HIV Statistics You Should Know

Since the first cases of human immunodeficiency virus (HIV) were reported back in 1981, an estimated 88.4 million people have been infected worldwide, resulting in over 42.3 million deaths.

As of 2023, almost 40 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 2023 alone, an estimated 1.3 million people were infected with HIV, while over 630,000 died of HIV-related complications.

Despite these grim statistics, there have been gains. Since the height of the pandemic in 2004, HIV-related deaths have dropped by no less than 69%, while the rate of mother-to-child transmission has been cut by 62% since 2010.

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

According to 2023 statistics, in the United States over 1.1 million Americans were 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.

In 2023, there were 4,496 HIV-related deaths in the United States. As many as 13% of those infected (roughly 158,000) remain unaware of their status. Of those who have been diagnosed, over 80% are linked to medical care, and 35% 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, continue to be significant concerns.

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.

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.

Likewise, many of the metropolitan areas with the highest rates of HIV diagnoses—such as Miami, Memphis, and Atlanta—are in the South.

These dynamics are reflected in the 10 U.S. states with the highest HIV prevalence rates, all but two (Nevada and Washington, D.C.) are in the South.

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 in 2023 was highest among people 25 to 34, declining steadily thereafter.

Youth also accounts for the highest rate of undiagnosed infections. Today, more than 40% 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 more than a quarter remain undiagnosed.

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 8% of men who have sex with men (MSM) who identify as straight.

While MSM accounts for only 3% of the U.S. population, they represent 66% of all new infections. In their 2023 HIV surveillance update, the CDC highlighted key disparities affecting MSM:

• The number of new infections among MSM was nearly eight times that of heterosexual men (25,916 versus 3,078).
• HIV infection rates have increased among three groups—MSM (8%), male heterosexual contact (15%), and female heterosexual contact (10%).
• For people age 13 to 24, MSM represented 83% of diagnoses, and 10% were among female heterosexual contacts.

There are many reasons for these disparities, including stigma (especially high in many communities of color), access to health care, biological vulnerabilities (including an increased risk of transmission via anal sex), and illicit drug use (especially among young MSM). Women experiencing violence in their relationships are also at greater risk of getting HIV.

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

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 Black people in the United States, whose new infection rate is eight times higher than that of Whites.

Currently, around 438,449 Black Americans are living with HIV compared to 307,187 White Americans. This is even though Black Americans account for 13.7% of the U.S. population compared to Whites, who represent 58.4%.

The statistics are not much better for Hispanics and Latinos, of whom over 302,000 currently live with HIV. Although the new infection rate among Hispanics and Latinos is more or less the same as that of Whites, they account for only 19.5% of the population.

Poverty, again, is a driving factor. According to the U.S. Census Bureau, the rate of poverty among Blacks and Hispanics/Latinos is much higher than that of Whites and Asians (17.9% and 16.6% versus 9.7% and 9.1%, 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 people, who alone account for 38% of all new HIV infections in 2023.

By Sex

Although men account for the majority of HIV infections in the U.S.—66% of whom are MSM—over 257,000 women are 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 2023, wherein 6,242 women were infected as a result of heterosexual sex compared to only 3.078 men.

The risk is especially high among Black women due to socioeconomic and gender inequalities. As a result, Black women and teenage girls are almost 10 times as likely to get HIV as White women and teenage girls. (By contrast, White women are more than twice as likely to get infected as a result of injecting drug use compared to Black 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 a high rate of undiagnosed infections of all risk groups (15.2%). 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.

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. In 2023, most occurred in the South and West, according to the CDC.

Global HIV Statistics

As with the United States, there have been impressive declines in global HIV infections and deaths since 2004, when about 2.1 million deaths were reported. Today, the annual number of HIV-related deaths is around 630,000—a reduction of roughly 69%.

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 39.9 million living with HIV today, almost half are in Africa, where the prevalence of HIV exceeds 10% in some countries and exceeds 20% in some countries. These are described in the latest surveillance report from the Joint United Nations Programme on HIV/AIDS (UNAIDS).

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 antiretroviral 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 in hard-hit countries like South Africa, where infections have fallen by 58% since 2010.

By contrast, infections continue to rise in Eastern Europe and Central Asia, where 94% of all new infections are among “key populations,” which include sex workers, men who have sex with men, and people who inject drugs. Government inaction and discrimination against gay men and other high-risk groups also help fuel the infection rates.

By Age and Sex

Globally, heterosexual sex remains the predominant mode of transmission in high-prevalence regions, such as sub-Saharan Africa. In this region, HIV is 2.3% more prevalent among young women and girls between the ages of 15 and 24. They also accounted for 62% of new infections.

Women and girls are often disproportionately affected, accounting for 44% of all new global infections in 2023. In addition to biological vulnerabilities, gender inequality, unfair access to services, and sexual violence have led to higher rates of infection, often at a far earlier age compared to men.

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 not have 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 that retail in the U.S. for thousands of dollars cost under $100 in Africa.

Globally, there are an estimated 30.7 million people on antiretroviral therapy—roughly 77% of the world’s HIV population. Data from UNAIDS suggests that, of these, 72% achieved an undetectable viral load (more or less in line with U.S. rates).

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 95% or more. Without treatment, the risk of transmission runs anywhere from 15% to 45%.

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

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 among women of reproductive age. However, HIV-related deaths have dropped dramatically in recent years, from 1.3 million in 2010 to 630,000 in 2023. All told, the mortality rate is 69% less than it was at the height of the pandemic in 2004.

Not all regions are following this trend. Countries in North Africa, the Middle East, Central and Eastern Europe, and Central Asia have experienced increases in mortality rates. For example, Russia saw a 43,5% increase as well as Mongolia (61.4%), Iraq (66.7), and China (100.5%).