NEW YORK CITY – March 2, 2007 – Most New Yorkers who engage in high-risk behaviors do not think they are at high risk of HIV, according to new data from the New York City Health Department. The findings – presented this week at the 14th annual Conference on Retroviruses and Opportunistic Infections (CROI) in Los Angeles – show that HIV affects all population groups in New York City and that many New Yorkers, including medical providers, still underestimate HIV's reach. The Health Department called on people of all backgrounds to take steps to protect themselves, and to seed out an HIV test.
New Yorkers Who Engage in High-Risk Behaviors Do Not Recognize their Risk
The Health Department presented preliminary data on HIV infection and risk practices from its NYC Health and Nutrition Examination Survey (NYC-HANES), conducted in 2004. For this survey, researchers conducted medical exams – including blood and urine analysis – on a representative sample of New Yorkers. Archived blood was anonymously tested for HIV. From survey findings, approximately one in every six New Yorkers (18%) engaged in risky sexual or drug use behaviors, such as having multiple sexual partners, inconsistent condom use or injecting drug use. When questioned, nearly all (92%) of these adults said they were not at risk for sexually transmitted diseases, including HIV.
Based on these anonymous testing results, the Health Department estimated that 1.4% of adults in the city's general household population are HIV-positive. Rates were highest among men who have sex with men (14%), and also elevated among blacks (3%), people aged 40-49 (2%), and men generally (2%).
"Our results indicate that New Yorkers who take risks, either sexually or by injecting drugs, continue to see themselves as being at low risk for disease," said Dr. Trang Nguyen, lead author on the report. "We need to keep reminding everyone of the potential consequences of these risky behaviors, to encourage more people to get tested for HIV, and to increase HIV testing by health care providers."
Late HIV Diagnoses among Elderly, Foreign Born in New York City
More than one in four new HIV diagnoses in New York City are made when the person is already sick with AIDS. People over 50, heterosexual men and foreign-born New Yorkers are particularly likely to receive late diagnoses. These late diagnoses suggest that patients aren't seeking out HIV testing, and that physicians are not routinely offering it.
- In 2004, 1,038 people were diagnosed with HIV and AIDS concurrently (in 2005, the number did not change significantly; it was 1,019)
- Among people diagnosed with HIV in 2004, those who were over 30, foreign-born or men with heterosexual or unknown transmission risk, were more likely to be sick with AIDS at the time of their HIV diagnosis.
Health Care Providers Are Not Routinely Screening "Low Risk" Patients
Another study looked at more than 7,000 responses from a national survey of doctors conducted by the Centers for Disease Control and Prevention. The survey asked if the doctors ever offered HIV screening to men and non-pregnant women who did not have possible symptoms of HIV infection. Overall, only one in four doctors screened either group for HIV. Family and general-practice physicians were most likely to screen (35%), followed by internists (21%), pediatricians (19%), OB/GYNs (16%), and emergency physicians (10%).
"Much work remains to be done," said Dr. Elizabeth Begier, Medical Director of DOHMH's Bureau of HIV/AIDS Prevention and Control said, "Institutional and structural changes are needed to implement more widespread HIV screening among asymptomatic patients, as recommended by the CDC. We need to take dramatic steps to address the persistent, nationwide problem of late HIV diagnosis."