NYC Reports Stalled Progress in HIV Prevention Amid Federal Funding Threats

The New York City Health Department released its 2024 HIV Surveillance Annual Report revealing a stabilization and increase in new HIV diagnoses for the fourth consecutive year, with 1,791 new cases reported in 2024, marking a 5.4% increase from the previous year. Estimated new infections saw a more marked rise of 17% compared with 2023, indicating a concerning shift after years of decline prior to 2020. This trend emerges amid potential cuts to federal funding, including a proposed elimination of the CDC Division of HIV Prevention and a $755.6 million reduction in CDC HIV prevention funds, which would significantly impact local initiatives including a $41 million loss for the NYC Health Department. Despite a historical 70% reduction in new HIV diagnoses since 2001, progress in New York City has plateaued, with persistent disparities along racial, ethnic, and socioeconomic lines. Black and Latino/a communities remain disproportionately affected, accounting for 86% of new HIV diagnoses, and geographic disparities persist with high-poverty neighborhoods being more heavily impacted. Social determinants such as poverty, housing instability, lack of insurance, and stigma contribute to ongoing challenges in HIV prevention and care access. The report highlights inequities in prevention uptake, noting a 14-fold increase in the use of pre-exposure prophylaxis (PrEP) since 2014 but uneven adoption across age, gender, and racial groups, particularly among younger adults, women, and Black and Latino populations. Stigma, mistrust of the healthcare system, and missed prevention opportunities during clinical encounters hinder broader prevention efforts. Newly diagnosed individuals report significant unmet needs including nearly half lacking health insurance and substantial proportions experiencing housing insecurity and food insufficiency, underscoring the relationship between social support and health outcomes. The looming federal cuts risk reducing access to essential services such as testing, treatment linkage, and preventive aids distributed by the NYC Health Department. In response to these challenges, stakeholders convened at a World AIDS Day 2025 event to strategize enhanced community and government collaboration aimed at reinvigorating efforts to end the HIV epidemic in NYC. Emphasis was placed on properly resourcing community organizations, expanding access to supportive services including housing and employment, adopting standardized sexual health discussions in primary care, and increasing public testing awareness. This report and associated surveillance materials are integral for insurance and healthcare providers, policymakers, and community leaders to understand current HIV trends and the implications of funding shifts. Maintaining robust federal support and addressing social determinants remain critical to achieving sustained declines in HIV transmission and improving health equity in urban centers.