METHODS: Data from the NYS HIV Registry for cases born 1965-1990 and diagnosed with HIV through 2014 were arrayed by birth year (BY) and diagnosis year. Adult male cases with unknown transmission risk were assigned to risk groups in proportion to known cases by sex and diagnosis year. For MSM-risk cases, cumulative diagnosis rates by age for each birth year were calculated using US Census data for 2000. Since named HIV reporting in NYS began in 2000, exact year of HIV diagnosis for cases before 2000 could not be ascertained; these cases were included in the cumulative count for 2000.
RESULTS:
MSM-risk diagnoses ranged from 3,097 for BY 1965 to 649 for BY 1990, corresponding to cumulative diagnosis rates of 1,299 and 449 cases/100,000 male population. For ages common to both curves, the rates for BY 1970 were 25% lower than those for BY 1965, strongly suggesting a correspondingly lower lifetime risk of HIV diagnosis. Similarly, the rates for BY 1975 were 12% lower than for BY 1970. In contrast, the rates for BY 1980 were 17% higher than BY 1975, and nearly the same as BY 1970 for the 5 age years the two curves had in common (30-34). For BY 1985, cumulative risk was similar to BY 1980 at age 20, but 24% higher at age 30. The curve for BY 1990 was nearly the same as for BY 1985.
CONCLUSIONS:
The trend of substantial decreases in long-term risk of HIV diagnosis seen in the 1965-1975 birth cohorts was reversed with the 1980 cohort, with subsequent cohorts showing even higher diagnosis rates. HIV prevention efforts must be tailored to newer cohorts of men whose diagnosis rates indicate that they have not been impacted by prevention efforts to the same degree as men born a decade earlier.