When NBA legend Magic Johnson announced his HIV diagnosis in 1991, it thrust the disease into conversations at dinner tables, sports bars, and water coolers across the U.S. However, HIV/AIDS was nothing new. By the early 80s, it had already earned epidemic status in the public health sphere. It also collected a host of misconceptions about its symptoms and transmission. Today, while the number of people living with HIV is higher than ever, public perceptions surrounding HIV infections have shifted drastically.
As HIV prevention, testing, and treatment have improved, AIDS-related deaths have decreased, and people with HIV can live long, healthy lives. The virus is still widespread, but by studying the statistics around HIV prevalence, transmission, treatment, and risk factors, we can better understand the disease and eliminate stigmas.
What is HIV?
Human immunodeficiency virus (HIV) is a retrovirus that attacks and destroys the immune system’s CD4 cells, heightening a person’s susceptibility to other diseases. It spreads through contact with an infected person’s bodily fluids, most commonly via unprotected sexual contact, intravenous drug use, pregnancy, or breastfeeding.
HIV symptoms usually come in three stages. The first, called acute HIV Infection, occurs 2–6 weeks after transmission and manifests as a fever, sore throat, body aches, chills, headaches, or rash. The next, clinical latency, is typically asymptomatic, even though the virus continues multiplying. During this stage, people who take medication and keep a low viral load can prevent further transmission.
Left untreated during clinical latency, HIV can become acquired immunodeficiency syndrome (AIDS). Symptoms of this late-stage infection may include persistent fatigue, weakness, oral lesions, chronic diarrhea, swollen lymph nodes, chills, fever, and weight loss. Not every person who has HIV will develop AIDS, especially if they take medication.
How common is HIV?
- In 2022, 39 million people worldwide were living with HIV. (WHO, 2023)
- Around the world, an estimated 4,000 people become infected with HIV every day, including 1,100 people ages 15–24 years. (UNAIDS, 2022)
- An estimated 5.5 million people worldwide did not know that they were living with HIV/AIDS in 2022. (amFAR, 2023)
- Since the start of the HIV epidemic in 1981, 85.6 million people have become infected. (amfAR, 2023)
Global HIV statistics
- Africa is the most severely affected region, with an estimated 25.6 million cases, followed by Southeast Asia with 3.9 million, South and North America with 3.8 million, Europe with 3.0 million, and the Western Pacific with 2.2 million. (WHO, 2023)
- In 2022, there were an estimated 1.3 million new HIV infections worldwide, the lowest in decades, with the strongest decline in sub-Saharan Africa. (UNAIDS, 2023)
- By the end of 2022, around 76% of people living with HIV were receiving antiretroviral therapy and 71% had suppressed viral loads. (WHO, 2023)
- From 1996 to 2022, HIV treatment has prevented almost 21 million AIDS-related deaths around the world. (UNAIDS, 2023)
- There were 630,000 AIDS-related deaths around the world in 2022, down 51% from 2010. (WHO, 2022)
HIV statistics in the U.S.
- As of 2021, there were an estimated 1,086,806 U.S. residents living with HIV. (AIDSvu, 2022)
- There were 36,189 new cases of HIV in the U.S. and its dependent areas in 2021, which was a 7% decrease since 2017. (CDC, 2023)
- Among U.S. regions, the South had the highest rate of HIV incidence due to male-to-male sexual contact, affecting 51% of this population., followed by the West (21%), Northeast (14%), and Midwest (14%). (CDC, 2023)
- In 2021, 75.3% of those living with HIV received care, and 65.9% were virally suppressed. (AIDSvu, 2022)
- In 2021, the death rate for HIV was 1.3 deaths per 100,000, down from 2.6 per 100,000 in 2010. (CDC, 2021)
HIV statistics by transmission category
- Male-to-male sexual contact is the most common cause of HIV diagnoses in the U.S. It accounted for 67% of new diagnoses in 2021. Heterosexual contact accounted for 22%, and intravenous drug use accounted for 7%. (CDC, 2023)
- Globally, people who inject drugs have 35 times the risk of acquiring HIV of the general population, female sex workers have 30 times the risk, gay men have 28 times the risk, and transgender women have 14 times the risk. (UNAIDS, 2022)
