HIV Statistics You Should Know

State, Regional, National, and Global Facts and Figures

Since the first cases of HIV were reported back in 1981, an estimated 76 million people have been infected worldwide, resulting in over 22 million deaths and 13 million AIDS orphans.

Today, around 38 million people are living with HIV, and, despite advances in treatment and the widespread distribution of antiretroviral drugs, infection and death rates remain alarmingly high. In 2019 alone, an estimated 1.7 million people were infected with HIV—roughly 5,000 per day— while over 690,000 died of HIV-related complications.

Despite these grim statistics, there have been gains. Since the height of the pandemic in 2004, HIV-related deaths and have dropped by no less than 60%, while the rate of mother-to-child transmission has been cut in half.

World AIDS Awareness

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Still, there are enormous gaps in the global response and challenges yet to be faced in the United States, where the poor, people of color, and gay and bisexual men are disproportionately affected.

HIV in the United States

Currently, in the United States, over 1.1 million Americans are living with HIV. After years of stagnation in the annual infection rate, which hovered at around 50,000 new infections per year, the rate has begun to steadily drop in recent years due to newer preventive strategies like PrEP (pre-exposure prophylaxis) and HIV treatment as prevention, the latter of which can reduce the risk of HIV transmission to zero.

According to data from the Centers for Disease Control and Prevention (CDC), 37,968 new HIV infections were reported in the 2019 surveillance—a drop of nearly 8% since 2010.

Despite these gains, around 15,800 people with HIV died in the United States in 2019, and as many as 14% of those infected (roughly 161,000) remain unaware of their status. Of those who have been diagnosed, only 63% are linked to medical care, and only 51% are unable to achieve an undetectable viral load needed to ensure a normal to near-normal life expectancy.

HIV stigma and a lack of access to medical care, particularly among the poor and communities of color, are among the driving factors for these failures.

HIV Infections by State

In the United States, where you live plays a large part in how likely you are to get HIV. While it is clear that dense urban populations with high prevalence rates contribute to the risk, there are other unique factors that account for a growing disparity between U.S. states.

A prime example is the rate of infection in states that have either adopted or refused Medicaid expansion, intended to expand healthcare to economically disadvantaged people.

According to the CDC, the 13 states that refused Medicaid expansion account for 42% of all new infections. Florida, Texas, Georgia, and North Carolina represent the lion's share of these infections.

Poverty remains a driving force for HIV infections, particularly in the South where the rates of poverty are highest. Moreover, nearly half of all Americans without health insurance live in the South.

With that being said, the Northeast has a higher prevalence rate overall, centered mainly in dense urban populations like New York City, Baltimore, and Washington, D.C.

These dynamics are reflected in the 10 U.S. states with the highest HIV prevalence rates, according to the CDC.

State/Area New HIV Diagnoses
Washington, D.C. 46.3 per 100,000
Georgia 24.9 per 100,000
Florida 22.9 per 100,000
Louisiana 22.1 per 100,000
Maryland 17.0 per 100,000
Nevada 16.5 per 100,000
Texas 15.4 per 100,000
Mississippi 14.3 per 100,000
South Carolina 14.3 per 100,000
New York 14.1 per 100,000
United States (total) 11.8 per 100,000

By Age

In the United States, the primary mode of HIV transmission is sex. It can come as no surprise, therefore, that the rates of new infection are highest among younger populations that are not only more sexually active but also more likely to have STDs, multiple sex partners, and other risk factors.

According to the CDC, the rate of new infections is highest among people 13 to 29, declining steadily thereafter.

Age Group New Infections, 2018
13-19 1,739
20-24 6,152
25-29 7,768
30-34 5,723
35-39 4,250
40-44 3,025
45-49 2,861
50-54 2,528
55-59 1,877
60-64 1,059
65 and over 900

Youth also accounts for the highest rate of undiagnosed infections. Today, nearly half of all HIV-positive youth between the ages of 13 and 24 are unaware of their status and, as a result, are more likely to infect others. The picture is little improved among adults 25 to 34, where one in three remains undiagnosed.

