Estimates of HIV Incidence Among Persons Testing for HIV Using the Sensitive/Less Sensitive Enzyme Immunoassy, New York City, 2001

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Abstract
Estimates of the incidence of HIV infection among persons testing for HIV can be derived by applying a newly available serologic test to the diagnostic specimen of HIV-positive persons. Such estimates would enhance the targeting of HIV prevention resources and provide a sensitive outcome measure for prevention program evaluation. The goal of this investigation was to estimate the incidence of HIV infection among persons testing for HIV in New York City. The study population consisted of persons testing for HIV in public settings in New York City during 2001 (n = 114,703). We applied a less sensitive enzyme immunoassay (LS-EIA) (Vironostika, BioMerieux, Durham, NC) to the diagnostic blood specimen of 1022 persons in whom HIV (non-AIDS) had been diagnosed for the first time in 2001. The distribution of transmission risk among HIV-negative persons-men who have sex with men (MSM), injection drug users (IDUs), heterosexuals-from a large telephone health survey was used to generate denominators for transmission risk groups. The 1022 persons tested by the LS-EIA represented 27% of all persons in whom HIV (non-AIDS) had been diagnosed in New York City during 2001. The incidence of HIV was estimated to be 0.29% per year (95% CI: 0.20-0.38), and was significantly higher for men than women (rate ratio 3.6, 95% CI: 2.6-5.1), and HIV incidence increased with age. Male IDU and MSM testers had the highest HIV incidence rates: 2.7% per year (95% CI: 2.3-3.1) and 2.5% per year (95% CI: 2.1-2.8), respectively. Male IDUs and MSM may be good candidates for intensified targeting of HIV prevention resources in New York City.

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