Priority Area: Infectious Disease - Human Immunodeficiency Virus (HIV)

The Burden of Infectious Diseases - Human Immunodeficiency Virus (HIV)

Approximately two million New Yorkers are tested for HIV every year. Yet, the Centers for Disease Control and Prevention (CDC) estimates that 21% of HIV-infected persons are unaware of their status and one-third of persons newly identified with HIV have either a concurrent AIDS diagnosis or are diagnosed with AIDS within one year. Sexual transmission is now responsible for the vast majority of new HIV cases. With approximately one-half of persons over 25 having other sexually transmitted infections, there is a risk of New Yorkers acquiring HIV at later ages. The face of New York's epidemic has changed remarkably over time. For example, in the early 1990's, 52 percent of all persons reported with AIDS were injection drug users. Now, the CDC estimates that only eight percent of those newly infected in 2006 are injection drug users.

Estimates of new infections in 2006 show that African Americans are 7.5 times more likely to be newly infected as Whites, with 105 new infections per 100,000 people as compared with 14 per 100,000 for Whites. Hispanics are also more likely than Whites to acquire new HIV infectionss, with an estimated 70 Hispanics newly infected per 100,000 population.


By the year 2013:

  • Increase the number of persons between the ages of 18 and 64 who report ever having an HIV test from 50 to 55%.
  • Reduce the percentage of people with concurrent and late HIV and AIDS diagnoses from 35% to 20%.
  • Assure that SDOH-sponsored HIV and STD prevention programs are fully integrated.
  • Determine accurate hepatitis C incidence and prevalence rates for use in conjunction with available research findings to guide decision making.

Indicators for Tracking Public Health Priority Areas

Each community's progress towards reaching these Prevention Agenda Objectives will be tracked so members can see how close each community is to meeting the objectives.

Data and Statistics

Strategies – The Evidence Base for Effective Interventions

  • 2008 Compendium of Evidence-Based HIV Prevention Interventions
    The evidence-based interventions, listed in this 2008 Compendium, have been identified by the HIV/AIDS Prevention Research Synthesis Project through a series of efficacy reviews. These interventions represent the strongest HIV behavioral interventions in the literature to date that have been rigorously evaluated and have demonstrated efficacy in reducing HIV or STD incidence, HIV-related risk behaviors or promoting safer behaviors.
    Interventions to Identify HIV-positive People Through Partner Counseling and Referral Services
    The Task Force on Community Preventive Services recommends provider referral partner notification based on sufficient evidence of effectiveness in increasing HIV testing and identification of previously undiagnosed HIV-positive individuals. There was insufficient evidence to determine the effectiveness of partner notification using either patient or contact referral because too few studies qualified for review.
    Opioid Overdose Prevention Program
    Drug overdose is a significant problem in New York State. A new life-saving law took effect on April 1, 2006, making it legal in NYS for appropriately trained non-medical persons to administer naloxone to other individuals to prevent opioid overdoses from becoming fatal. Naloxone (Narcan) is a prescription medicine that reverses an overdose by blocking opioids in the brain for 30 to 90 minutes. Training includes: education about opioid overdose, how to identify an overdose, steps to be taken and the administration of naloxone.
    Prevention of HIV/AIDS, other STIs and Pregnancy: Interventions to Reduce Sexual Risk Behaviors or Increase Protective Behaviors to Prevent Acquisition of HIV in Adult Men Who Have Sex with Men (MSM)
    Person-to-person behavioral interventions, for men who have sex with men, can be implemented at the individual, group, and community levels. Components can include information and skill-building to change knowledge, attitudes, beliefs and self-efficacy.
    Syringe Access
    This is an intervention to prevent the transmission or acquisition of HIV, hepatitis B and C, and other blood-borne infections among drug injectors
    Currently in New York State, there are two initiatives facilitating legal access to sterile syringes (without prescriptions) by drug injectors: 1) the syringe exchange programs (SEPs); and 2) the Expanded Syringe Access Program (ESAP). Both of these interventions have been studied and proven to reduce transmission of HIV and hepatitis C among drug injectors. All SEPs and several ESAP-registered providers have options for safe disposal of syringes.
    Youth Development Behavioral Interventions
    Youth development behavioral interventions use a holistic approach to prevent adolescent risk behavior. The Task Force on Community Preventive Services recommends interventions coordinated with community services to reduce sexual risk behaviors in adolescents. Components of these interventions consist of social, emotional, or cognitive competence training. There was insufficient evidence to determine the effectiveness of interventions coordinated with work and vocational training or sports and club participation to reduce sexual risk behaviors in adolescents.

