Trends in the AIDS epidemic among men who reported sex with men in New York City: 1981-1993.

New York City is a major urban epicenter of the AIDS epidemic in the United States, and has reported nearly one fifth of the nation's cases. This paper chronicles trends in the AIDS epidemic among men who have sex with men (MSM) from 1981 through 1993 in New York City. Annual AIDS incidence and cumulative deaths are described, results of survival analysis by race/ethnicity for three time periods are reported, and the effects of the epidemic on premature mortality are shown from the beginning of the epidemic through 1993. Among 25,812 cases reported in MSM, 52% were white, 25% were black and 21% were Hispanic. AIDS incidence among whites has been declining since 1987 and is continuing to increase among minorities. Survival has been improving over time among all groups analyzed, but a persistent differential in survival between different race and ethnic groups is found, with whites surviving longer than minorities. Overall, nearly one half a million person years of life before age 65 were lost among MSM between 1981 and 1993. A rapid increase in AIDS cases among men born 1970-79 who were diagnosed after 1988 suggests a new wave of the epidemic may be occurring, and continued efforts in AIDS education and prevention among MSM entering the age of sexual activity is required.