Approximately 1.2 million people in the U.S. are living with HIV today. About 14 percent of them (1 in 7) don’t know it and need testing.
HIV continues to have a disproportionate impact on certain populations, particularly racial and ethnic minorities and gay and bisexual men.
An estimated 36,400 new HIV infections occurred in the United States in 2018.
- In 2018, 37,968 people received an HIV diagnosis in the U.S. and 6 dependent areas—an overall 7% decrease compared with 2014.
- HIV diagnoses are not evenly distributed across states and regions. The highest rates of new diagnoses continue to occur in the South.
Estimated New HIV Infections (HIV Incidence)
HIV incidence refers to the estimated number of new HIV infections during specified period of time (such as a year), which is different from the number of people diagnosed with HIV during a given year. (Some people may have HIV for some time but not know it, so the year they are diagnosed may not be the same as the year they acquired HIV.)
According to the latest estimates from the Centers for Disease Control and Prevention, approximately 36,400 new HIV infections occurred in the United States in 2018.a Annual infections in the U.S. have been reduced by more than two-thirds since the height of the epidemic in the mid-1980s. However, CDC data indicate that the progress has stalled in recent years, at about 38,000 new HIV infections each year between 2014 and 2018.
The latest estimates indicate that effective HIV prevention and treatment are not adequately reaching those who could most benefit from them, and certain groups such as men who have sex with men (MSM), transgender persons, African Americans, and Hispanics/Latinos continue to be disproportionately affected. Additionally, the highest rates of new HIV infection continue to occur in the South.
Key Points: HIV Incidence
- HIV incidence remained stable in 2018 as compare with 2014. The estimated number of HIV infections was 36,400 and the rate was 13.3 (per 100,000 people).
- By age group, the annual number of HIV infections in 2018, compared with 2014, decreased among persons aged 13–24, but remained stable among all other age groups. In 2018, the rate was highest for persons aged 25-34 (31.5), followed by the rate for persons aged 35-44 (16.9).
- By race/ethnicity, the annual number of HIV infections in 2018, compared with 2014, decreased among persons of multiple races, but remained stable for all other races/ethnicities. In 2018, the highest rate was for blacks/African Americans (45.4), followed by Hispanic/Latinos (22.4) and persons of multiple races (19.3).
- By sex at birth, the annual number of new HIV infections in 2018, as compared to 2014, remained stable among males and females. In 2018, the rate for males (22.1) was 5 times the rate for females (4.8).
- By HIV transmission category, the annual number of HIV infections in 2018, compared with 2014, remained stable among all transmission categories. In 2018, the largest percentages of HIV infections were attributed to male-to-male sexual contact (67% overall and 82% among males.)
New Infections by Race and Transmission Group, U.S. 2014-2018
HIV diagnoses refers to the number of people who have received an HIV diagnosis during a year, regardless of when they acquired HIV. (Some people can live with HIV for years before they are diagnosed; others are diagnosed soon after infection.)
According to the latest CDC data, in 2018, 37,968 people received an HIV diagnosis in the United States. From 2014 through 2018, the annual number and rate of diagnoses of HIV infection in the United States decreased. However, trends varied for different groups of people.
Key Points: HIV Diagnoses
Gay, bisexual and other men who have sex with men (MSM) b are the population most affected by HIV in the U.S. In 2018:
- MSM accounted for 69% of the 37,968 new HIV diagnoses in the United States.c
- Black/African American MSM accounted for 25% (9,444) of the 37,968 HIV diagnoses and 38% of diagnoses among all MSM.
- Hispanic/Latinod MSM made up 20% (7,653) of the 37,968 new HIV diagnoses.
The number of HIV diagnoses decreased among MSM overall, but trends varied by race/ethnicity. From 2014 through 2018:
- The number of HIV diagnoses remained stable among American Indian/Alaska Native, Asian, black/African American, and Hispanic/Latino MSM.
- HIV diagnoses decreased among MSM of multiple races and among white MSM.
- HIV diagnoses increased among Native Hawaiian/other Pacific Islander MSM.
Transgender people have experienced increases in HIV diagnoses:
- From 2014 through 2018, the number of diagnoses of HIV infection for transgender male-to-female (MTF) and transgender female-to-male (FTM) adults and adolescents increased.
- In 2018, the largest percentage (27%) of diagnoses of HIV infection was for transgender MTF adults and adolescents aged 25–29 years, followed by the percentage (25%) for transgender MTF adults and adolescents aged 20– 24 years.
- In 2018, transgender MTF accounted for slightly more than 1% of annual HIV diagnoses and transgender FTM accounted for less than 1%.
Heterosexuals and people who inject drugs also continue to be affected by HIV. From 2014-2018:
- The number of infections attributed to heterosexual contact decreased. In 2018, 24% of HIV diagnoses were attributed to heterosexual contact.
- HIV diagnoses increased among people who inject drugs (PWID), with notable increases occurring among white PWID.
By race/ethnicity, Blacks/African Americans and Hispanics/Latinx continue to be disproportionately affected by HIV. From 2014 to 2018:
- HIV diagnoses rates decreased among Blacks/African Americans. Among all races/ethnicities, the highest rate was 39.2 for Blacks/African Americans.
