Incidence and Predictors of HIV Infection Among Men Who Have Sex with Men Attending Public Sexually Transmitted Disease Clinics, New York City, 2007–2012

We examined five annual cohorts (2007–2011) of men who have sex with men (MSM) attending New York City STD clinics who had negative HIV-1 nucleic acid amplification tests (NAATs) on the day of clinic visit. Annual HIV incidence was calculated using HIV diagnoses within 1 year of negative NAAT, determined by matching with the citywide HIV registry. Predictors (demographic; behavioral; bacterial STD from citywide STD registry match) of all new HIV diagnoses through 2012 were calculated from Cox proportional hazards models. Among 10,487 HIV NAAT-negative MSM, 371 had an HIV diagnosis within 1 year. Annual incidence was 2.4/100 person-years, and highest among non-Hispanic black MSM (4.1/100 person-years) and MSM aged <20 years (5.7/100 person-years). Characteristics associated with all 648 new HIV diagnoses included: black race (aHR 2.2; 95 % CI 1.6–3.1), condomless receptive anal sex (aHR 2.1; 95 % CI 1.5–2.8), condomless insertive anal sex (aHR 1.3; 95 % CI 1.1–1.8), and incident STD diagnosis (aHR 1.6; 95 % CI 1.3–1.9). MSM attending STD clinics have substantial HIV incidence and report risk behaviors that are highly associated with HIV acquisition. Increased uptake of effective interventions, e.g., pre- and post-exposure prophylaxis, is needed.