Reports and Resources

  • Aging & HIV/AIDS
    Continued improvements in HIV treatment have meant longer life spans for people with HIV and AIDS, and cultural changes have posed new HIV prevention and care challenges for older adults. In New York State as of December 31, 2007, three quarters of the people living with HIV or AIDS were 40 years of age or older. As people with HIV/AIDS age, they face a range of chronic conditions that usually impact aging populations in general. The AIDS Institute, like other agencies and organizations, is involved in planning efforts to provide appropriate services for an aging HIV population. This population includes older people living with HIV, those newly diagnosed as older adults, and seniors most vulnerable to HIV infection and other chronic conditions.
    Buprenorphine ("Bupe")
    This New York State Department of Health web page provides general information regarding buprenorphine ("bupe"), a prescription drug that helps people to stop using heroin or other opioid drugs (i.e., prescription pain pills). People who use heroin or other opioids may be at risk for drug overdose, arrest, incarceration, HIV, hepatitis C and sexually transmitted diseases (STDs). This web page also includes links to resources for providers and consumers.
    2010-2015 Viral Hepatitis Strategic Plan
    This New York State Department of Health web page provides the 2010-2015 Viral Hepatitis Strategic Plan, which uses a modular approach and separate frameworks for hepatitis A, B and C. Each framework is inclusive of a wide range of goals and strategies necessary for a comprehensive approach. This web page also provides the background/rationale for the Viral Hepatitis Strategic Plan's goals and strategies and resources for strategic planning.
    Anonymous HIV Counseling and Testing Resource Directory - January 2008.
    The directory provides phone numbers to call when requesting an anonymous HIV test; that means no name is attached to the test or test result. If additional tests are needed to confirm test results, a code number is used when sending specimens to laboratories.
    Funding Opportunities in HIV/AIDS
    Links to State Department of Health Request for Applications (RFAs) or Request for Proposals (RFPs).
    Hepatitis C
    This New York State Department of Health web page has information and resources links related to Hepatitis C. About one quarter of HIV-infected persons in the United States are also infected with hepatitis C virus (HCV). HCV is a bloodborne virus transmitted through direct contact with the blood of an infected person. Thus, coinfection with HIV and HCV is common (50%-90%) among HIV-infected injection drug users. The U.S. Public Health Service/Infectious Diseases Society of America guidelines recommend that all HIV-infected persons be screened for HCV infection.
    HIV/AIDS Reports
    New York State Department of Health web page links to HIV/AIDS reports from the State Department of Health.
    HIV Counseling and Testing Resource Directory, January 2008 Update
    New York State Department of Health web page lists service providers that provide counseling and testing throughout New York State.
    Youth Development
    New York State Department of Health web page has selected youth development resources.
    Youth, Issue Brief 2, National Alliance of State and Territorial AIDS Directors, May 2009 (pdf, 8 pages)
    The web brief explores the application of youth development principles as part of an overall strategy in which youth play a meaningful role in determining what health department efforts could best help improved sexual health outcomes for adolescents.

Return on Investment

  • Does funding for HIV and sexually transmitted disease prevention matter? Evidence from panel data. Chesson HW, Harrison P, Scotton CR, and Varghese B. Evaluation Review 2005; 29(1): 3-23
    The study provided evidence that funding for STD and HIV prevention has a discernable impact on new cases of STDs. The authors found that greater amounts of federal STD and HIV prevention funding in a given year are associated with reductions in reported gonorrhea rates at the state level in following years. Results suggest that each dollar of prevention funding (per capita) is associated with a later decrease in gonorrhea of up to 20 percent. Because gonorrhea is a marker for risky sexual behavior, the findings are likely generalizable to other STDs, including HIV.
    Do Needle Syringe Programs Reduce HIV Infection Among Injecting Drug Users: A Comprehensive Review of the International Evidence. Journal of Substance Use and Misuse, 41:777-813. Wodak A, Cooney A (2006)
    Studies cited include National Commission on AIDS (1991), Centers for Disease Control and Prevention (1993), General Accounting Office (1994), Office of Technology Assessment of the U.S. Congress (1995), National Institutes of Health Consensus Panel (1997), U.S. Department of Health and Human Services (2001), Institute of Medicine of the National Academy of Science (2001). The studies demonstrate that needle exchange programs decrease HIV and hepatitis transmission, but do not increase the use of injection drugs.
    Effectiveness of needle-exchange programmes for prevention of HIV infection. Hurley, SF, Jolley, DJ, Kalidor, JM (1997). The Lancet, 348:987-991
    HIV infection among Injection Drug Users (IDUs) has been shown to increase 6% per year on average in cities that do not have needle exchange. In contrast, HIV declined 6% per year among IDUs in cities that have exchange programs.
    Return on Investment in Needle and Syringe Programs in Australia. Health Outcomes International (HOI), National Center for HIV Epidemiology and Clinical Research, Drummond, M (2002). Canberra: Commonwealth Department of Health and Aging
    An Australian survey found that HIV prevalence declined 19% per year in cities with needle exchange compared to an 8% increase in cities that did not have exchange programs.
    The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United States. Schackman, BR et al. (2006). Medical Care, 44,11:990-997
    Estimates that the life-time medical cost to treat one person who has HIV is estimated to be $385,200.


More Information

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