We calculated population-based tuberculosis (TB) rates among HIV-infected persons in New York City from 2001 through 2005 using data from the city's TB and HIV/AIDS surveillance registries, and we examined those rates using linear trend tests and incidence rate ratios (IRRs). HIV-infected individuals had 16 times the TB rate of a "non-HIV" population (HIV status negative or unknown; IRR = 16.0; 95% confidence interval = 14.9, 17.2). TB rates declined significantly among the US-born HIV-infected population (P (trend) < .001) but not among the foreign-born HIV-infected population (P (trend) = .355). Such disparities must be addressed if further declines are to be achieved.