Approximately 1.2 million people in the United States are living with HIV, which works out to roughly 0.36% of the population. That’s about 1 in every 275 Americans. While that number has grown as treatments keep people alive longer, the rate of new infections is actually declining.
How Many New Cases Occur Each Year
An estimated 31,800 people acquired HIV in the U.S. in 2022, the most recent year with complete data. That represents a 12% drop from 2018, when roughly 36,300 new infections occurred. The decline reflects expanded access to preventive medication (known as PrEP), broader testing, and faster treatment after diagnosis.
The federal Ending the HIV Epidemic initiative has set ambitious targets: reduce new infections by 75% by 2025 and by 90% by 2030, compared to baseline levels. Whether those goals are realistic remains an open question, but the overall trajectory is moving in the right direction.
Many People Don’t Know They Have It
About 15% of Americans living with HIV, roughly 1 in 7, don’t know they’re infected. That translates to approximately 165,000 people. This matters because people who are unaware of their status can’t start treatment, and they’re more likely to transmit the virus to others. The CDC recommends that everyone between ages 13 and 64 get tested at least once, with more frequent testing for those at higher risk.
Certain communities have even lower awareness rates. Among American Indian and Alaska Native people with HIV, only 77 out of every 100 knew their status, a gap that reflects broader inequities in healthcare access.
Racial and Ethnic Disparities
HIV does not affect all communities equally. Black and Hispanic/Latino Americans accounted for 70% of estimated new infections in 2022, despite making up a much smaller share of the total U.S. population. These disparities aren’t driven by individual behavior alone. They reflect structural factors like poverty, limited access to healthcare and preventive services, housing instability, and stigma that discourages testing and treatment.
In 2022, 37,981 people received a formal HIV diagnosis across the U.S. and its territories. The gap between diagnoses and estimated new infections reflects the delay many people experience between acquiring HIV and learning they have it.
Viral Suppression and What It Means
Modern antiretroviral therapy can reduce the amount of virus in a person’s body to undetectable levels. At that point, the virus can’t be transmitted sexually, a concept known as “undetectable equals untransmittable.” In 2022, 65% of people with diagnosed HIV in the U.S. had achieved viral suppression.
That 65% figure highlights both progress and a significant gap. It means about one in three people who know they have HIV still aren’t on effective treatment or aren’t taking it consistently enough to suppress the virus. Barriers include cost, inconsistent access to care, substance use, mental health challenges, and the daily burden of taking medication indefinitely. Among American Indian and Alaska Native people with a diagnosis, only 76 out of 100 were receiving any HIV care at all.
Putting the Numbers in Context
At 0.36% of the population, the U.S. has a relatively low HIV prevalence compared to countries in sub-Saharan Africa, where rates in some nations exceed 20%. But among high-income countries, the U.S. rate is notably higher than in most of Western Europe, partly because the American healthcare system leaves more gaps in prevention and treatment access.
The overall number of people living with HIV in the U.S. has been rising gradually for years, not because the epidemic is worsening, but because effective treatment means far fewer people are dying from the disease. Someone diagnosed today and started on treatment promptly can expect a near-normal lifespan. The growing population of people living with HIV is, paradoxically, a sign that treatment is working.