- Across the globe, an estimated 1.3 million women and girls living with HIV become pregnant each year. Without intervention, the rate of transmission during pregnancy, labor, delivery, or breastfeeding ranges from 15% to 45%. (WHO, 2019)
- In the U.S. and Europe, however, HIV medicines and other healthcare interventions have helped lower the rate of perinatal transmission of HIV to 1% or less. (NIH, 2023)
HIV statistics by race and ethnicity
- In 2021, Black/African American people accounted for 40% of new HIV infections of those ages 13 years and older in the U.S., followed by Hispanic/Latino people at 29%, White people at 25%, multiracial people at 3%, and Asian people at 2%. (CDC, 2023)
- Black men are 6 times more likely to die from HIV than non-Hispanic White men, and Black women are 15.3 times as likely than White women. (U.S. Dept. of Health and Human Services, 2022)
- While 78% of White people who could benefit from PrEP received the medication in 2021, only 11% of Black people and 21% of Hispanic/Latino people who could benefit received it. (CDC, 2023)
HIV statistics by sex and gender
- Of the new HIV diagnoses in the U.S. in 2018, 81% were men, and 86% of that population were men who have sex with men (MSM). (CDC, 2022)
- Globally, 46% of all new HIV infections were among women and girls in 2022. In sub-Saharan Africa, women and girls accounted for 63% of all new HIV infections. (amfAR, 2023)
- Since 2010, AIDS-related mortality has declined by 55% among women and girls and by 47% among men and boys globally. (UNAIDS, 2023)
- Transgender people are about 13 times more likely to be HIV-positive than those who are not transgender. (WHO, 2020)
HIV statistics by age
- In 2021, 40.6% of people living with HIV were 55 years of age and older in the U.S., 22.7% were ages 45-54 years, 18.9% were ages 35-44 years, 15.2% were ages 25-34 years and 2.6% were ages 13-24 years. (AIDSvu, 2022)
- However, in 2021, U.S. residents ages 13 to 34 years accounted for more than half (56%) of the 36,136 new diagnoses, and people ages 25 to 34 represented 37% of those newly diagnosed. (CDC, 2023)
- The HIV-related death rate in the U.S. was highest among adults ages 55–59 years in 2021. (Statista, 2023)
- Worldwide, 2 out of every 7 new HIV infections in 2019 were among people 15–24 years of age. (UNAIDS, 2021)
- In 2021, 160,000 children acquired HIV, and children made up 15% of all AIDS-related deaths worldwide. (WHO, 2023)
Common HIV complications
- In 2019, an estimated 30% of the 690,000 AIDS-related deaths worldwide were due to tuberculosis, the leading cause of death among those with HIV. (WHO, 2020)
- People who have HIV are 18 times more likely to contract tuberculosis. (UNAIDS, 2022)
- A 2015 meta-analysis of studies from around the world showed that the most common reasons for hospitalization among people living with HIV were AIDS-related illnesses (46%) and bacterial infections (31%). (The Lancet, 2015)
- An estimated 8% to 10% of people with HIV around the world have chronic Hepatitis B infection. (Topics in Antiviral Medicine, 2023)
- In 2020, 21% of people living with HIV reported needing but not receiving mental health services in the previous 12 months. (CDC, 2023)
- From 2010 to 2017, HIV-related death rates decreased by 48.4% in the U.S. (CDC, 2020)
The cost of HIV
- In recent years, the U.S. government’s spending on HIV has risen to more than $28 billion per year. (HIV.gov, 2023)
- The estimated average cost of antiretroviral therapy in 2018 ranged from $36,000 to $48,000 per patient per year. (JAMA Internal Medicine, 2020)
- Antiretroviral therapy is the fifth costliest therapeutic class in the U.S., totaling $22.5 billion in 2018 spending. (JAMA Internal Medicine, 2020)
- The estimated average HIV-related medical cost throughout an HIV-positive person’s lifetime ranges from $420,285 to $1,079,999. (, 2021 )
Causes of HIV
HIV is a sexually transmitted disease (STD), but while unprotected sex is the most common cause, it’s not the only one. The transmission of HIV also comes from exchanges of blood, semen, breast milk, and vaginal or rectal fluids. So, unclean needles, pregnancy, breastfeeding, and other exposures to bodily fluids can also lead to infection.
“HIV can be contracted by anyone, regardless of your age, race, sexual orientation, religion, or lifestyle,” says Jill Fuller, Ph.D., CRNP, who is a representative for Take Control HIV. “If you have sex, you are at risk. If you utilize used street drug equipment, you are at risk.”
