HIV and Asians

Between 2014 and 2018 the Asian populationa in the United States (US) grew around 10%, which is more than three times as fast as the total US population.b During the same period, in the US and dependent areas, the number of Asians receiving an HIV diagnosis remained stable, driven primarily by HIV diagnoses among Asian  gay, bisexual, and other men who have sex with men remaining stable. c,d Asians, who make up 6% of the population, accounted for about 2% of HIV diagnoses in 2018 in the US and dependent areas. e

The Numbers

HIV Diagnosesf

Of the 37,968 new HIV diagnoses in the US and dependent areas in 2018, 2 percent were among Asians.
New HIV Diagnoses Among Adult and Adolescent Asians in the US and Dependent Areas by Transmission Category and Sex,* 2018
Most new HIV diagnoses were among Asian gay and bisexual men.
Among Asian men, 89 percent of diagnoses were attributed to male-to-male sexual contact, 8 percent were attributed to heterosexual contact, 2 percent were attributed to injection drug use 2 percent were attributed to male-to-male sexual contact and injection drug use, 1 percent were attributed to other, and 1 percent were attributed to perinatal.
Among Asian women, 94 percent were attributed to heterosexual contact, 4 percent were attributed to injection drug use, 1 percent were attributed to other, and 1 percent were attributed to perinatal.

* Based on sex at birth and includes transgender people.
† Includes hemophilia, blood transfusion, perinatal exposure, and risk factors not reported or not identified.
Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report 2020;31.

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From 2014 to 2018, annual HIV diagnoses in the US and dependent areas remained stable among Asians overall, with trends varying by age and sex.

HIV Diagnoses Among Adult and Adolescent Asians in the US and Dependent Areas, 2014-2018*
By age, Asians 13-24 decreased 8 percent, 25-34 increased 10 percent, 35-44 decreased 21 percent, 45-54 decreased 12 percent, 55 and older increased 43 percent.
By sex, Asian men were stable and Asian women decreased 18 percent.

* Changes in populations with fewer HIV diagnoses can lead to a large percentage increase or decrease.
† Does not include perinatal and other categories.
‡ Based on sex at birth and includes transgender people.
Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report 2020;31.

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Living With HIV

Adult and Adolescent Asians with HIV in the 50 States and the District of Columbia
At the end of 2018, an estimated 1.2 million people had HIV. Of those, 17,600 were Asian.
4 in 5 Asians knew they had the virus.
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It is important for Asians to know their HIV status so they can take medicine to treat HIV if they have the virus. Taking HIV medicine every day can make the viral load undetectable. People who get and keep an undetectable viral load (or stay virally suppressed) have effectively no risk of transmitting HIV to HIV-negative sex partners.

When compared to all people with HIV, Asians have about the same viral suppression rates.
When compared to all people with HIV, Asians have about the same viral suppression rates.

* Had 2 viral load or CD4 tests at least 3 months apart in a year.
† Based on most recent viral load test.
Source: CDC. Estimated HIV incidence and prevalence in the United States, 2014-2018. pdf icon[PDF – 3 MB] HIV Surveillance Supplemental Report. 2020;25(1).
Source: CDC. Selected national HIV prevention and care outcomes (slides). pdf icon[PDF – 2 MB]

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Deaths

During 2018, there were 79 deaths among Asians with diagnosed HIV in the US and dependent areas. These deaths may be due to any cause.

Prevention Challenges

There are some behaviors that put everyone at risk for HIV. These include having anal or vaginal sex without protection (like a condom or medicine to prevent or treat HIV) or sharing injection drug equipment with someone who has HIV. Other factors that affect Asians particularly include:

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Undiagnosed HIV. People with undiagnosed HIV cannot obtain the care they need to stay healthy and may unknowingly transmit HIV to others. A lower percentage of Asians with HIV have received a diagnosis, compared to other races/ethnicities.

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Cultural factors. Some Asians may avoid seeking testing, counseling, or treatment because of language barriers or fear of discrimination, the stigma of homosexuality, immigration issues, or fear of bringing shame to their families.

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Limited research. Limited research about Asian health and HIV infection means there are few targeted prevention programs and behavioral interventions for this population.

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Data limitations. The reported number of HIV cases among Asians may not reflect the true HIV diagnoses in this population because of race/ethnicity misidentification. This could lead to the underestimation of HIV infection in this population.

What CDC Is Doing

CDC is pursuing a high-impact HIV prevention approach to maximize the effectiveness of HIV prevention interventions and strategies. Funding state, territorial, and local health departments and community-based organizations (CBOs) to develop and implement tailored programs is CDC’s largest investment in HIV prevention. This includes longstanding successful programs and new efforts funded through the Ending the HIV Epidemic in the U.S. initiative. In addition to funding health departments and CBOs, CDC is also strengthening the HIV prevention workforce and developing HIV communication resources for consumers and health care providers.

  • Under the integrated HIV surveillance and prevention cooperative agreement, CDC awards around $400 million per year to health departments for HIV data collection and prevention efforts. This award directs resources to the populations and geographic areas of greatest need, while supporting core HIV surveillance and prevention efforts across the US.
  • In 2019, CDC awarded $12 million to support the development of state and local Ending the HIV Epidemic in the U.S. plans in 57 of the nation’s priority areas. To further enhance capacity building efforts, CDC uses HIV prevention resources to fund the National Alliance of State and Territorial AIDS Directors (NASTAD) $1.5 million per year to support strategic partnerships, community engagement, peer-to-peer technical assistance, and planning efforts.
  • In 2020, CDC will award around $109 million per year to support the implementation of state and local Ending the HIV Epidemic in the U.S. plans with a five-year funding program.
  • Under the flagship community-based organization cooperative agreement, CDC awards about $42 million per year to community organizations. This award directs resources to support the delivery of effective HIV prevention strategies to key populations.
  • In 2019, CDC awarded a cooperative agreement to strengthen the capacity and improve the performance of the nation’s HIV prevention workforce. New elements include dedicated providers for web-based and classroom-based national training, and technical assistance tailored within four geographic regions.
  • Through its Let’s Stop HIV Together campaign, CDC offers resources about HIV stigma, testing, prevention, and treatment and care. This campaign is part of the Ending the HIV Epidemic in the U.S. initiative.

a A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.
b The US Census Bureau’s population estimates include the 50 states, the District of Columbia, and Puerto Rico.
c  The term male-to-male sexual contact is used in CDC surveillance systems. It indicates a behavior that transmits HIV infection, not how individuals self-identify in terms of their sexuality.
d Includes infections attributed to male-to-male sexual contact and injection drug use (men who reported both risk factors).
e Unless otherwise noted, the term United States includes the 50 states, the District of Columbia, and the 6 dependent areas of American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, the Republic of Palau, and the US Virgin Islands.
f HIV diagnoses refers to the number of people who received an HIV diagnosis during a given time period, not when the people got HIV infection.