An estimated 1.2 million people in the United States aged 13 and older were living with HIV at the end of 2022, the most recent year with complete data. That figure includes both diagnosed and undiagnosed cases. About 13% of those people, roughly 158,000, don’t know they have the virus.
New Infections Are Declining
The overall trajectory is moving in the right direction. Estimated new HIV infections dropped 12% between 2018 and 2022. That progress reflects wider use of prevention tools like pre-exposure prophylaxis (PrEP), expanded testing, and faster connections to treatment after diagnosis. The federal Ending the HIV Epidemic initiative set a goal of reducing new infections by 75% by 2025 and 90% by 2030, though meeting those targets would require a much steeper decline than what’s been achieved so far.
Who Is Most Affected
HIV does not spread evenly across the population. Black and Hispanic/Latino Americans accounted for roughly 70% of estimated new infections in 2022, despite making up a much smaller share of the overall U.S. population. These disparities are driven less by individual behavior and more by structural factors: unequal access to healthcare, higher rates of poverty, stigma that discourages testing, and historically underfunded public health infrastructure in the communities most affected.
Gay and bisexual men continue to bear a disproportionate share of the epidemic as well. Male-to-male sexual contact remains the most common transmission route, followed by heterosexual contact and injection drug use.
The Undiagnosed Gap
The 158,000 people living with HIV who haven’t been diagnosed represent one of the biggest remaining challenges. People who don’t know their status can’t start treatment, which means the virus continues replicating in their bodies and can be passed to others. By contrast, someone who takes antiretroviral medication and achieves viral suppression has effectively zero risk of transmitting HIV sexually, a concept known as U=U (undetectable equals untransmittable).
The CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once, with more frequent testing for people at higher risk. Rapid tests and at-home test kits have made this easier than it was a decade ago, but stigma and lack of routine screening in primary care still leave a significant number of people unaware of their status.
Treatment and Viral Suppression
Getting diagnosed is only the first step. The goal of HIV treatment is viral suppression, meaning the amount of virus in the blood is so low it’s undetectable on standard tests. In 2022, 65% of people with diagnosed HIV in the U.S. had achieved viral suppression. That number sounds modest, and the gaps along the care continuum explain why.
Over 80% of newly diagnosed people were linked to care within a month of their diagnosis, which is a strong starting point. But only 76% of all people living with diagnosed HIV had received any care during the year, 54% were retained in ongoing care, and just 65% reached viral suppression. The drop-off at each stage reflects real-world barriers: insurance gaps, transportation issues, mental health struggles, substance use, housing instability, and the simple difficulty of maintaining a daily medication regimen for life.
How Surveillance Data Works
HIV data in the U.S. comes from a national surveillance system that collects confidential, name-based case reports from all 50 states, the District of Columbia, and six U.S. territories. About 80% of new diagnoses are reported to the CDC in the same year they occur, and 98% are reported by the end of the following year. Because of this reporting lag, the most current complete data typically runs about one to two years behind the calendar year. The 2022 figures cited throughout this article reflect the latest available estimates; provisional 2023 data has been collected but is still being finalized.
The 1.2 million figure is itself an estimate that uses statistical models to account for people who have HIV but haven’t been tested. Surveillance captures only diagnosed cases, so researchers adjust upward based on testing patterns and population data to arrive at the true total.