Theoretically, an organ transplant or blood transfusion could spread HIV as well but donated blood and tissues go through rigorous screenings, so this is exceptionally rare. The virus cannot spread through saliva, sweat, tears, sharing utensils, toilet seats, swimming pools, or bug bites.
HIV prevention
The good news is that anyone who’s aware of HIV’s risk factors can take measures to avoid or mitigate them. Since it often spreads via unprotected sexual contact, wearing a condom during sex—particularly for MSM and sex workers—can be especially effective. Limiting the number of sexual partners and getting tested for other sexually transmitted diseases helps, too, since having an STD can make it easier to contract and spread HIV.
For people who inject drugs, avoiding shared needles is essential to prevention. “While the transmission of HIV through heterosexual and homosexual intercourse remains significant due to the higher numbers, it’s important to note that sharing needles from multiple people can be more common than engaging in sexual activities with multiple partners,” says Chief Clinical Officer at Symetria Recovery, Dr. Lea McMahon, LPC, EdD.
It’s best to avoid injecting drugs entirely—or at least use clean, new equipment every time. However, Dr. McMahon says that mental health treatment is just as important for prevention because “individuals with mental health challenges or substance use disorders often engage in high-risk behaviors, increasing their vulnerability to HIV transmission.”
People who engage in risky activities can also take PrEP, a drug regimen that reduces the chances of contracting HIV via sex by around 99%, and via injecting drugs by at least 74%, according to the CDC. If you take part in these activities, Dr. Fuller says, “Find a medical provider you can be honest with, so you can properly protect yourself from HIV.”. She also suggests “utilizing local resources, such as sites for free condoms, needle exchange programs, and education programs so you can learn more about HIV prevention.”
Regular HIV testing and locating nearby HIV prevention services is also important for anyone who thinks they have been exposed to the virus or may be exposed in the future. Dr. Fuller says that anyone engaging in risk-taking behavior should get tested at least two to three times per year.
Treating HIV
The most effective treatment for HIV is antiretroviral therapy (ART), a combination of several medications that reduce a person’s viral load. When taken as prescribed, these medications can reduce it so much that the virus is undetectable by lab tests. People who can maintain this undetectable viral load also won’t transmit HIV sexually.
Antiretroviral medicines that healthcare providers often prescribe for HIV treatment include nucleoside/nucleotide reverse transcriptase inhibitors like Ziagen (abacavir), non-nucleoside reverse transcriptase inhibitors like Sustiva (efavirenz), protease inhibitors like Reyataz (atazanavir), entry inhibitors like Fuzeon (enfuvirtide), and integrase inhibitors like Isentress (raltegravir). Typically, a course of ART will include two or three drugs from different classes.
Some people with HIV can benefit substantially from mental health treatment as well. “Treating addiction and mental health alongside HIV is crucial because improving mental health positively impacts treatment adherence, quality of life, and coping mechanisms during challenging phases,” says Dr. McMahon.
Even though there is currently no cure for HIV/AIDS, medications can help people with HIV live long, healthy lives.
HIV questions and answers
What percentage of the U.S. has HIV?
Approximately 0.3% of the U.S. population has HIV—around 1.2 million people, according to the CDC.
What is the survival rate of people with HIV?
According to the CDC, the death rate for HIV was 1.3 deaths per 100,000 in 2021, around half of what it was in 2010— 2.6 deaths per 100,000.
How many people receive an HIV diagnosis each year in the U.S.?
Approximately 32,100 U.S. adults received an HIV diagnosis in 2022. That’s down 12% since 2017, when new HIV diagnoses totaled 36,500.
Sources
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- Global AIDS update 2022, UNAIDS (2022)
- HIV/AIDS in the world, amfAR (2023)
- HIV estimates, July 2023, World Health Organization (2023)
- 2023 global AIDS update executive summary, UNAIDS (2023)
- Number of people dying from HIV-related causes, World Health Organization (2022)
- Local Data: United States, AIDSVu (2022)
- Diagnoses of HIV infection in the United States and dependent areas 2021: national profile, Centers for Disease Control and Prevention (2023)
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- HIV death rate in the U.S. in 2021, by age, Statista (2023)
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- Estimated lifetime HIV-related medical costs in the United States, Journal of the American Sexually Transmitted Diseases Association, 2021