While HIV infection rates have begun to decline in all other population groups, the rate of infections among people 13 to 24 is climbing.

By Sexual Orientation

Gay and bisexual men account for the lion's share of HIV infections in the U.S. This not only includes men who identify as gay or bisexual but the nearly one in 10 men who have sex with men (MSM) who identify as straight.

While MSM accounts for only 2% of the U.S. population, they represent 69% of all new infections and 55% of Americans living with HIV. In their 2018 surveillance, the CDC highlighted key disparities affecting MSM:

  • There are more than twice as many MSM living with HIV in the United States than heterosexuals (678,900 versus 304,800).
  • The number of new infections among MSM was nearly four times that of heterosexuals (24,933 versus 4,350).
  • While the HIV infection rate is declining among heterosexuals in general, the rate of new infections among MSM 24 to 35 is climbing.
  • MSM represented more than half of all deaths among people with HIV.

There are many reasons for these disparities, including stigma (especially high in many communities of color), biological vulnerabilities (including an increased risk of transmission via anal sex), and illicit drug use (especially among young MSM).

By contrast, women who exclusively have sex with women are considered to be at low risk of infection.

In fact, the only group with a higher prevalence rate than MSM are injecting drug users, who account for 186,500 of all U.S. infections. A third of these are MSM.

By Race

HIV and race are integrally linked, with people of color disproportionately affected. There are many reasons for this, not least of which are the economic disparities and lack of access to quality healthcare in many ethnic and racial communities. This is especially true among Blacks in the United States whose new infection rate outpaces that of Whites by 34%.

Currently, there are around 447,000 Black Americans living with HIV compared to 323,000 White Americans. And this, despite the fact that Blacks account for 13.4% of the U.S. population compared to Whites, who represent 60.1%.

The statistics are not much better for Hispanics and Latinos, of whom 242,500 currently live with HIV. Although the new infection rate among Hispanics and Latinos is more or less the same as Whites, they account for only 18.5% of the population.

Race/Origin New Infections, 2018 Living With HIV
White 9,700 340,700
Black/African American 16,000 482,900
Hispanic/Latino 10,500 247,100
Asian 720 17,600
Native American 190 3,900
Multiple Races 1,300 52,900

Poverty, again, is a driving factor. According to the U.S. Census Bureau, the rate of poverty among Blacks and Hispanic/Latinos is more than double that of Whites and Asians (18.8% and 15.7% versus 7.3% and 7.3% respectively).

Race also plays an integral role in the risk of HIV among MSM. The vulnerabilities experienced by all gay and bisexual men are further exacerbated by high rates of stigma in many ethnic and racial communities. There is likely no better illustration of this than among Black MSM, who alone account for 26% of all new HIV infections.

Due to the multitude of intersecting risk factors, Black MSM in the United States have no less than a 50% lifetime risk of getting HIV, according to a 2018 study in the Annals of Epidemiology.

By Sex

Although men account for the majority of HIV infections in the U.S.—75% of whom are MSM—there are around 258,000 women living with HIV, the majority of whom were infected through heterosexual sex.

As the receptive partner in a heterosexual couple, women are twice as likely to get HIV as their male partners. This is reflected by data published by the CDC in 2018, wherein 5,900 women were infected as a result of heterosexual sex compared to only 2,900 men.

The risk is especially high among Black women due to socioeconomic and gender inequalities. As a result, a Black woman is 13 times more likely to get HIV than a White woman of the same age. (By contrast, White women are more than twice as likely to get infected as a result of injecting drug use compared to Black women).

Despite a woman's inherent vulnerability to HIV, increased public awareness has lead to a 9% decline in new infections since 2010, including Black women and younger women.

None of this should suggest that heterosexual men have less to worry about. In fact, the low perception of risk among heterosexual men has translated to the highest rate of undiagnosed infections of all risk groups (17.1%). This not only increases the risk of a late diagnosis but also the chance that a man will unknowingly pass the virus to others.

Mortality Rates

HIV causes the depletion of immune cells (called CD4 T-cells) that, over time, reduces a person's ability to fight otherwise harmless infections. When the immune defenses have been fully compromised, these infections can become life-threatening. It is these so-called opportunistic infections that are among the main causes of death in people living with HIV.

