Data on long-term survival among people with HIV (PWH) can inform the development of services for this population. An estimated 90,000 PWH live in New York City (NYC). Using HIV surveillance data, we conducted survival analysis of PWH diagnosed in NYC before and after introduction of highly active antiretroviral therapy (HAART) (pre-HAART cohort: 1981-1994; post-HAART cohort: 1995-2016). We created Kaplan-Meier curves by cohort and demographic factors, and Cox proportional hazards models to evaluate adjusted mortality risk by cohort. 205,584 adults and adolescents were diagnosed with HIV in NYC from 1981 to 2016, half each in the pre-HAART and post-HAART eras. The pre-HAART cohort had significantly poorer survival compared with the post-HAART cohort. Adjusted mortality risk in the pre-HAART cohort was almost threefold that in the post-HAART cohort (HR 2.84, 95% confidence interval [CI] 2.80-2.88). In sex- and risk-stratified models, men who have sex with men (MSM) had the largest difference in mortality risk pre-HAART versus post-HAART (HR 5.41, 95% CI 5.23-5.59). Race/ethnic disparities were pronounced among MSM, with Latino/Hispanic and White MSM having lower mortality than Black MSM. Females with heterosexual risk born outside the US had lower mortality than US-born women. The improvement in survival post-HAART was most pronounced for White people. Survival among persons diagnosed with HIV in NYC increased significantly since the introduction of HAART. However, among MSM and among PWH overall, improvements even post-HAART lagged for Black and Latino/Hispanic people, underscoring the need to address structural barriers, including racism, to achieve optimal health outcomes among people with HIV.

中文翻译：

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1981 年至 2017 年纽约艾滋病病毒感染者的生存情况：种族/族裔和传播风险的不平等持续到后 HAART 时代。

HIV 感染者 (PWH) 的长期生存数据可以为该人群的服务发展提供信息。估计有 90,000 名 PWH 居住在纽约市 (NYC)。利用 HIV 监测数据，我们在引入高效抗逆转录病毒疗法 (HAART) 之前和之后对纽约市确诊的 PWH 进行了生存分析（HAART 前队列：1981-1994；HAART 后队列：1995-2016）。我们通过队列和人口因素创建了 Kaplan-Meier 曲线，并创建了 Cox 比例风险模型来评估按队列调整的死亡风险。从 1981 年到 2016 年，纽约市有 205,584 名成年人和青少年被诊断出患有艾滋病毒，其中一半是在 HAART 之前和 HAART 之后的时代。与 HAART 后队列相比，HAART 前队列的生存率明显较差。HAART 前队列的调整后死亡风险几乎是 HAART 后队列的三倍（HR 2.84，95% 置信区间 [CI] 2.80-2.88）。在性别和风险分层模型中，男男性行为者 (MSM) 在 HAART 前与 HAART 后的死亡风险差异最大 (HR 5.41, 95% CI 5.23-5.59)。MSM 之间的种族/民族差异很明显，拉丁裔/西班牙裔和白人 MSM 的死亡率低于黑人 MSM。在美国以外出生的具有异性恋风险的女性死亡率低于美国出生的女性。HAART 后生存率的改善对白人最为明显。自引入 HAART 以来，纽约市被诊断出患有 HIV 的人的存活率显着提高。然而，在 MSM 和 PWH 整体中，即使是 HAART 后的改善也落后于黑人和拉丁裔/西班牙裔人，