New diagnoses of HIV in New York City have reached an all-time low

30 november 2017

New diagnoses of HIV in New York City have reached an all-time low, the Health Department announce. In 2016, 2,279 people were newly diagnosed with the virus — down 8.6% from 2015, according to data from the city's HIV Surveillance Annual Report.

“I would even go so far to say that it's good and big news,” Dr. Demetre Daskalakis, the Health Department's Deputy Commissioner for Disease Control, told the Daily News. “I'm pretty euphoric about the news, to be honest.”

That's down from 5,906 new infections in 2001, when the city first started tracking new HIV diagnoses. The drop was even starker among men who have sex with men: Among that population, diagnoses fell from 1,450 in 2015 to 1,236 in in 2016 — a 14.8% drop.

New diagnoses among that group had been stalled in recent years, Daskalakis said — and the city believes this year's sudden drop is thanks to increased use of pre-exposure prophylaxis, or PrEP. Those are preventative drugs that can be taken by people who don't have HIV, but are at risk of it — and are increasingly being prescribed to men who have sex with men.

“I'm excited because if this is what happened in 2016, I can only imagine what's going to happen in 2017 in terms of accelerating the decline of new infections,” he said. “We've launched so many new interventions that focus on getting people on new medicines.”

The city estimates that 5% of men who have sex with men were on PrEP at the start of 2016 — but that grew to 30% by the end of the year.

It was an area “where we'd seen no movement,” Charles King, the director of AIDS-service organization Housing Works, said. "And suddenly we're seeing sudden movement."

He, too, believed PrEP to be behind much of the decrease — in part because there had not been a similar decrease in diagnoses among groups that are less likely to be prescribed PrEP. In fact, infections among women rose in 2016.

“That's the part that to me is the most concerning,” Daskalakis said. In the past, “I would look at the (men who have sex with men) diagnoses and say, 'oh we've plateaued. And now I look at the women diagnoses as we've gone down (elsewhere) and say, 'oh we've plateaued.'”

After having success with men, the city will look to make more women who might be at risk of contracting HIV — and their doctors — aware of PrEP in the next year.

“When the providers of care for women really buy into pre-exposure prophylactics and understand its role, all of a sudden they're prescribing to their patients,” Daskalakis said.

The city has also looked to overcome racial disparities in diagnoses. Men of color still make up the majority of new diagnoses, though new infections declined among black, Latino and white men in 2016. The city worked to reach black and Hispanic men with information about PrEP in 2016, Daskalakis said.

That included rebranding STD clinics to sexual health clinics and establishing a more advanced system for delivering PrEP to people who need it. Among those receiving PrEP from the city's clinics, about 60% are black and Latino — a much higher share of the population on PrEP than nationally.

Among those who do have HIV, 76% have achieved “viral suppression.” People with HIV who take antiretroviral medicines to maintain an undetectable viral load for at least six month have effectively no risk of sexually transmitting HIV, according to the Health Department.

King said he wanted to see that figure increase in the city — in part by getting people other than doctors involved in ensuring people stay on their medicine.

“We need for non-clinical providers, whether it's housing, case management, anybody who is touching the lives of people who are HIV-positive, to own, track, report on viral suppression for the people they serve,” he said.

Autor: Anna Fedoryak