HIV affects people of every age, gender, and background, but the burden is far from equal. Roughly 40.8 million people worldwide were living with HIV in 2024, with 1.3 million new infections that year alone. Certain regions, age groups, and communities carry a dramatically higher share of that burden due to a combination of biology, social conditions, and access to healthcare.
Sub-Saharan Africa Bears the Heaviest Burden
About two-thirds of all people living with HIV globally are in Sub-Saharan Africa. That concentration has persisted for decades and reflects a combination of factors: limited early access to prevention tools, high rates of concurrent sexual partnerships, economic instability, and health systems that were slow to scale up testing and treatment. Countries like South Africa, Mozambique, and Nigeria account for a large share of these cases.
Within the region, the epidemic hits young women especially hard. Adolescent girls and young women aged 15 to 24 in Sub-Saharan Africa represent just 10% of the population but account for roughly 25% of all new HIV infections. In some high-risk settings, the numbers are staggering. Among teenage girls in fishing communities in Uganda, HIV incidence has been documented as high as 12.4%. Among young female sex workers in South Africa and Zimbabwe, rates reach 10 to 13%.
Gay and Bisexual Men
Globally, men who have sex with men face a risk of acquiring HIV that is 26 times higher than the general population. HIV prevalence among this group ranges from about 5% in South-East Asia to over 12% in Eastern and Southern Africa. In Asia and the Pacific, men who have sex with men accounted for 44% of all new infections as recently as 2019.
The elevated risk stems partly from the biology of anal sex, which carries a higher per-act transmission probability than vaginal sex. But stigma, criminalization, and barriers to healthcare access compound that biological vulnerability. In countries where same-sex behavior is illegal, men are less likely to get tested, seek treatment, or disclose their status to partners.
Transgender Women
Transgender women carry one of the highest HIV burdens of any population globally. A large systematic review found an overall HIV prevalence of 19.1% among transgender women worldwide. Compared to all adults of reproductive age, transgender women were nearly 49 times more likely to be living with HIV. That ratio held regardless of whether the country was high-income or low-income, suggesting the drivers go beyond poverty alone.
Social marginalization plays a central role. Transgender women frequently face discrimination in healthcare settings, housing instability, and involvement in survival sex work, all of which increase exposure and reduce access to prevention and treatment.
Women and Girls in High-Prevalence Settings
While HIV affects more men than women globally, that pattern reverses in parts of Sub-Saharan Africa, where young women are infected at rates far exceeding young men of the same age. Gender-based violence, age-disparate relationships (where teenage girls have older male partners), and economic dependence all drive this imbalance. In many communities, young women have little power to negotiate condom use or refuse sex.
Poverty amplifies the gender gap. Research from New York City illustrates how this works even in a high-income country: HIV diagnosis rates climbed steeply with neighborhood poverty, from about 14 per 100,000 in low-poverty areas to 76 per 100,000 in the poorest neighborhoods. That poverty effect was stronger for women than for men at every income level, suggesting that economic hardship layers additional risk onto the vulnerabilities women already face.
Children and Mother-to-Child Transmission
An estimated 1.37 million children worldwide are living with HIV, and about 120,000 new infections occurred in children under 14 in 2023. Nearly all pediatric HIV results from mother-to-child transmission, which can happen during pregnancy, childbirth, or breastfeeding.
When a pregnant woman receives antiretroviral treatment and maintains viral suppression, the risk of passing HIV to her baby drops to near zero. The persistence of pediatric infections reflects gaps in prenatal care, particularly in low-resource settings where women may not be tested during pregnancy or may not have reliable access to medication throughout pregnancy and breastfeeding.
People Over 50
The HIV-positive population is aging. The proportion of people living with HIV who are 50 or older rose from 8% in 2000 to roughly 16% by 2016, and projections put it above 20% by 2020. This shift is largely a success story: effective treatment means people diagnosed decades ago are living into older age. But it also reflects new infections in older adults who may not see themselves as at risk and are less likely to be offered routine testing.
Aging with HIV brings its own challenges. Even with well-controlled viral loads, long-term HIV infection accelerates certain aging-related conditions, including cardiovascular disease, bone loss, and kidney problems. Older adults living with HIV often manage multiple chronic conditions simultaneously.
Poverty as a Consistent Driver
Across every region and demographic, poverty is one of the strongest predictors of HIV risk. In the United States, neighborhoods where at least 20% of residents live below the federal poverty line account for about half of all new HIV diagnoses. The pattern is dose-dependent: as poverty increases in a neighborhood, so do diagnosis rates, in a nearly linear fashion.
Poverty affects HIV risk through multiple pathways. It limits access to prevention tools like pre-exposure prophylaxis, reduces the likelihood of regular testing, and creates conditions where transactional sex becomes more common. It also makes consistent treatment harder to maintain, since housing instability, food insecurity, and lack of transportation all interfere with staying on medication.
Gaps in Testing and Treatment
Globally, progress toward the goal of diagnosing 95% of people with HIV, treating 95% of those diagnosed, and achieving viral suppression in 95% of those treated has been uneven. As of 2023, the global averages stood at 86% diagnosed, 89% of those on treatment, and 93% of those virally suppressed. Women over 15 were closer to the targets (91-91-94), while men lagged behind (83-86-94).
That gap among men reflects a persistent pattern: men are less likely to get tested, less likely to start treatment after diagnosis, and more likely to drop out of care. Children and adolescents also trail behind adult women on every measure, partly because pediatric HIV formulations have historically been harder to access in low-resource settings.