Approximately 1.2 million people are living with HIV in the United States. In 2022, an estimated 31,800 new HIV infections occurred, and 37,981 people received a formal HIV diagnosis. While those numbers are lower than the epidemic’s peak decades ago, HIV remains a significant public health challenge, with new infections concentrated among specific communities and regions of the country.
New Infections Each Year
The 31,800 estimated new infections in 2022 represent actual transmissions, while the 37,981 diagnoses that year include people who may have been infected months or years earlier and are only now being tested. That gap matters: it means a portion of people living with HIV don’t know their status and can unknowingly pass the virus to others. Roughly 13% of people with HIV in the U.S. have not been diagnosed.
The federal government’s Ending the HIV Epidemic initiative set a goal of reducing new infections by 75% by 2025 and 90% by 2030. Progress has been uneven. New diagnoses among some groups have declined in recent years, while others have seen increases.
How New Infections Break Down by Transmission
Gay, bisexual, and other men who have sex with men account for the largest share of new HIV infections by far. In 2022, male-to-male sexual contact was linked to 67% of the estimated 31,800 new infections (about 21,400 cases). Heterosexual contact accounted for 22% (roughly 7,000), and injection drug use accounted for 7% (about 2,300).
Racial and Ethnic Disparities
HIV does not affect all communities equally. Black/African American people made up about 12% of the U.S. population in 2022 but accounted for 37% of estimated new HIV infections (11,900). Hispanic/Latino people, roughly 18% of the population, accounted for 33% (10,500). White people, at 61% of the population, accounted for 24% (7,600). Together, Black and Hispanic/Latino communities represented 70% of all new infections that year.
The pattern holds in formal diagnoses too. Of the 37,981 new diagnoses in 2022, Black/African American people accounted for 38% (14,553) and Hispanic/Latino people for 32% (12,167). Between 2018 and 2022, diagnoses among Black/African American individuals decreased by 5%, a modest but real improvement. During the same period, diagnoses among Hispanic/Latino people increased 17%, a trend that public health officials are watching closely.
These disparities are not driven by differences in individual behavior. They reflect structural factors: poverty, limited access to healthcare and prevention tools like PrEP (a daily pill that prevents HIV infection), stigma, and historically underfunded health systems in the communities most affected.
Who Is Most Affected by Gender
Men account for the large majority of new HIV diagnoses, driven primarily by male-to-male sexual contact. Among men receiving a new diagnosis in 2022, Black/African American men who have sex with men made up 35% of all diagnoses nationally (8,831 cases), and Hispanic/Latino men who have sex with men accounted for 37% (9,374 cases).
Among women, the numbers are smaller overall but the racial disparity is stark. Black/African American women accounted for 50% of all new HIV diagnoses among females in 2022, despite making up a far smaller share of the female population. White women accounted for 24% and Hispanic/Latina women for 20%.
Geographic Concentration
HIV is not spread evenly across the country. The epidemic is heavily concentrated in the South, which consistently accounts for more than half of all new diagnoses despite having about 38% of the U.S. population. States like Florida, Texas, Georgia, and Louisiana report some of the highest numbers. Urban centers in other regions, including New York City, Los Angeles, Chicago, and Washington, D.C., also carry a significant share of cases. Rural areas in the South have seen growing concern because of limited access to testing, treatment, and prevention services.
Living With HIV Today
The picture for people living with HIV has changed dramatically since the early days of the epidemic. Modern antiretroviral therapy can suppress the virus to undetectable levels, meaning a person on effective treatment cannot transmit HIV sexually. This concept, often summarized as “undetectable equals untransmittable,” has reshaped both treatment and prevention. Most people who are diagnosed and stay in care can expect a near-normal lifespan.
The challenge is getting everyone into that care pipeline. Of the 1.2 million people living with HIV, not all are consistently receiving treatment or achieving viral suppression. Gaps in insurance coverage, transportation to clinics, housing stability, and mental health support all create barriers. People who cycle in and out of care are more vulnerable to health complications and more likely to transmit the virus.
Prevention tools have also expanded. PrEP, when taken as prescribed, reduces the risk of getting HIV from sex by about 99%. A long-acting injectable version, given every two months, removes the need for a daily pill. Despite its effectiveness, PrEP uptake remains low among the communities most affected, particularly Black and Hispanic/Latino populations, again reflecting gaps in access rather than awareness alone.