A study investigated HIV incidence trends among men who have sex with men (MSM) in New York City (NYC) from 2010 to 2018, relative to Ending the HIV Epidemic (EHE) initiatives. Analyzing data from NYC Sexual Health Clinics and citywide HIV registries, researchers identified decreasing HIV incidence overall, from 2.82 to 0.82 per 100 person-years across all demographics. However, racial disparities persisted and worsened over time. Black and Latino MSM had significantly higher seroconversion rates compared with White MSM, even within the same age groups and neighborhood poverty levels. Adjusted incidence rate ratios revealed an increase in HIV incidence among black and Latino MSM from 2010–2012 to 2016–2018, exacerbating racial inequities. The findings underscore the importance of addressing structural factors influencing HIV risk disparities in EHE initiatives, emphasizing the need for targeted interventions to mitigate racial inequities in HIV transmission.