In the early days of the AIDS pandemic, most people died within two years of their diagnosis. With the introduction of combination antiretroviral therapy (CART) in 1996, the number of HIV-related death plummeted by an astonishing 47% in just one year.

In 2018, a total of 15,820 people living with HIV died in the United States. Of these, around a third were believed to have been caused by an HIV-related complication.

And, although this is only an eighth of the number of deaths reported back in 1996, the numbers remain unacceptably high given the efficacy of CART. Most occurred in the South and Northeast, accounting to the CDC.

U.S. Region Number of Deaths Percentage
South 7,435 47%
Northeast 3,481 22%
West 2,689 17%
Midwest 1,899 12%
U.S. Protectorates 316 2%

Global HIV Statistics

As with the United States, there have been impressive declines in global HIV infections and deaths since 2004, when over 1.7 million deaths were reported. Today, the annual number of HIV-related deaths hover around 690,000—a reduction of roughly 60%.

At the same time, there has been a leveling off of many of the early gains and an increase in infection rates in certain hotspots around the world. Stagnating economic contributions from developed countries are only part of the reason why.

The vast majority of people living with HIV are in low- to medium-income countries. Of the 38 million living with HIV today, more than half are in Africa where adults infection rates often exceed 10%, 20%, and even 25% in some countries. These are described in the latest surveillance report from the United Nations Programme on HIV/AIDS (UNAIDS).

Geographic Area Living With HIV Percentage
Southern and East Africa 20.7 million 54%
Asia and the Pacific 5.8 million 15%
Central and West Africa 4.9 million 13%
Western and Central Europe and North America 2.2 million 6%
Latin America 2.1 million 6%
Eastern Europe and Central Asia 1.7 million 4%
The Caribbean 330,000 Less than 1%
Middle East and North Africa 240,000 Less than 1%

Prevalence Rates

The rate of global HIV infections has generally been on the decline since the height of the pandemic in 2004. Much of the success has been attributed to the United Nations-led 90-90-90 campaign, a global effort to have 90% of the world's HIV population diagnosed, 90% of those placed on HIV therapy, and 90% of those to achieve undetectable viral loads by 2020.

Although there remain questions as to how sustainable the goals truly are—considering that rich countries like the United States have yet to meet them—they have helped reduce the prevalence rate in hard-hit countries like South Africa, where infections have fallen by some 40% since 2010.

Countries With the Highest HIV Prevalence
Country Adult Prevalence, 2003 Adult Prevalence, 2019 Living With HIV Today
Eswatini
(Swaziland)
38.8% 27.3% 210,000
Lesotho 28.9% 23.6% 340,000
Botswana 37.3% 21.9% 360,000
South Africa 21.5% 20.4% 7,700,000
Namibia 21.3% 13.8% 230,000
Zimbabwe 24.6% 13.5% 1,300,000
Zambia 16.5% 12.4% 1,200,000
Mozambique 12.6% 12.3% 1,800,000
Malawi 12.2% 9.2% 1,000,000
Uganda 6.7% 6.5% 1,400,000
United States 0.3% 0.3% 1,100,000

By contrast, there has been a steep rise in infections in places like Russia and Central Asia, where more than a third of all new infections is due, directly or indirectly, to injecting drug use. Government inaction and discrimination against gay men and other high-risk groups also help fuel the infection rates.

By Age and Sex

Unlike the United States, heterosexual sex remains the predominant mode of transmission in high-prevalent regions, such as sub-Saharan Africa. Within this context, younger, sexually active youth between the ages of 15 and 24 account for over a third of all new infections, while those aged 15 to 45 represent 60%.

Women are often disproportionately affected. In addition to biological vulnerabilities, gender inequality, unfair access to services, and sexual violence has led to higher rates of infection, often at a far earlier age compared to men.

A 2016 study in PLoS One reported that women in sub-Saharan Africa, the center of the global pandemic, are infected five to seven years earlier than their male peers, and today account for nearly two of three infections.

