HIV (human immunodeficiency virus) does not affect all groups equally. In the United States, Black and Latinx people, men who have sex with men (MSM), trans women/transfeminine people, and the trans community at large are disproportionately impacted. Women are twice as likely to get HIV and three times more likely to die from the disease than their male partners.

There are many reasons for this, but poverty, unequal access to healthcare and employment, stigma, racism, sexism, and unequal access to education all play key roles. Injecting drug use also contributes, particularly among MSM, trans women, and Latinx people.

Today, Black people in the U.S. are eight times more likely to be diagnosed with HIV than White people, while MSM are five times more likely to be HIV-positive compared to all other groups. Research suggests Black MSM have a 50% chance of testing positive for HIV in their lifetime due to compounding structural inequity. Moreover, nearly two-thirds of Black trans women and over one-third of Latinx trans women are living with HIV in the U.S. today.

The same social and economic barriers that fuel HIV infection rates are evident in lower rates of testing and higher rates of treatment failure in disproportionately impacted groups. Among Black people living with HIV, only 59% have received care. Of those who have received care, only 43% are able to fully suppress the virus with treatment. By comparison, 67% of White people with HIV are linked to care, while 57% have been able to achieve complete viral suppression.

In addition, language barriers and the current public debate about immigration are other reasons why Black and Latinx migrants are more likely to delay HIV testing and treatment until the condition advances.

There are no easy answers to any of these concerns, but, by focusing on treatment, prevention, and disproportionate areas, the federal government hopes to slash the number of new HIV cases by at least 90% by 2030 under its Ending the HIV Epidemic in the U.S. (EHE) initiative.

In an effort to support these goals, the latest destination in Verywell’s Health Divide series aims to provide:

  • Educational insights into how poverty, stigma, racism, transphobia, homophobia, inequality, and other factors place different groups at risk of HIV in very different ways
  • An understanding that through testing and then treatment HIV can be suppressed
  • An understanding of how historic shortcomings continue to discourage many disproportionately impacted people from accessing HIV testing and treatment
  • Stories from people who have experienced the challenges of living with HIV firsthand
  • Resources to help people with HIV or who belong to a group disproportionately impacted by HIV access services, get information, find support, acquire financial assistance, and learn where to find free testing

-- James Myhre, HIV educator, & Dennis Sifris, MD, HIV specialist

Health Divide

HIV

Health Divide: HIV

THE IMPACT OF HIV

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Jessica Shepherd MD, MBA, FACOG, is a board certified OB-GYN and the Chief Medical Officer for Verywell Health. She is the founder and CEO of Sanctum Med + Wellness, a wellness concierge practice, and is affiliated with Baylor University Medical Center in Dallas, Texas.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Pellowski JA, Kalichman SC, Matthews KA, Adler K. A pandemic of the poor: social disadvantage and the U.S. HIV epidemic. Am Psychol. 2013 May-Jun;68(4):197-209. doi:10.1037/a0032694

  3. Centers for Disease Control and Prevention. Estimated percentages and characteristics of men who have sex with men and use injection drugs — United States, 1999–2011. MMWR Morbid Mortality Week Rep. 2013 Sep 20;62(37):757-62.

  4. Centers for Disease Control and Prevention. HIV infection, risk, prevention, and testing behaviors among transgender women–National HIV Behavioral Surveillance–7 U.S. cities, 2019-2020. In: HIV Surveillance Special Report 2021. April 2021.

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  10. HIV.gov. What Is Ending the HIV Epidemic in the U.S.? Updated June 2, 2021.