Globally, new HIV infections have dropped 40% since 2010, falling to 1.3 million in 2024. But that number barely budged from the year before, and in certain regions and populations, infections are genuinely increasing. The answer depends on where you look and who you’re asking about.
The Global Picture: Progress Has Stalled
The long-term trend is clearly downward. Compared to 2010, far fewer people are acquiring HIV each year worldwide, and AIDS-related deaths have fallen 56%. That progress came from decades of investment in testing, treatment, and prevention programs across dozens of countries.
The problem is that the decline has essentially flatlined. The 1.3 million new infections recorded in 2024 was almost unchanged from the previous year, meaning the world is no longer making meaningful gains. UNAIDS has described “huge gaps in HIV prevention” that remain unfilled. And a sudden collapse in global AIDS funding now threatens to reverse what progress has been made, particularly in low-income countries that depend on international support for testing and treatment programs.
Trends in the United States
In the U.S., roughly 39,200 people received an HIV diagnosis in 2023. That number has held relatively steady in recent years, hovering between 38,000 and 39,000 annually from 2018 onward. So HIV isn’t surging in the U.S., but it isn’t declining meaningfully either.
One factor that should be driving numbers down is PrEP, the daily or injectable medication that prevents HIV infection. PrEP coverage in the U.S. jumped from less than 1% in 2012 to over 26% by 2022. States with higher PrEP uptake have seen larger drops in new diagnoses, with national diagnosis rates falling modestly from 13.0 to 10.6 per 100,000 people over that same decade. A Lancet analysis found a clear dose-response pattern: the more people using PrEP in a given area, the fewer new HIV diagnoses that area reported. The relationship held even after accounting for the effect of viral suppression (when people already living with HIV take medication that makes them unable to transmit it).
Still, PrEP access is uneven. It reaches some communities far more effectively than others, which helps explain why national numbers haven’t dropped as fast as the science would suggest they could.
Where Infections Are Actually Rising
Eastern Europe and Central Asia stand out as a region where HIV is genuinely on the rise. New infections there reached 130,000 in 2024, a 7% increase since 2010. That upward trend runs directly counter to the global pattern and reflects limited access to prevention tools, stigma around key populations, and restrictive drug policies that discourage people who inject drugs from seeking care.
This region is one of the few in the world where the epidemic is expanding rather than contracting, making it a major focus of concern for global health organizations.
Who Is Most Affected in the U.S.
The burden of HIV in the United States falls disproportionately on specific groups. Black and African American women account for half of all HIV diagnoses among women, despite making up just 13% of the female population. Their diagnosis rate is 11 times that of white women and three times that of Hispanic/Latina women. These disparities reflect systemic differences in healthcare access, poverty rates, and the prevalence of HIV within sexual networks, not differences in individual behavior.
Young people between 13 and 24 account for about 19% of new U.S. diagnoses each year, roughly 7,100 cases in 2022. Most young men diagnosed with HIV acquired it through male-to-male sexual contact, while most young women acquired it through heterosexual contact. Several factors make younger people more vulnerable: lower rates of condom use, higher rates of other sexually transmitted infections (which increase susceptibility to HIV), less knowledge about HIV prevention, and substance use including injection drug use.
Why the Numbers Can Be Misleading
It’s worth understanding what “diagnoses” actually measure. A diagnosis count tells you how many people learned their HIV status in a given year, not exactly how many people were newly infected. If testing expands, more people get diagnosed sooner, and the numbers can temporarily rise even if actual transmission is flat or falling. Conversely, if testing drops (as it did during the COVID-19 pandemic), diagnoses fall without infections necessarily decreasing.
Currently, about 10% of people at elevated risk in middle- and high-income countries get tested annually. Mathematical modeling suggests that doubling that rate to 20% would allow 90% of people living with HIV to be diagnosed within about eight years of infection, dramatically reducing both late-stage illness and onward transmission. Early diagnosis is one of the most powerful tools available: people who know their status and start treatment quickly can achieve an undetectable viral load, which eliminates the risk of sexually transmitting the virus.
The Funding Threat
Perhaps the most significant factor shaping whether HIV rises in coming years is money. The global AIDS response depends heavily on international funding, particularly from the United States through programs like PEPFAR. UNAIDS has warned that a “sudden collapse in funding” arrived just as progress was stalling, creating a genuine crisis. Countries that had been steadily expanding treatment and prevention programs now face the prospect of scaling them back. If that happens, the stalled decline could reverse, and new infections could start climbing again in the regions least able to absorb the blow.