About 0.7% of adults worldwide are living with HIV. That translates to roughly 40.8 million people as of 2024, out of a global population of more than 8 billion. The number is higher than it was decades ago, but not because the epidemic is worsening. New infections have actually dropped 39% since 2010. The total count keeps climbing because antiretroviral treatment now keeps people alive for decades, meaning fewer people die from the virus each year.
Global Prevalence by the Numbers
UNAIDS estimates HIV prevalence among adults aged 15 to 49 at 0.7% globally. Of the 40.8 million people living with HIV worldwide, about 39.4 million are adults and 1.4 million are children under 15. Women and girls make up 53% of all people living with the virus, a disparity driven largely by biological vulnerability, gender inequality, and limited access to prevention in certain regions.
That 0.7% figure is a global average, which smooths over enormous regional differences. In parts of southern and eastern Africa, adult prevalence runs above 10% in several countries, while in East Asia or Western Europe it sits well below 0.5%. Where you live changes the picture dramatically.
HIV in the United States
In the U.S., an estimated 1.2 million people were living with HIV as of 2022. By 2023, just over 1.13 million people aged 13 and older had a diagnosed HIV infection. With a U.S. population of roughly 335 million, that puts the national rate at about 0.3%, less than half the global average.
New diagnoses in the U.S. totaled about 38,000 in 2022, with 31,800 estimated new infections that year. Gay and bisexual men accounted for 67% of those new infections and 86% of all diagnoses among men. People who inject drugs made up about 7% of new infections. These patterns have held fairly steady in recent years, though overall new infection numbers have been slowly declining.
Why the Total Keeps Rising
It seems counterintuitive: fewer people are getting infected each year, yet the total number of people living with HIV keeps going up. The explanation is straightforward. Antiretroviral therapy has transformed HIV from a fatal diagnosis into a manageable chronic condition. A 40-year-old starting treatment today with a healthy immune cell count can expect to live into their late 70s or early 80s, only a few years less than someone without HIV. A large Lancet analysis found that life expectancy for people on treatment who started after 2015 reached about 79 to 82 years of age, depending on sex and immune health at the start of treatment.
Because treatment keeps people alive much longer, people accumulate in the “living with HIV” category faster than they leave it. That’s a success story disguised as a rising number.
Where HIV Hits Hardest
Sub-Saharan Africa remains the epicenter of the global epidemic. The region is home to roughly two-thirds of all people living with HIV worldwide, despite having only about 14% of the global population. Countries like Eswatini, Lesotho, and Botswana have adult prevalence rates above 20%, meaning roughly one in five adults carries the virus.
Outside Africa, the epidemic concentrates in specific populations rather than spreading broadly. In most of North America, Europe, and Asia, HIV prevalence in the general adult population stays under 0.5%. The burden instead falls disproportionately on key groups: men who have sex with men, people who inject drugs, and transgender women. In the U.S., for example, gay and bisexual men account for about two-thirds of all new HIV infections despite representing a small fraction of the overall population.
New Infections Are Declining
The number of people newly acquiring HIV each year has dropped significantly. In 2010, about 2.1 million people were infected globally. By 2024, that figure had fallen by 39%. Expanded access to treatment plays a role here too: a person on effective therapy with an undetectable viral load cannot transmit the virus sexually. Preventive medications taken by HIV-negative people have also helped bend the curve downward, particularly in high-income countries.
Still, progress has been uneven. While new infections have dropped sharply in eastern and southern Africa, some regions, particularly Eastern Europe and parts of Asia, have seen slower declines or even increases. The global goal of reducing new infections to under 500,000 per year by 2020 was missed, and current trajectories suggest reaching near-zero transmission remains far off.
Many People Don’t Know Their Status
Not everyone with HIV has been diagnosed. Globally, the goal is for 95% of all people living with HIV to know their status, 95% of those diagnosed to be on treatment, and 95% of those on treatment to have the virus fully suppressed. Progress toward these targets has been substantial but incomplete. Millions of people worldwide are still unaware they carry the virus, which means the true prevalence is somewhat higher than diagnosed case counts suggest. In the U.S., the CDC estimates that roughly 13% of people with HIV don’t know they have it.
Undiagnosed infections matter for two reasons. People who don’t know their status can’t start treatment, which shortens their own lives. And they’re more likely to transmit the virus to others, since they aren’t benefiting from the viral suppression that treatment provides. Expanding testing access, particularly in communities with higher prevalence, remains one of the most effective tools for shrinking the epidemic.