- HIV diagnoses rates decreased among Hispanics/Latinx. The rate for Hispanics/Latinx was 16.4.
- HIV diagnoses rates increased for Native Hawaiians/Other Pacific Islands; remained stable among American Indian/Alaska Natives; and decreased among people of multiple races and whites.
By age group, from 2014 through 2018, the rates for persons aged 13–24, 35–44, 45–54, and 55 years and older decreased, and the rate for persons aged 25–34 years remained stable.
Across states and regions,e HIV diagnoses are not evenly distributed. From 2014 through 2018, the annual number and rate of diagnoses of HIV infection in the United States and 6dependent areas decreased. In 2018, the rates were 15.6 in the South, 9.9 in the Northeast, 9.7 in the West, and 7.2 in the Midwest.
Most diagnoses are now highly concentrated in certain geographic areas. More than 50 percent of new HIV diagnoses in 2016 and 2017 occurred in 48 counties, Washington, D.C., and San Juan, Puerto Rico. These 50 jurisdictions are prioritized in Phase I of Ending the HIV Epidemic: A Plan for America, along with seven states with a disproportionate occurrence of HIV in rural areas.
HIV Diagnoses, 2018
Living with HIV
An estimated 1.2 million people in the United States aged 13 and older were living with HIV in the U.S. at the end of 2018, the most recent year for which this information is available.
According to the latest CDC data:
- About 14% (or 1 in 7) people living with HIV in the U.S. don’t know it and so need testing. Early HIV diagnosis is crucial. Everyone aged 13-64 should be tested at least once. People at higher risk of acquiring (or exposure to) HIV should be tested at least annually. Sexually active gay and bisexual men may benefit from more frequent testing (e.g., every 3-6 months).
- Young people are the most likely to be unaware of their infection. According to a CDC analysis, in 2018, an estimated 44.9% of young people aged 13-24 who were living with HIV were unaware of their infection. From 2014 to 2018, the percentage of people living with undiagnosed HIV infection increased among people ages 13-24, but decreased among people ages 35-44.
- According to another CDC report, of the people with HIV (diagnosed and undiagnosed) in 2018, about 76% have received some HIV care, 58% were retained in care, and 65% were virally suppressed or undetectable. Having a suppressed or undetectable viral load protects the health of a person living with HIV, preventing disease progression. There is also a major prevention benefit. A person living with HIV who takes HIV medicine daily as prescribed and gets and stays virally suppressed can stay healthy and has effectively no risk of sexually transmitting HIV to HIV-negative partners.
In 2018, there were 15,820 deaths among adults and adolescents with diagnosed HIV in the United States and 6 dependent areas. These deaths may be due to any cause.
Ending the HIV Epidemic: A Plan for America
Ending the HIV Epidemic: A Plan for America, announced by the President in his 2019 State of the Union address, is a bold approach to eliminate new HIV infections in our nation. It is built upon the following key strategies or pillars:
- Diagnosing all individuals with HIV as early as possible.
- Treating people with HIV rapidly and effectively to achieve sustained viral suppression.
- Preventing new HIV transmissions by using proven interventions, including pre-exposure prophylaxis (PrEP) and syringe services programs (SSPs).
- Responding quickly to potential HIV outbreaks to get needed prevention and treatment services to people who need them.
The proposed initiative is designed to rapidly increase use of these strategies in 50 jurisdictions (48 counties, Washington, D.C., and San Juan, Puerto Rico) with the highest number of HIV diagnoses as well as seven states with a substantial number of HIV diagnoses in rural areas. The goal is to reduce new HIV infections by 75 percent in 5 years and by 90 percent in 10 years.
a Unless otherwise noted, the term United States (U.S.) includes the 50 states, the District of Columbia, and the 6 dependent areas of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the U.S. Virgin Islands.
b The term male-to-male sexual contact is used in CDC surveillance systems. It indicates a behavior that transmits HIV infection, not how individuals self-identify in terms of their sexuality. This web content uses the term gay, bisexual and men who have sex with men.
c This includes infections attributed to male-to-male sexual contact and injection drug use (men who reported both risk factors)
d Hispanics/Latinx can be of any race.
e This page uses the regions defined by the U.S. Census Bureau and used in CDC’s National HIV Surveillance System:
Northeast: CT, ME, MA, NH, NJ, NY, PA, RI, VT
Midwest: IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI
South: AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV
West: AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY.
CDC. Diagnoses of HIV Infection in the United States and Dependent Areas, 2018 (Updated). HIV Surveillance Report 2020; 31.
CDC. Estimated HIV incidence and prevalence in the United States, 2014-2018. HIV Surveillance Supplemental Report 2020; 25(No. 1).
CDC. Monitoring Selected National HIV Prevention and Care Objectives by Using HIV Surveillance Data—United States and 6 Dependent Areas, 2018. HIV Surveillance Supplemental Report 2020;25(No. 2).
CDC. NCHHSTP AtlasPlus. Updated 2019.