AIDS in New York City: Update 2001

By Dr. Elizabeth M. Whelan

President, ACSH

Question 1

In 1990, the New York City Department of Health estimated that there were 200,000 New Yorkers infected with the AIDS virus. Was that estimate on target?

Answer

Looking back with the benefit of 11 years of hindsight, we now know that the 200,000 estimate overstated the prevalence of HIV infection in New York City (NYC), perhaps by a factor of two or three. Given the limited data available at that time, however, it is understandable how this overestimate came to be.

Question 2

How many New Yorkers have died from AIDS since the disease was first reported in the early 1980s?

Answer

As of March 31, 2000, there have been 72,207 AIDS cases known dead in NYC. The City began counts of AIDS deaths in l981.

Question 3

How many New Yorkers are suffering from AIDS or infected with HIV?

Answer

ACSH attempted to find an answer to that question, but we were unable to do so. There are no official or unofficial estimates of the total burden of HIV or AIDS now in NYC.

We do know that there have been 116,316 AIDS total cases diagnosed in NYC, a number that includes 72,207 AIDS cases known dead, up until March 31, 2000.

Thus, one might assume that those not known dead (44,109 New Yorkers) have AIDS/HIV at the present time and that that number is the minimum estimate of the current HIV burden. But it does not include (a) unreported or not-yet-counted AIDS cases, and (b) reported and unreported HIV-positive persons who do not have criteria that meet the definition of AIDS.

HIV seropositivity became a reportable statistic in June 2000 (physicians are now required to provide named reporting of newly diagnosed HIV infection, in addition to the previously required reporting of AIDS cases).

Therefore, as of spring 2001, New York City does not have up-to-date statistics on the number of reported HIV-positive patients. When we do get these newly reported figures, even these may underestimate the number of HIV-positive persons, as this figure will represent only those who have been tested and reported.

A major finding of this ACSH review is that there are very few reliable statistics available about the prevalence of HIV infection in New York City, the variation in prevalence by key demographic variables, or the profile of AIDS prevalence for the next decade in the city. This is critically needed information. ACSH recommends that the City of New York make a more concerted effort to develop reliable estimates of the prevalence and demographics of HIV infection. This effort should be facilitated by mandatory HIV reporting now in effect, but will need to be supplemented through population surveys and other statistical means.

Question 4

How many New Yorkers are currently receiving anti-HIV therapy?

Answer

Once again, ACSH was not able to determine this figure. There is no central reporting of numbers of antiviral medications prescribed to combat AIDS.

Question 5

How many new HIV infections occur each year in NYC?

Answer

Because HIV infections were not required to be reported until June 2000, and until then only persons who were diagnosed with AIDS were reported, we do not know how many HIV infections occur each year.

Question 6

What percentage of gay men and intravenous drug users of NYC are infected with HIV? How does that break down by race?

Answer

The full answer to this question is also not available from City statistics. A very limited bit of data has been released, specifically:

The NYC Department of Health recently presented data revealing the racial disparities among gay men who are HIV-infected. Based on a department survey of 542 gay men in NYC, aged 23 to 29 years, they found that two percent of the gay white men and 14 percent of the Latinos were HIV-positive, while an alarming 33 percent of the African-Americans were HIV-positive.

In the classification system used for this report, men who both use injection drugs and engage in sex with other men (men-sex-with-men, or MSM) are categorized as MSM, so that the overall proportion that has injected drugs is higher than that shown in the tables.

Question 7

ACSH reported that during the week of January 21, 1990, an average of 1,981 hospital beds were occupied by AIDS patients in NYC about 8 percent of the general bed capacity. What are those percentages in 2001?

Answer

These data are no longer reported to the City, and thus estimates are not available. It appears that because AIDS and HIV disease are now less likely to require hospitalization, and are instead treated on an outpatient basis, that it is not as critical as it was in l990 to be aware of the size of the hospitalized AIDS population.