HIV/AIDS Today

The number of people living with HIV infection in the United States (HIV prevalence) is higher than ever before. More than 1 million people were estimated to be living with HIV infection in the United States at the end of 2006, the most recent year with national prevalence estimates (1). This is an increase of 11% from the previous estimate in 2003 (2).

Good News
Concerns
What Is Being Done

Good News

Despite the increase in the number of people living with HIV infection, the annual number of new infections (HIV incidence) has remained relatively stable (1). Recent data suggests that HIV prevention efforts are taking hold:

Lower transmission rate. The majority of people infected with HIV do not transmit the virus to others. CDC estimates that there were 5 transmissions per 100 persons living with HIV infection in the United States in 2006 (3), meaning that 95% of those infected did not transmit HIV, an 89% decline in the estimated rate of transmission since the peak of the epidemic in the mid-1980s (1). This decline is likely due to prevention efforts and availability of improved testing and treatment (1).

More know of their HIV infection. The estimated proportion of persons in the United States with HIV who know they are infected increased from 75% in 2003 to 79% in 2006 (4). This is a sign of progress for HIV prevention because research shows that most individuals reduce behaviors that could transmit HIV when they learn they are infected (5).

Concerns

Despite successes, there are still concerns:

Significant cause of death. More than half a million people with an AIDS diagnosis in the United States died from the beginning of the epidemic through 2007, the most recent year that death statistics are available (6). From 2005 through 2007, deaths of persons with a diagnosis of HIV infection have increased 17% and the estimated rate of deaths increased 14% (1).

Late diagnoses. Too many persons continue to be diagnosed with HIV late in the course of their infection and miss opportunities for treatment and prevention. In 2008, one-third (32%) of individuals with an HIV diagnosis reported to the CDC received a diagnosis of AIDS within 12 months of their initial HIV diagnosis (6).

Disproportionate impact on certain populations and geographic locations. Men who have sex with men (MSM), blacks/African Americans, and Hispanic/Latinos are the groups most affected by HIV infection. Geographically, urban areas are the most heavily impacted.

MSM represent 2% of the population; however, their HIV diagnosis rate is more than 44 times that of other men and more than 40 times that of women (7). MSM is the only risk group with increasing numbers of new HIV infections annually, and they account for more than half of all new infections in the United States each year (8).
Blacks/African Americans are the racial/ethnic group most affected by HIV. They represent about 12% of the population but are almost half of all new HIV infections (8). Over the course of their life, 1 in 16 black/African American men will receive a diagnosis of HIV, as will 1 in 30 black women (9). HIV infection rates are higher among black MSM compared to other MSM. More new HIV infections occurred among young black MSM (aged 13–29) than among any other age and racial group of MSM (10).
Hispanics/Latinos represent 15% of the population (11) but account for an estimated 17% of new HIV infections (8).
Women of color continue to be disproportionately affected by HIV infection. The rate of new HIV infection for black/African American women is nearly 15 times the rate for white women (12). The rate of new HIV infection among Hispanic/Latina women is nearly four times that of white women (12).
Specific locations are more affected, although HIV and AIDS have had a severe impact on all regions of the country. AIDS remains mainly an urban disease, with most individuals diagnosed in 2008 living in cities with more than 500,000 people. Areas hardest hit based on ranking of AIDS cases include Miami and Jacksonville, Florida; New Orleans and Baton Rouge, Louisiana; Baltimore, Maryland; and Washington, D.C. Due to differences in population sizes, rates do not always highlight the large number of people diagnosed with AIDS in certain metropolitan areas, such as New York City or San Francisco (6).

Learn More About Populations Affected By HIV:
Men Who Have Sex with Men (MSM): CDC
Blacks/African Americans: CDC | NPIN
Hispanics/Latinos: CDC | NPIN
Women: CDC | NPIN

What Is Being Done?

Prevention—both biomedical and behavioral—is the best hope for further reducing the spread of HIV.

As the lead agency for HIV prevention in the United States, CDC provides leadership in helping control the HIV/AIDS epidemic by working with community, state, national, and international partners in surveillance, research, and prevention and evaluation activities. CDC's programs work to improve treatment, care, and support for persons living with HIV/AIDS and to build capacity and infrastructure to address the HIV/AIDS epidemic in the United States and around the world. The Division of HIV/AIDS Prevention (DHAP), part of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, coordinates CDC's HIV/AIDS prevention efforts.

Learn more about DHAP's HIV initiatives.

¹ CDC. HIV in the United States: An Overview. Atlanta, GA: U.S. Department of Health and Human Services; 2010. (cited 2010 Sep 21). Available from: http://www.cdc.gov/hiv/topics/surveillance/resources/factsheets/us_overview.htm.
² CDC. HIV prevalence estimates-United States, 2006. MMWR. 2008;57(39):1073-1076. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5739a2.htm.
³ Holtgrave DR, Hall HI, Rhodes PH, Wolitski R. Updated annual HIV transmission rates in the United States, 1977-2006. J Aquir Immune Defic Syndr. 2009;50(2):236-8.
⁴ Campsmith ML, Rhodes PH, Hall HI, Green TA. Undiagnosed HIV prevalence among adults and adolescents in the United States at the end of 2006. J Acquir Immune Defic Syndr. 2010;53(5):619-24.
⁵ Marks G, Crepaz N, Senterfitt JW, Janssen RS. Meta-analysis of high-risk sexual behavior in persons aware and unaware they are infected with HIV in the United States: Implications for HIV prevention programs. J Acquir Immune Defic Syndr. 2005;39(4):446-53.
⁶ CDC. Diagnoses of HIV infection and AIDS in the United States, 2008. HIV Surveillance Report, v. 20. Atlanta, GA: U.S. Department of Health and Human Services; 2010. (cited 2010 Sep 21). Available from: http://www.cdc.gov/hiv/surveillance/resources/reports/2008report.
⁷ Purcell DW, Johnson C, Lansky A, Prejean J, Stein R, Denning P, et al. Calculating HIV and syphilis rates for risk groups: Estimating the national population size of men who have sex with men (abstract). Presented at 2010 National STD Prevention Conference; 2010 Mar 10; Atlanta, GA. (cited 2010 Sep 21). Available from: http://www.cdc.gov/hiv/topics/msm/resources/research/msm.htm.
⁸ Hall HI, Song R, Rhodes P, Prejean J, An Q, Lee LM, et al. Estimation of HIV incidence in the United States. JAMA. 2008;300(5):520-9.
⁹ Hall HI, An Q, Hutchinson A, Sansom S. Estimating the lifetime risk of a diagnosis of the HIV infection in 33 States, 2004-2005. J Acquir Immune Defic Syndr. 2008;49(3):294-7.
¹⁰ CDC. HIV among African Americans. Atlanta, GA: U.S. Department of Health and Human Services; 2010. (cited 2010 Sep 22). Available from: http://www.cdc.gov/hiv/topics/aa/index.htm.
¹¹ U.S. Census Bureau. USA QuickFacts. Washington, DC: U.S. Department of Commerce; 2010. (cited 2010 Sep 21). Available from: http://quickfacts.census.gov/qfd/states/00000.html.
¹² CDC. Subpopulation estimates from the HIV incidence surveillance system—United States, 2006. MMWR. 2008;57(36):985-989. Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5736a1.htm.

Page Last Updated: October 5, 2010