Roughly half of all people living with HIV worldwide are women and girls, placing the global estimate at approximately 19 million. In the United States alone, about 19% of the more than 1.1 million people living with diagnosed HIV are female. These numbers reflect decades of progress in testing and treatment, but they also reveal persistent gaps, particularly for young women in sub-Saharan Africa.
The Global Picture
HIV does not affect men and women equally, and geography plays an enormous role. Sub-Saharan Africa carries the heaviest burden: the region accounts for the vast majority of new infections among women, driven by a combination of biological vulnerability, economic inequality, and limited access to prevention tools. In 2023, an estimated 4,000 adolescent girls and young women ages 15 to 24 acquired HIV every single week, totaling roughly 210,000 new infections in that age group for the year.
Outside of sub-Saharan Africa, the share of women among people living with HIV is smaller but still significant. In Eastern Europe, Central Asia, and parts of Latin America, injection drug use and heterosexual transmission both contribute to new cases among women, though the overall numbers are far lower than in Africa.
Women Living With HIV in the United States
As of 2023, approximately 1,132,739 people aged 13 and older were living with diagnosed HIV in the United States and its territories. Women accounted for 19% of new diagnoses that year, or about 7,350 cases. That percentage has held relatively steady over the past several years, making women a consistent minority of new U.S. diagnoses but still a substantial group in absolute terms.
Black and African American women are disproportionately affected. They represent a far higher share of new diagnoses among women than their proportion of the U.S. population would suggest. Hispanic and Latina women also face elevated rates compared to white women. These disparities are driven less by individual behavior and more by structural factors: poverty, unequal access to healthcare, housing instability, and higher background prevalence of HIV in some communities, which increases the statistical likelihood of exposure.
How Women Acquire HIV
Among women in the U.S., heterosexual contact is the dominant route of transmission, accounting for 83% of new infections. The remaining cases are largely attributed to injection drug use, which accounts for about 3% of all estimated new infections (roughly 1,000 cases per year among women). A small number of cases involve both risk factors.
Biologically, women are more susceptible to HIV during vaginal sex than their male partners. The vaginal and cervical lining has a large surface area of mucous membrane that can be exposed to the virus, and microscopic tears during intercourse create additional entry points. This is one reason prevention tools designed specifically for women, such as pre-exposure prophylaxis (PrEP) taken as a daily pill or a long-acting injectable, have become a growing focus of public health efforts.
Pregnancy and Preventing Transmission to Babies
Globally, about 1.2 million pregnant women were living with HIV in 2023. Of those, an estimated 84% received antiretroviral treatment to prevent passing the virus to their babies during pregnancy, labor, or breastfeeding. When a pregnant woman takes these medications consistently and maintains a very low viral level, the chance of transmission to her infant drops to less than 1%.
That 84% figure represents enormous progress. Two decades ago, hundreds of thousands of infants acquired HIV each year. But the remaining 16% of pregnant women not yet reached by treatment still translates to tens of thousands of preventable infant infections annually, almost entirely concentrated in low-income countries with the weakest healthcare infrastructure.
Young Women Face the Highest Risk
The age group most vulnerable to new HIV infection globally is women between 15 and 24. The 210,000 new infections estimated in this group for 2023 are not spread evenly across the world. The overwhelming majority occur in sub-Saharan Africa, where young women acquire HIV at rates three to four times higher than young men of the same age. Contributing factors include age-disparate sexual relationships (partnerships with older men who are more likely to already have HIV), gender-based violence, barriers to staying in school, and limited negotiating power around condom use.
In the U.S., the age pattern looks somewhat different. Women in their 20s and 30s account for the largest share of new diagnoses, but the numbers are far smaller in absolute terms than in high-burden African countries. Access to PrEP, widespread testing, and rapid treatment initiation have helped keep new infections among American women relatively low, though uptake of PrEP among women remains much lower than among men.
Treatment Access and Viral Suppression
Modern antiretroviral therapy allows most women living with HIV to reach viral suppression, meaning the amount of virus in their blood is so low it’s undetectable on standard tests. At that level, HIV cannot be transmitted sexually, a concept sometimes summarized as “undetectable equals untransmittable.” Women who maintain viral suppression live near-normal lifespans and can have healthy pregnancies.
Access to treatment, however, is uneven. In the U.S. and Western Europe, the majority of women diagnosed with HIV are on treatment and virally suppressed. In parts of sub-Saharan Africa and Southeast Asia, gaps remain. Women in rural areas, women who face stigma from partners or family, and adolescent girls who may not disclose their status are among the hardest groups to keep engaged in care over the long term.