Approximately 1.2 million people in the United States are living with HIV. That figure, based on CDC estimates, includes both people who have been diagnosed and those who don’t yet know they carry the virus. Roughly 13% of people with HIV in the U.S. are unaware of their status, which means an estimated 150,000 or more individuals haven’t been tested or diagnosed.
New Infections Each Year
In 2022, there were an estimated 31,800 new HIV infections across the country, a rate of about 11.3 per 100,000 people. That number has declined significantly from the epidemic’s peak in the mid-1980s, when new infections topped 100,000 annually, but progress in recent years has been uneven. Some populations have seen meaningful drops in new cases while others have seen little change or even increases.
The federal Ending the HIV Epidemic initiative set ambitious targets: a 75% reduction in new infections by 2025 and a 90% reduction by 2030. Meeting those goals depends on expanding access to prevention tools like PrEP (a daily or injectable medication that prevents infection) and ensuring more people who test positive start treatment quickly.
Racial and Ethnic Disparities
HIV does not affect all communities equally. Of the estimated 31,800 new infections in 2022:
- Black/African American individuals accounted for 11,900 new infections, making this community the most affected despite representing about 13% of the U.S. population.
- Hispanic/Latino individuals accounted for 10,500 new infections.
- White individuals accounted for 7,600 new infections.
These disparities are driven largely by systemic factors: unequal access to healthcare, higher rates of poverty, stigma that discourages testing, and historically lower access to prevention medications. They do not reflect differences in individual behavior.
Who Is Most Affected
Gay and bisexual men remain the population most heavily impacted by HIV in the United States, accounting for the majority of new infections each year. Within that group, young men between the ages of 25 and 34 see the highest rates of new diagnoses. Heterosexual contact and injection drug use are the other primary routes of transmission, though they account for a smaller share of new cases.
Geographically, the U.S. South carries a disproportionate share of the epidemic. States like Florida, Georgia, Texas, and Louisiana consistently report some of the highest rates of new diagnoses and people living with HIV. Many Southern states also have lower rates of Medicaid expansion and fewer sexual health clinics, which limits access to testing and treatment.
Treatment and Viral Suppression
Modern antiretroviral therapy can reduce the amount of virus in a person’s blood to undetectable levels. When someone reaches and maintains an undetectable viral load, they effectively cannot transmit HIV to sexual partners. This concept, known as “undetectable equals untransmittable” or U=U, has reshaped how both clinicians and patients think about living with HIV.
Getting to that point requires knowing your status, accessing care, and staying on medication. As of 2020 CDC data, about 65% of the roughly 944,000 people ages 13 and older with diagnosed HIV in the U.S. had achieved viral suppression. That means more than a third of diagnosed individuals had not, often because of gaps in insurance coverage, housing instability, substance use, or inconsistent access to a provider. Closing that gap is one of the most direct ways to reduce both HIV-related illness and new transmissions.
Why the Undiagnosed Number Matters
People who don’t know they have HIV can’t start treatment and are more likely to transmit the virus to others. Studies consistently show that a large share of new transmissions come from the relatively small group of people who are undiagnosed or diagnosed but not yet in care. The CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once in their lifetime, and that people with ongoing risk factors test at least annually.
Rapid HIV tests can now deliver results in 20 minutes at a clinic, and home test kits are available over the counter at most pharmacies. Early diagnosis not only protects partners but also improves long-term health outcomes for the person living with HIV, since starting treatment sooner prevents immune system damage.