
55+
4
DEER | NYSDOH | December 2015
RISK INCIDENCE TREND 2006 – 2013
Estimates by transmission risk category are shown in Figure 4. From 2006-2013, there was a 25% decrease in new
HIV infections among MSM, compared to a 63% decrease among IDU and a 57% decrease among “other risk.” Other
risk includes heterosexual risk cases and cases that lack a CDC risk category designation. In this estimation procedure,
estimated infections among persons with both MSM and IDU risk are grouped with IDU risk.
Figure 4. NYS Estimated New HIV Infections by Risk
3,500
Incidence Estimate
3,000
2,500
2,000
1,500
1,000
500
0
2006
2007
2008
2009
MSM
2010
IDU
2011
2012
2013
Other
SEX AT BIRTH INCIDENCE TREND 2006 – 2013
Estimates by sex at birth are shown in Figures 5a and b. A 35% decrease was seen among males and a 59% decrease
among females from 2006-2013. Of the total estimated infections for 2013, 80% were in males.
4,500
Figure 5a. NYS Estimated New HIV Infections
by Sex at Birth
4,197
Incidence Estimate
4,000
3,500
3,455
2,937
3,000
2,845
2,785
2,430
2,389
2,500
2,339
2,000
1,500
1,374
1,303
994
1,000
845
663
783
500
570
585
2012
2013
0
2006
2007
2008
Male
2009
2010
2011
Female
5
DEER | NYSDOH | December 2015
Population Rate (per 100,000)
60
Figure 5b. NYS Estimated Incidence Rate by Sex at
Birth
50
40
53.9
44.7
37.3
30
20
36.1
35.3
30.5
16.4
30.6
29.3
6.6
6.8
2012
2013
15.3
11.8
9.9
10
7.8
9.2
2010
2011
0
2006
2007
2008
2009
Male
Female
SPECIAL FOCUS: DEMOGRAPHIC TRENDS AMONG MSM 2006-2013
To further examine MSM subpopulations, incidence estimates were created for 12 subgroups 2 characterized by age
(13-29, 30+ years), transmission risk (MSM, non-MSM/persons with all other risks including those with unknown
risk), and race/ethnicity (non-Hispanic black, Hispanic, and Other). The ‘other’ race/ethnicity designation includes
non-Hispanic white, multi-race, Native American/Alaska Native, and Asian/Pacific Islander. Figure 6a shows
decreases over time in incidence estimates for both MSM and non-MSM. However, non-MSM have experienced a
percent decline more than twice that of MSM (59% decline among non-MSM vs. 25% among MSM). In 2013 an
estimated 71% of new infections were in MSM with 29% in non-MSM.
Figure 6a. NYS Incidence Estimates by
Major Risk Subgroups: 2006-2013
Estimated New Infections
3,500
3,000
2,500
2,000
1,500
1,000
500
0
2006
2007
2008
MSM
2009
2010
2011
2012
2013
Non-MSM
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DEER | NYSDOH | December 2015
Figure 6b shows 2006–2013 incidence trends among MSM and Non-MSM ages 13-29 and 30+. Between 2006 and
2013, large decreases in new infections were seen for all groups except the MSM 13-29 group, which experienced
an increase of 12% in the same period.
Figure 6b. NYS Incidence Estimates by Age/Risk
2000
1500
1000
500
0
2006
2007
MSM 13-29
2008
MSM 30+
2009
2010
2011
2012
Non-MSM 13-29
2013
Non-MSM 30+
Figures 7a-d examine more closely trends among the 12 subgroups. Here we see all risk/age/race subgroups
experiencing declining incidence since 2006, and a few subgroups experiencing small increases in 2013 over earlier
years.
Figure 7b. Non-MSM ages 13-29 by Race
Figure 7a. MSM ages 13-29 by Race
750
750
Est. New Infections
1000
Est. New Infections
1000
500
500
250
250
0
2006 2007 2008 2009 2010 2011 2012 2013
Black
Hisp.
Other
Figure 7c. MSM ages 30+ by Race
0
2006 2007 2008 2009 2010 2011 2012 2013
Black
Other
Figure 7d. Non-MSM ages 30+ by Race
1000
750
750
500
Est. New Infections
1000
Est. New Infections
Hisp.
500
250
250
0
2006 2007 2008 2009 2010 2011 2012 2013
Black
Hisp.
Other
0
2006 2007 2008 2009 2010 2011 2012 2013
Black
Hisp.
Other
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DEER | NYSDOH | December 2015
Figure 8 shows the estimated number of new infections occurring in each subgroup in 2013. It underscores the need
to ensure all populations benefit from the enhanced Ending the Epidemic efforts to reduce new HIV infections to
750 by the end of 2020. The black-shaded bars represent MSM groups; the gray-shaded bars represent non-MSM
groups.
Figure 8. NYS 2013 Incidence Estimates
among MSM and non-MSM Subgroups
Risk | Race | Age
MSM | OTHER | 30+
471
MSM | HISPANIC | 13-29
402
MSM | BLACK | 13-29
378
NON-MSM | BLACK | 30+
327
MSM | HISPANIC | 30+
321
MSM | OTHER | 13-29
275
MSM | BLACK | 30+
223
NON-MSM | HISPANIC | 30+
180
NON-MSM | OTHER | 30+
128
NON-MSM | BLACK | 13-29
96
NON-MSM | HISPANIC | 13-29
73
NON-MSM | OTHER | 13-29
50
0
100
200
300
400
500
CONCLUSION
New York State has made decisive progress in driving down new infections from 2006 levels. In order to reach the
goal of 750 new infections by the end of 2020 it will be important to capitalize on this progress, ensuring that Ending
the Epidemic activities effectively serve those groups where new infections continue to occur.
Questions about this report may be sent to the Bureau of HIV/AIDS Epidemiology at [email protected] or (518)
474-4284.
END NOTES
1
Incidence data, derived by using a CDC-developed method called the stratified extrapolation approach (SEA)
(http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919237/), combine a range of data sources and analytical
methods to produce an estimate of the number of new HIV infections in a given year. Whereas counts of newly
diagnosed cases may include HIV infections that occurred many years ago, incidence estimates are limited to only
those infections that happened within a specified time frame.
2
The subgroups were chosen to facilitate evaluation of HIV incidence among race/ethnicity and age subgroups of
MSM. To meet the minimum size requirements of the SEA procedures, disparate groups of individuals were
combined in the “non-MSM” category (males and females with IDU, heterosexual, and unknown risk) and in the
“other” race/ethnicity category (whites, Asian/Pacific Islanders, Native Americans/Alaska Natives, multiracial). The
aggregate estimate for these combined categories provides some information about the relative magnitude of
incidence in these groups, but the trajectory of the epidemic in any one group may not be accurately represented
by the aggregate number.
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DEER | NYSDOH | December 2015