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HIV in the United States

About 1.2 million people in the United States are living with HIV infection. The newest data show that in the United States, there were about 47,000 estimated HIV diagnoses in 2013. Overall, the number of people who have HIV has been increasing each year because people with HIV are now living longer and the number of new HIV diagnoses has stayed about the same over the last few years.

About 80% of estimated new diagnoses in the United States were among men and 20% among women in 2013. Most new HIV estimated diagnoses among women were from heterosexual contact (86%), and to a lesser extent, injection drug use (13%). About 21% of estimated new HIV diagnoses in 2013 were among young people aged 13 to 24, 30% were among people aged 25 to 34, 21% were among people aged 35 to 44, 18% were among people aged 45 to 54, and 10% were among people aged 55 or older.

When you live in a community where many people have HIV infection, the chances of having sex with someone who has HIV are higher. This map shows the percentage of people with HIV ("prevalence") in different US communities. Within any community, the prevalence of HIV can vary among different populations.

Risky behaviors, like having anal or vaginal sex without using a condom or taking medicines to prevent or treat HIV and sharing needles or syringes play a big role in HIV transmission in the United States. However, certain cultural and societal factors can also play a part in HIV risk. These factors include poverty, lack of educational opportunities, lack of access to health care, homophobia, stigma, and racial/ethnic or gender discrimination. Overall, research shows

  • Gay, bisexual, and other men who have sex with men (MSM) have the largest number of new HIV diagnoses in the United States. About 4% of the US male population is gay or bisexual, but gay and bisexual men accounted for 81% of all estimated new HIV diagnoses among men in 2013 and 65% of all estimated diagnoses. The estimated number of new HIV diagnoses among gay and bisexual men was highest in men aged 25-34. Young black or African American gay and bisexual men (aged 13 to 24) accounted for 58% of estimated new diagnoses among young gay and bisexual men overall and 45% of estimated new diagnoses among all black or African American gay and bisexual men.
  • Blacks or African Americans and Hispanics or Latinos are disproportionally affected by HIV than other racial and ethnic groups. About 12% of the US population is black or African American, but they accounted for 46% of estimated new HIV diagnoses in 2013. Similarly, although about 17% of the total US population is Hispanic or Latino, they accounted for about 21% of all estimated new HIV diagnoses in 2013.
  • Transgender women who have sex with men are among the groups at highest risk for HIV infection. Because we don't have uniform reporting of data for this population, we don't know how many transgender women in the United States are infected with HIV. However, data collected by local health departments and scientists studying these communities show high levels of HIV infection, with some studies finding that as many as 30% of transgender women are living with HIV. +

Many cultural, socioeconomic, and health-related factors may increase HIV risk for some transgender individuals. Some examples include,

  • Discrimination and social stigma can reduce access to education, employment, and housing opportunities.
  • Higher rates of drug and alcohol use, sex work, incarceration, homelessness, attempted suicide, unemployment, lack of family or social support, violence, and limited health care access may contribute to high risk of HIV infection among transgender people.
  • Health care provider insensitivity to transgender identity or sexuality can make it harder for transgender people who are HIV-positive to seek health care. Even if they seek care, research shows that transgender women who are HIV-positive are just as likely to have health insurance coverage as non-transgender people living with HIV, but the transgender women are less likely to take antiretroviral therapy (ART). Reasons for this difference could be related to provider decisions or to concerns among transwomen about potential interactions between ART and hormones.
  • Injection drug users remain at significant risk for getting HIV. In 2013, 7% of the estimated 47,352 diagnoses of HIV infection in the United States were attributed to injection drug use and another 3% to male-to-male sexual contact and injection drug use. Sixty-three percent of the 3,096 HIV diagnoses attributed to injection drug use in 2013 were among men and 37% were among women.