Abstract
Between 1981 and August 1997, 100,000 AIDS cases were reported in New York City (NYC): 77,067 men, 20,818 women, 307 teenagers, and 1,808 children. This report examines AIDS trends in NYC as the epidemic evolved from a predominantly white male epidemic among men with same sex contact (MSM) mostly from a single borough to a geographically diffuse epidemic that includes injecting drug users (IDU), persons of color, and women infected heterosexually. Case data were collected by active surveillance methods augmented by electronic laboratory based reporting. Mortality data were obtained from NYC Vital Statistics. 1990 Census data were used to derive incidence rates and prevalence by neighborhood income. Rates per 100,000 adults by neighborhood ranged from 260 to 5,500. Total AIDS incidence peaked in 1993 and has subsequently declined. Among men there was a shift from MSM to IDU as the predominant risk group, and increasing incidence among men reporting heterosexual contact. IDU was the leading risk factor among women, and women increased from 8 to 30 percent of all cases between 1982 and 1997. Unlike incidence, AIDS prevalence is rising among socially and economically marginalized populations, and will remain a major public health challenge well into the next century.
Similar content being viewed by others
References
Blum, S., Singh, T. P. & Gibbons, J. ntet al. (1994). Trends in survival among persons with acquired immunodeficiency syndrome in New York City: the experience of the first decade of the epidemic, American Journal of Epidemiology 39: 351–361.
Bozette, S. A., Berry, S. H. & Duan, N. ntet al. (1998). The care of HIV-infected adults in the United States, New England Journal of Medicine 339: 1897–1904.
CDC, Centers for Disease Control (1982). Update on AIDS, Morbidity and Mortality Weekly Report 31: 507–514.
CDC (1984). Declining rates of rectal and pharyngeal gonorrhea in males, New York City, Morbidity and Mortality Weekly Report 33: 295–297.
CDC (1985). Revision of the case definition of acquired immunodeficiency syndrome for national reporting, United States, Morbidity and Mortality Weekly Report 34: 373–375.
CDC (1987). Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome, Morbidity and Mortality Weekly Report 36 (suppl): 15–155.
CDC (1992). 1993 revised classification for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults, MMRW 1992: 41 (RR-17).
CDC (1997). HIV/AIDS Surveillance Report 9(2): 8–9.
General Accounting Office (1998). HIV/AIDS drugs funding implications of new combination therapies for federal and state programs. Washington, DC (GAO/HEHS-99-2).
Chiasson, M. A., Berenson, L. & Li, W. ntet al. (1997). Declining AIDS mortality in New York City. 4th Conference on Retroviruses and Opportunistic Infections. Washington, DC.
Des Jarlais, D. C., Friedman, S. R. & Sotheran, J. L. ntet al. (1994). Continuity and change within an HIV epidemic: injecting drug users in New York City, 1984 through 1992, Journal of the American Medical Association 271: 121–127.
Fordyce, E. J., Araneta, M. R. G. & Stoneburner, R. ntet al. (1988). Disproportionate change in sexual behavior among minority gay/bisexual men in New York City: 1981–86. 4th International Conference on AIDS, Stockholm, Sweden (Abstract 6549).
Fordyce, E. J., Blum, S., Shum, R., Singh, T. P., Chiasson, M. A. & Thomas, P. (1995). The changing AIDS epidemic in New York City: a descriptive birth cohort analysis of AIDS incidence and age at diagnosis, AIDS 9: 605–610.
Fordyce, E. J., Thomas, P. & Shum, R. (1997). Evidence of an increasing AIDS burden in rural America, Statistical Bulletin 78(2): 2–9. Metropolitan Life Insurance, New York.
Fordyce, E. J., Williams, R. D. & Surick, I. W. ntet al. (1995). Trends in the AIDS epidemic among men who reported sex with men in New York City: 1981–1993, AIDS Education and Prevention 7 (suppl): 3–12.
Hu, D. J., Frey, R. & Costa, S. J. ntet al. (1994. Geographical AIDS rates and socio-economic variables in the Newark, New Jersey metropolitan area, AIDS and Public Policy Journal 9(1): 20–25.
Krasner, M. (1994). Zip Code area profiles, 1994. New York: United Hospital Fund.
Longini, I. M. (1991). The dynamics of CD4C t-lymphocyte decline in HIV infected individuals: a Markov modelling approach, Journal of AIDS 4: 1141–1147.
Obiri, G. U., Fordyce, E. J., Singh, T. P. & Forlenza, S. (1998). Effect of HIV/AIDS versus other causes of death on premature mortality in New York City, 1983–1994, American Journal of Epidemiology 147: 840–845. PRODAS, Professional database analysis system, version 3.2. (1987). Conceptual Software, Inc.
Shapiro, M., Morton, S. & McCaffrey, D. ntet al. (1998). Variations in care for HIV/AIDS in the United States: results from the HCSUS study. 12th World AIDS Conference, Geneva, 28 June–3 July 1998 (Abstract 42296).
SAS, Statistical analysis system, version 612. (1996). Cary, NC: SAS Institute Inc.
Stoneburner, R., Chiasson, M. A. & Weisfuse, I. B. ntet al. (1990). The epidemic of AIDS and HIV-1 infection among heterosexuals in New York City, AIDS 4: 99–106.
Thomas, P. A., Weisfuse, I. B. & Greenberg, A. E. ntet al. (1993). Trends in the first ten years of AIDS in New York City, American Journal of Epidemiology 137: 121–133.
US Bureau of the Census (1992). 1990 Census public use data tapes, summary tape file 3B, Department of Commerce, Washington, DC.
US Congress (1990). The Ryan White Comprehensive AIDS Resources Emergency Act of 1990. Washington, DC: Congressional Record, US House of Representatives. H6024–H6048.
World Health Organization (1979). International Classification of Diseases, 9th Revision. Geneva, Switzerland.
World Health Organization (1986). Acquired immunodeficiency syndrome (AIDS): WHO/CDC case definition for AIDS, Weekly Epidemiological Record 7 March: 69–72.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Fordyce, E.J., Singh, T.P., Vazquez, F.M. et al. Evolution of an urban epidemic: The first 100,000 AIDS cases in New York City. Population Research and Policy Review 18, 523–544 (1999). https://doi.org/10.1023/A:1006214312764
Issue Date:
DOI: https://doi.org/10.1023/A:1006214312764