Due to the increased access to antiretroviral therapy, people with HIV are now living longer than ever, even in high-prevalence regions. Where only 8% of people with HIV lived beyond the age of 50 in 2010, now over 20% are in their 50s and older. That number is expected to increase as the 90-90-90 targets are met.

Antiretroviral Coverage

The impressive gains in the global fight against HIV could have not been achieved without the manufacture of low-cost generic antiretrovirals.

Around 80% of these are produced in India where the Indian Patents Act, implemented in the 1970s, allowed for the breaking of international patent laws on the grounds that HIV was a global health emergency. Because of this, HIV drugs like Odefsey (emtricitabine, rilpivirine, and tenofovir) that retail for $3,000 per month in the United States cost as little as $75 per year in Africa.

Globally, there are an estimated 25.4 million people on antiretroviral therapy, or roughly 67% of the world's HIV population. Data from UNAIDS suggests that, of these, 59% achieved an undetectable viral load (more or less in line with U.S. rates).

Countries With Highest Antiretroviral Coverage
Country Antiretroviral Coverage (%)
Eswatini 96%
Italy 90%
Latvia 90%
Lithuania 90%
Netherlands 87%
Rwanda 87%
Albania 85%
Armenia 85%
Namibia 85%
Spain 85%
Zambia 85%
Zimbabwe 85%
Burundi 84%
Cambodia 84%
Australia 83%
Botswana 82%
Comoros 82%
France  82%
United States 64%

Mother-to-Child Transmission

One of the success stories of the global fight against HIV has been the use of antiretroviral drugs to prevent mother-to-child transmission (MTCT). When used appropriately, the preventive strategy can reduce the risk of MTCT by 98% or more. Without treatment, the risk of transmission runs anywhere from 15% to 45%.

As a result of prenatal interventions, the rate of HIV transmission during pregnancy has dropped by 47% globally since 2010, averting nearly 1.6 million infections.

Even so, the rate of MTCT remains unacceptably high, with some countries reporting as many as one in four transmissions during pregnancy or as the result of breastfeeding.

Countries With the Highest MTCT Infections
Country Rate (%)
Indonesia 26.6%
Angola 21%
Ghana 17.7%
Ethiopia 15.9%
Chad 14.2%
Côte d'Ivoire 14.1%
Democratic Republic of Congo 13.3%
Cameroon 12.8%
Mozambique 11.1%
Tanzania 11%
United States Less than 1%

In 2016, Armenia, Belarus, Thailand, and, the Republic of Moldova were the first four developing countries to report the elimination of MTCT from within their borders.

Mortality Rates

HIV remains a leading cause of death worldwide and the leading cause of death globally of women of reproductive age. However, HIV-related deaths have dropped dramatically in recent years, from 1.1. million in 2010 to 690,000 in 2019. All told, the mortality rate is 59% less than it was at the height of the pandemic in 2004.

According to a 2019 study in The Lancet HIV, no less than 122 of 195 countries experienced a decline in HIV-related deaths. Some countries like Burundi, Ethiopia, and Zimbabwe have seen the death rate drop by as much as 20%.

Not every country is following this trend. Russia, a country often cited for its failure to address infection rates within its borders, accounted for more than 80% of new infections in the Eastern European and Central Asian regions from 2010 to 2015. A recent commitment to increase antiretroviral access to 75% of Russians living with HIV will hopefully reverse this trend.

  Country 2018 2010 2000 Trend
1 South Africa 71,000 140,000 100,000
2 Mozambique 54,000 64,000 40,000
3 Nigeria 53,000 72,000 78,000
4 Indonesia 38,000 24,000 19,000
5 Kenya 25,000 56,000 19,000
6 Tanzania 24,000 48,000 80,000
7 Uganda 23,000 56,000 85,000
8 Zimbabwe 22,000 54,000 120,000
9 Thailand 18,000 27,000 54,000
10 Zambia 17,000 26,000 62,000
11 Côte d'Ivoire 16,000 24,000 44,000
12 Cameroon 15,000 22,000 19,000
13 Brazil 15,000 15,000 15,000
14 Ghana 14,000 17,000 18,000
15 Angola 14,000 10,000 4,8000
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