HIV affects roughly 1.1 million people in the United States, making it relatively uncommon in the general population but far more concentrated in specific groups and regions. About 31,800 new infections occurred in 2022, a number that has declined over the past decade thanks to better treatment and prevention tools, though progress has been uneven.
How Many People Are Living With HIV
As of 2023, approximately 1,132,739 people aged 13 and older were living with diagnosed HIV in the U.S. and its territories, according to the CDC. That translates to roughly 1 in every 300 people. For context, diabetes affects about 1 in 10 Americans, and hepatitis C affects roughly 1 in 140. So while HIV is a significant public health concern, the average American’s individual risk is low, and it varies enormously depending on demographics and geography.
An important caveat: the 1.1 million figure counts only people who have been diagnosed. Some people are living with HIV and don’t know it. Closing that diagnosis gap remains one of the biggest challenges in HIV prevention, because people who don’t know their status can’t start treatment and are more likely to transmit the virus.
Who Is Most Affected
HIV does not spread evenly across the population. The single most affected group is men who have sex with men, who accounted for 67% of all estimated new infections in 2022, roughly 21,400 out of 31,800. Among all males who acquired HIV that year, the share was even higher: 87%. This doesn’t mean HIV is rare among heterosexual people, but the numbers are significantly smaller. About 7,000 new infections in 2022 were attributed to heterosexual contact, with women making up the larger portion of that group (4,900 compared to 2,100 men).
Black and Latino communities bear a disproportionate burden relative to their share of the U.S. population. These disparities are driven largely by structural factors: unequal access to healthcare, lower rates of insurance coverage, stigma that discourages testing, and geographic concentration in areas with fewer HIV services. Individual behavior alone does not explain the gap.
Where HIV Is Concentrated
The U.S. South consistently has the highest HIV diagnosis rates. States like Florida, Georgia, Louisiana, Texas, and Mississippi account for a large share of new cases each year, even though they don’t always have the largest populations. Urban centers everywhere tend to have higher rates than rural areas, but the South stands out because it combines high prevalence with lower access to prevention tools like pre-exposure prophylaxis (PrEP) and fewer clinics offering routine testing. Washington, D.C., New York, and parts of California also remain significant hotspots, though their rates have been declining faster in recent years thanks to aggressive public health campaigns.
How Treatment Has Changed the Picture
Modern antiretroviral therapy has transformed HIV from a fatal diagnosis into a manageable chronic condition. A 20-year-old who starts treatment today and maintains a strong immune response can expect to live into their early-to-mid 70s, only a few years less than the general population. A large collaborative study published in The Lancet found estimated ages at death for 20-year-olds on treatment ranging from 69 to 83 years, depending on the cohort and when treatment began.
The key concept here is viral suppression. When someone takes their medication consistently and their viral load drops to undetectable levels, they effectively cannot transmit HIV to a sexual partner. This principle, known as “undetectable equals untransmittable,” has been confirmed in multiple large studies. In 2022, 65% of people diagnosed with HIV in the U.S. had achieved viral suppression. That number is meaningful progress but still leaves a gap: only 54% of diagnosed individuals were consistently retained in care, meaning they had regular follow-up appointments and lab work. The drop-off between diagnosis and sustained treatment is one of the reasons new infections haven’t fallen faster.
Prevention Tools Available Now
Beyond treatment, the biggest prevention advance in the past decade is PrEP, a medication that people who are HIV-negative can take to reduce their risk of infection by about 99% when used consistently. PrEP is available as a daily pill or as an injection given every two months. Despite its effectiveness, uptake remains well below where it needs to be. Disparities in PrEP use mirror disparities in HIV rates: Black and Latino individuals, women, and people in the South are less likely to be prescribed PrEP even when they would benefit from it.
The federal government’s “Ending the HIV Epidemic” initiative set a goal of reducing new infections by 75% by 2025 and by at least 90% by 2030, which would prevent an estimated 250,000 total infections. Meeting those targets depends on expanding testing, connecting people to treatment faster, and getting PrEP to the communities that need it most.
What This Means for Your Risk
For most Americans, the statistical likelihood of acquiring HIV is low. But “low on average” masks wide variation. Your personal risk depends on specific factors: the types of sexual contact you have, whether you use condoms or PrEP, whether your partners know their HIV status, and whether you share injection equipment. Geography and community prevalence also play a role. Someone in rural Vermont faces a very different landscape than someone in Atlanta or Miami.
Routine HIV testing is the simplest step anyone can take. The CDC recommends that everyone between 13 and 64 get tested at least once, with more frequent testing for people at higher risk. Rapid tests that use a finger prick or oral swab can return results in 20 minutes, and home testing kits are available over the counter. Early diagnosis leads to early treatment, which protects both the individual and their partners.