HIV and Women: HIV Risk Behaviors

The risk of getting or transmitting HIV varies widely depending on the type of exposure or behavior. Most commonly, people get or transmit HIV through anal or vaginal sex, or sharing needles, syringes, or other drug injection equipment—for example, cookers.

Sexual Behaviors Among Heterosexual Women in 23 US Cities, 2019*

HIV can be transmitted through vaginal or anal sex without a condom.
89 percent of women reported having sex without a condom in the past 12 months.
Anal sex is the riskiest type of sex for getting HIV.
24 percent of women reported having anal sex without a condom in the past 12 months.

Sexual Behaviors Among Women with Diagnosed HIV in the US, 2018*

65 percent of transgender women and 51 percent of cisgender women engaged in anal or vaginal sex in the past 12 months.
7 percent of cisgender women had sex in the past 12 months without using any HIV prevention strategy.

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*Note: Data for transgender women who had sex without using any HIV prevention strategy are not included because the numbers are too small to report.
* Based on current gender identity.
Had sex while not virally suppressed with a partner whose HIV status was negative or unknown, a condom was not used, and the partner was not taking PrEP.
Visit the terminology section for terms and definitions.
Source: CDC. Behavioral and clinical characteristics of persons with diagnosed HIV infection—Medical Monitoring Project, United States, 2018 cycle (June 2018–May 2019) pdf icon[PDF – 905 KB]. HIV Surveillance Special Report 2020; 25.

Injection Behaviors Among Women Who Inject Drugs in 23 US Cities, 2018*

Sharing needs, syringes, or other drug injection equipment puts people at high risk for HIV and other infections.
36 percent of women who inject drugs reported using a syringe after someone else used it in the past 12 months.
62 percent of women who inject drugs reported using any injection equipment after someone else used it in the past 12 months

Cisgender: A person whose sex assigned at birth is the same as their gender identity or expression.

Gender expression: A person’s outward presentation of their gender (for example, how they dress).

Gender identity: A person’s internal understanding of their own gender.

Transgender: A person whose gender identity or expression is different from their sex assigned at birth.

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  2. CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 pdf icon[PDF – 7 MB]HIV Surveillance Report 2020;31.
  3. CDC. Estimated HIV incidence and prevalence in the United States, 2014-2018 pdf icon[PDF – 3 MB]HIV Surveillance Supplemental Report 2020;25(1).
  4. CDC. HIV infection risk, prevention, and testing behaviors among heterosexually active adults at increased risk for HIV infection–National HIV Behavioral Surveillance – 23 U.S. Cities, 2019 pdf icon[PDF – 3 MB]. HIV Surveillance Special Report 2021; 26.
  5. CDC. HIV infection risk, prevention, and testing behaviors among persons who inject drugs–National HIV Behavioral Surveillance: injection drug use – 23 U.S. Cities, 2018 pdf icon[PDF – 2 MB]. HIV Surveillance Special Report 2020; 24.
  6. CDC. HIV risk behaviors. Accessed January 28, 2020.
  7. CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2018 pdf icon[PDF – 4 MB]HIV Surveillance Supplemental Report 2020;25(2).
  8. CDC. Selected national HIV prevention and care outcomes pdf icon[PDF – 2 MB] [slides].
  9. CDC. Social determinants of health among adults with diagnosed HIV infection, 2018 pdf icon[PDF – 10 MB]. HIV Surveillance Supplemental Report 2020;25(3).
  10. CDC. Sexually transmitted disease surveillance, 2018. Accessed January 28, 2020.
  11. Bradley E, Forsberg K, Betts JE, et al. Factors affecting pre-exposure prophylaxis implementation for women in the United States: A systematic review. J Womens Health 2019;28(9):1272-85. PubMed abstractexternal icon.
  12. Evans ME, Tao G, Porter SE, Gray SC, Huang YA, Hoover KW. Low HIV testing rates among US women who report anal sex and other HIV sexual risk behaviors, 2011-2015. Am J Obstet Gynecol 2018;219(4):1-7. PubMed abstractexternal icon.
  13. McCree DH, Koenig LJ, Basile K, Fowler D, Green Y. Addressing the intersection of HIV and intimate partner violence among women with or at risk for HIV in the United States. J Womens Health 2015; 24(5):331-335. PubMed abstractexternal icon.
  14. Waldron M, Burnett-Zeigler I, Wee V, et al. Mental health in women living with HIV: The unique and unmet needs. J Int Assoc Provid AIDS Care 2021;20:1-18. PubMed abstractexternal icon.

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