Aim: To review the epidemiology of HIV in NSW and compare HIV rates in NSW with those of other comparable jurisdictions. Method: The rate of newly diagnosed cases of HIV reported in NSW was compared with those published from other Australian and comparable international jurisdictions. Results: Until recent years, NSW has consistently reported the highest rate of newly diagnosed HIV infections in Australia with a peak of 29.1 per 100 000 population in 1987. Since then the notification rate has decreased significantly and has been stable since 2000 at an average annual rate of 5.6 per 100 000. Rates in NSW and in other Australian states and territories are lower than most comparable international jurisdictions, although stability in rates has been observed elsewhere. Between 1984 and 2008, 82% of infections that reported a risk exposure occurred among men who have sex with men. Conclusion: Rates of HIV infection in NSW have been stable over the last decade, remaining among the highest in Australia but lower than those in other comparable industrialised jurisdictions. In NSW, the majority of cases continue to occur among men who have sex with men.