Declining HIV/AIDS mortality in New York City

Background: New York City has only 3% of the U.S. population but has report ed nearly 16% of all AIDS cases. Methods: This is an observational study using the New York City vital event s and AIDS case surveillance registries to describe trends in HIV/AIDS mort ality from 1983 through June 30, 1998. Results: Annual HIV/AIDS deaths increased steadily until stabilizing at 704 6 in 1995, declined 29% to 4998 in 1996, and declined 47% to 2625 in 1997. Comparing data from 1997 with those from 1995, declines occurred in all dem ographic groups and in all major HIV transmission categories: 74% in men wh o have sex with men, 68% in injecting drug users, and 64% in heterosexuals. In the first 6 months of 1998, declines were smaller than they had been in previous 6-month intervals in all demographic groups except Hispanic males and those between 35 and 44 years of age. From 1995 to the first 6 months of 1998, the number of people living with AIDS in New York City increased 2 2% (from 32,692 to 39,976). Conclusions: The precipitous 63% decline in HIV/AIDS deaths from 1995 to 19 97 occurred at the same time that more effective antiretroviral therapies b ecame widely available. The slowing in the mortality decline observed in 19 98, however, suggests that although these new therapies may have a profound effect at the population level, deaths due to AIDS will continue.