To examine the incidence rates (IR) of HIV-associated tuberculosis in France, we selected 72,580 patients followed between January 1, 1997, and December 31, 2008, from the French hospital database on HIV infection, and compared incidence rates in different periods relative to 2002–2003. A first episode of tuberculosis was diagnosed in 1,693 patients during the follow-up period. The tuberculosis IR was 0.40 per 100 person-years. The adjusted risk of tuberculosis was 2.01 times (95% CI [1.79–2.26]) higher among migrants than among non-migrants. Adjusted TB incidence rates increased between 1997 and 2002–2003 among both migrants and non-migrants, and continued to rise after 2002–2003—significantly among migrants and non-significantly among non-migrants—with an adjusted risk of 1.49 (95% CI [1.04–2.14]) and 1.21 (95% CI [0.86–1.70]) in 2008 compared to 2002–2003, respectively. Other factors independently associated with the risk of tuberculosis were follow-up duration ≤ 6 months, no prior antiretroviral therapy, low CD4 counts, and high viral load. Non-migrant, non-homosexual patients residing in Île-de-France or in the French departments of the Americas, or those at the AIDS stage, were also at higher risk of tuberculosis. While the crude incidence of HIV-associated tuberculosis remained unchanged, the adjusted incidence increased in France between 1997 and 2008, after accounting for other risk factors for tuberculosis. (R.A.)