HIV Statistics
It is estimated that more than one million people are living with HIV in the USA and that more than half a million have died after developing AIDS.
HIV statistics reported in the USA are currently only available for 40 states and five U.S. dependent areas with confidential name-based HIV infection reporting (since at least January 2006). AIDS statistics include all 50 states, the District of Columbia and five U.S. dependent areas. For more explanation, see the 'Interpreting HIV and AIDS statistics for the USA' section towards the end of this page.
The U.S. Centers for Disease Control and Prevention (CDC) estimates that at the end of 2008, there were 682,668 people living with a diagnosis of HIV infection in the 40 states and five U.S. dependent areas. However, the total number of people living with an HIV infection in the U.S. is thought to be more than one million.1 2 The discrepancy between these figures is due to several factors, including:
- confidential name-based reporting of HIV diagnoses has not yet been implemented in all states;
- anonymous tests, including home tests, are excluded from case reports;
- and one in every five people living with HIV has not even had their infection diagnosed, let alone reported.3
During 2009, there were an estimated 42,959 new diagnoses of HIV infection in the 40 states and five dependent areas. Adult or adolescent males accounted for three-quarters of new HIV diagnoses. The main transmission route among males was male-to-male sexual contact (74%), followed by heterosexual contact (14%) and injecting drug use (8%). Among female adult and adolescents, 84.9% were infected through heterosexual contact and 14.8% through injecting drug use.
In 2009 blacks/African Americans made up an estimated 50% of new HIV diagnoses, whites 27%, and Hispanics/Latinos 19%. HIV was diagnosed in an estimated 166 children (<13 years at diagnosis) in 2009, all but 35 became infected through mother-to-child transmission.
AIDS statistics
The CDC estimates that by the end of 2008 there were 490,696 people living with an AIDS diagnoses in the United States and five dependent areas, around 38,000 more than 2006. Since 2000 the annual number of new AIDS diagnoses has remained relatively constant, with an estimated 34,993 in 2009. In total, an estimated 1,142,714 people have been diagnosed with AIDS in America since the beginning of the epidemic.
Just over 75% of adults and adolescents living with an AIDS diagnosis are men.
Race/ethnicity of adult and adolescents living with an AIDS diagnosis in the U.S. in 2008
As the pie chart below shows, blacks/African Americans accounted for the largest proportion of people living with an AIDS diagnosis in 2008.
Transmission category of male and female adults and adolescents living with an AIDS diagnosis in the U.S. in 2008
Almost half of male adults and adolescents living with AIDS in 2008 became infected with HIV through male-to-male sexual contact. Two-thirds of female adults and adolescents living with an AIDS diagnosis in 2008 were infected through heterosexual contact.
AIDS diagnoses among children
An estimated 4,043 children (<13 years at diagnosis) were living with an AIDS diagnosis in 2008. The vast majority of these children acquired HIV through mother-to-child transmission. During 2009 there were an estimated 13 AIDS diagnoses among children, compared to 195 in 1999 and 896 in 1992. The decline in paediatric AIDS incidence is associated with a significant increase in HIV testing among pregnant women and the use of antiretroviral drugs to prevent mother-to-child transmission.
Deaths among people diagnosed with AIDS
In 1981, the first cases of what is now known as AIDS were reported in the U.S. During the 1980s there was a rapid increase in the number of reported AIDS cases and AIDS deaths. Cases peaked with the 1993 expansion of the case definition,4 and then declined. The most dramatic drops in both cases and deaths began in 1996, with the widespread use of combination antiretroviral therapy.
People with AIDS are now surviving longer and are contributing to a steady increase in the overall number of people living with AIDS. This trend will continue as long as the number of new diagnoses exceeds the number of people dying each year.
The number of deaths of persons with an AIDS diagnosis has stabilised in recent years at around 16,500-18,000 per year. (Deaths of persons with an AIDS diagnosis may be due to any cause).
Since the beginning of the epidemic, an estimated 617,025 people with AIDS have died in the U.S.
Interpreting HIV & AIDS statistics for the USA
In order to monitor the spread of the American HIV and AIDS epidemic and to assess the need for services and resources, there is a need for accurate surveillance. In the USA, statistics on both HIV and AIDS are collected by the Centers for Disease Control and Prevention (CDC) and published in an annual report. The latest statistics on HIV and AIDS in the USA were published in February 2011.
The CDC surveillance report includes data on the number of people diagnosed with AIDS, the number living with AIDS and the number of people with AIDS who have died or survived. Such AIDS statistics include not only the 50 states and the District of Columbia but also dependent areas - Puerto Rico, American Samoa, Guam, Northern Mariana Islands and the U.S. Virgin Islands. HIV statistics are based on data from these five U.S. dependent areas and only 40 states that have used confidential name-based HIV infection reporting for a significant period of time. States and areas that use confidential name-based HIV infection reporting take personal details after diagnosis of HIV infection. When this data is submitted to the CDC all personal identifying information is removed. These states comprise Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Jersey, New Mexico, New York, Nevada, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin and Wyoming.
In recent years the use of antiretroviral therapy has slowed the progression of HIV in many infected persons and hence contributed to a decline in AIDS incidence. This means that AIDS surveillance data are less able to represent trends in the incidence of HIV infection or the impact of the epidemic on the healthcare system. In response, all 50 states have now implemented confidential name-based HIV infection reporting. However, only 40 states have been doing so long enough for the CDC to apply statistical adjustments. The HIV Surveillance Report for 2012 (published in 2014) will be the first time HIV data from all 50 states will be included.
In order to make better use of the data collected, the CDC has made a number of changes from previous reports, including replacing the older definition 'HIV/AIDS' with 'diagnosis of HIV infection'. 'Summary of Changes to the National HIV Surveillance Report' contains more information. The term 'living with AIDS' includes every living person who has ever received an AIDS diagnosis, regardless of their current state of health. The term 'living with a diagnosis of HIV infection' includes every living person with a diagnosis of HIV infection regardless of stage of disease at diagnosis.
There is often a delay between the time of diagnosis of HIV or AIDS, or the time of death, and the time at which the event is reported. For this reason the CDC estimates the number of people living with HIV or AIDS by adjusting for reporting delays. No adjustment is made for incomplete reporting.
'Adults and adolescents' are defined as persons aged 13 years or more. The term 'transmission route' refers to the most probable route of transmission of HIV infection. The term 'male-to-male sexual contact' includes gay men, bisexual men and some men who consider themselves to be neither gay nor bisexual. The 'heterosexual contact' category comprises persons who report specific heterosexual contact with a person with, or at high risk for, HIV infection (e.g., an injecting drug user). This does not include adults and adolescents born in, or who had sex with someone born in, a country where heterosexual transmission was believed to be the main mode of HIV transmission, unless they meet the criteria stated in the previous sentence.