Approximately 1.1 million people in the United States are living with diagnosed HIV, which works out to roughly 0.3% of the population. That number comes from the CDC’s 2023 surveillance data, which counted 1,132,739 people aged 13 and older with a diagnosed infection. The true total is somewhat higher because some people carry the virus without knowing it.
How Many New Cases Occur Each Year
The U.S. saw an estimated 31,800 new HIV infections in 2022. That number has been declining over the past decade thanks to wider testing, better treatment, and preventive medications. The national diagnosis rate sits at about 13.3 per 100,000 people, though that average masks enormous variation from state to state.
The federal Ending the HIV Epidemic initiative set a goal of reducing new infections by 75% by 2025 and 90% by 2030. Progress has been steady but uneven, with certain communities and regions still experiencing high rates of transmission.
Who Is Most Affected
HIV does not spread evenly across the population. The largest share of new infections, about 67% (roughly 21,400 cases in 2022), occurred among men who have sex with men. That group accounted for 87% of all estimated new infections among males. Heterosexual contact was the next most common route, responsible for about 22% of new infections (7,000 cases). Injection drug use accounted for roughly 7% (2,300 cases).
Race and ethnicity also play a significant role, driven largely by disparities in healthcare access, poverty, and stigma rather than biology. Black and Hispanic Americans made up more than 70% of estimated new HIV infections in 2022 despite representing a much smaller share of the overall population.
Age Distribution Has Shifted
HIV is no longer a disease that primarily affects younger adults. As of 2022, about 54% of all people living with HIV in the United States were aged 50 or older. This reflects the success of modern treatment: people diagnosed decades ago are living long, healthy lives. At the same time, new diagnoses still skew younger. People aged 50 and older accounted for 16% of new diagnoses in 2022, less than half the share among people in their 20s.
One concerning trend involves older adults and late diagnosis. The CDC reported that people aged 65 and older made up more than a third of all new AIDS diagnoses in 2023. That means many older Americans are not getting tested until the virus has already caused significant immune damage.
Where HIV Rates Are Highest
Geography matters. The District of Columbia has the highest HIV diagnosis rate in the nation at 36.6 per 100,000, nearly three times the national average. Georgia follows at 27.4 per 100,000, roughly double the national rate. Southern states collectively bear a disproportionate burden, driven by factors like limited Medicaid expansion, fewer clinics, and higher rates of poverty.
Treatment and Viral Suppression
Getting diagnosed is the first step, but staying in care is what keeps people healthy and prevents further transmission. A person who takes antiretroviral therapy consistently and achieves viral suppression (meaning the virus is undetectable in their blood) effectively cannot transmit HIV to a sexual partner. That makes treatment a powerful prevention tool.
The care pipeline, however, has gaps. In 2022, over 80% of newly diagnosed people were linked to care within a month. But only 76% of all people with diagnosed HIV had received any care that year, just 54% were retained in ongoing care, and only 65% had achieved viral suppression. That means roughly one in three people with diagnosed HIV in the U.S. has not reached the point where their virus is fully controlled. Barriers include cost, transportation, stigma, mental health challenges, and housing instability.
The Undiagnosed Gap
The 1.1 million figure only counts people who have been tested and received a diagnosis. CDC estimates have consistently suggested that a meaningful percentage of people living with HIV don’t know their status. These undiagnosed individuals cannot benefit from treatment and are more likely to transmit the virus unknowingly. Routine testing, particularly for people in higher-risk groups and adults who have never been tested, remains one of the simplest ways to close this gap. The CDC recommends that everyone between ages 13 and 64 get tested at least once as part of routine healthcare.