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EtE Progress in New York State

In 2014, Governor Cuomo announced a three-point plan to end HIV/AIDS as an epidemic in the state. In 2015, a task force appointed by the Governor developed – with extensive input from a parallel ad hoc community “kitchen cabinet” coalition – the New York State Blueprint which includes 30 key recommendations. Several metrics are being tracked in order to assess progress on recommendations from the plan, many of which can be tracked via the online EtE Dashboard.

The New York State AIDS Institute uses nine population-level metrics to help track progress toward Ending the Epidemic by 2020. Advocates have been eager to see results from state surveillance for 2016 – widely considered the first year to demonstrate significant effects of EtE implementation. Below are graphs showing hopeful progress on three of the nine state metrics (click for larger view and for all EtE targets).

  

New diagnoses dropped from 3,443 in 2014 to 2,881 in 2016. Notably, new diagnoses among gay and bisexual men overall dropped by 12 percent from 2015. Much of the decrease in diagnoses in men who have sex with men (MSM) was driven by a dramatic 18 percent reduction in new diagnoses among Latino gay and bisexual men, giving hope that the state is simultaneously addressing racial and ethnic disparities. This trend was also reflected in aggregate statistics in which Black and Latino communities both saw 11 percent decreases compared with a 7 percent increase in whites.

Estimated incidence, overall, declined from 2,436 new infections in 2015 to 2,115 in 2016. Although impressive, this drop did not quite reach the intended 2016 target of 2,050 estimated new infections. Efforts will need to be accelerated to meet next year’s targets, but the gap of 65 infections is a modest failure in the context of ambitious targets.

Not all of the findings are necessarily rosy, however. When we look at the data for parts of the state outside of NYC, much of the progress seen in the aggregate statistics diminishes considerably. Although the decrease in diagnoses between 2015 and 2016 was 12 percent in NYC, the rest of the state saw only a 1 percent decrease, with an increasing number of infections in Albany. Incidence estimates back this up, showing only a modest decline outside of NYC between 2014 and 2016. In addition, although there has been an overall drop in new diagnoses for people who inject drugs, for the first time ever the number of diagnosed infections related to injection drug use was higher for areas outside of NYC.

Indicators looking at linkage to care for people living with HIV have stalled or even gone slightly in the wrong direction throughout the state, highlighting a weak spot in statewide EtE efforts.

Much of the success in NYC is undoubtedly a result of a number of progressive policy victories, including increased funding for the city sexual health and wellness clinics, policy changes that facilitate screenings for HIV testing, coverage of transgender health services under Medicaid, and significant increases in housing assistance for people living with and vulnerable to HIV infection, just to name some of the highlights. Even more successful, evidence-based policy changes will be needed to accelerate progress in the city and ensure that the rest of the state is not left behind.