Tables | Volume 25, Number 3 | HIV Surveillance | Reports | Resource Library | HIV/AIDS

Table 1. Diagnoses of HIV infection among adults, by race/ethnicity, sex at birth, and selected social determinants of health, 2018—census tract level, United States and Puerto Rico
	American Indian/Alaska Native		Asian		Black/African American		Hispanic/Latino^a		Native Hawaiian/other Pacific Islander		White		Multiple races		Total
	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate
Male
Below federal poverty level (%)
<6	15	14.0	139	6.4	873	45.9	726	26.6	9	19.4	1,430	6.0	93	14.7	3,285	10.5
6.00–10.99	26	13.3	164	8.5	1,667	57.3	1,629	34.6	13	20.0	1,937	7.8	163	20.7	5,599	16.0
11.00–17.99	33	12.8	190	14.5	2,513	69.4	2,143	38.4	17	30.1	1,773	9.8	167	24.1	6,836	23.4
≥18	28	7.0	190	16.8	4,972	83.8	3,411	43.5	19	40.2	1,819	16.0	220	31.3	10,659	39.7
Less than high school diploma (%)
<6	22	17.6	178	7.4	1,277	63.1	952	39.0	10	19.9	2,029	7.7	141	19.0	4,609	13.5
6.00–9.99	26	15.8	127	9.1	1,564	63.0	965	36.1	9	18.6	1,553	7.5	128	20.5	4,372	15.7
10.00–17.99	31	9.7	184	12.7	3,289	69.3	1,854	37.1	20	29.5	1,924	9.1	184	23.5	7,486	22.6
≥18	23	6.4	195	15.0	3,900	74.9	4,146	38.2	19	38.3	1,454	14.9	190	27.9	9,927	36.0
Median household income (U.S. $)
<42,000	28	7.6	119	15.5	4,817	82.6	2,885	42.9	15	44.0	1,636	14.4	175	28.4	9,675	38.4
42,000–56,999	32	11.6	155	15.3	2,411	68.7	2,155	38.6	14	29.7	1,739	9.0	173	26.5	6,679	22.1
57,000–77,999	26	13.6	186	12.2	1,688	61.2	1,689	35.3	17	26.9	1,871	8.4	155	21.4	5,632	17.6
≥78,000	16	12.7	223	6.9	1,098	49.8	1,177	31.5	12	17.1	1,710	6.9	137	16.9	4,373	12.6
Without health insurance (%)
<5	12	11.9	167	7.2	943	50.1	707	28.3	10	18.1	1,536	5.9	117	16.7	3,492	10.5
5.00–8.99	19	11.2	172	9.6	1,655	55.7	1,217	32.3	13	20.3	1,738	7.8	145	19.2	4,959	15.7
9.00–14.99	28	11.5	174	12.6	2,721	64.9	1,841	37.1	22	41.2	1,829	10.1	153	21.1	6,768	23.1
≥15	43	9.6	170	15.9	4,709	88.6	4,145	43.0	13	30.5	1,856	16.1	228	35.8	11,164	39.5
Gini index (%)
<38	22	12.9	154	8.6	1,800	58.3	1,570	30.3	15	21.9	1,528	7.7	150	20.3	5,239	17.2
38.00–41.99	22	9.2	154	8.8	2,234	66.7	2,016	35.9	14	25.0	1,717	7.6	154	20.8	6,311	18.6
42.00–45.99	27	11.0	151	10.5	2,328	70.3	1,934	40.6	15	31.5	1,665	9.2	146	23.0	6,266	22.3
≥46	31	10.1	224	14.1	3,658	80.0	2,388	45.2	14	32.8	2,046	11.7	190	27.3	8,551	28.9
Subtotal^b	103	10.6	699	10.6	10,209	70.6	8,009	38.2	58	26.8	7,087	9.1	657	23.2	26,822	21.9
Female
Below federal poverty level (%)
<6	2	1.9	22	0.9	303	15.3	85	3.1	0	0.0	178	0.7	16	2.5	606	1.8
6.00–10.99	6	3.0	17	0.8	558	17.4	172	3.7	0	0.0	288	1.1	39	4.8	1,080	2.9
11.00–17.99	5	1.9	24	1.6	893	21.8	286	5.2	0	0.0	316	1.7	37	5.1	1,561	5.1
≥18	8	1.9	31	2.6	1,780	25.0	580	7.3	4	8.3	425	3.6	70	9.2	2,898	10.1
Less than high school diploma (%)
<6	3	2.3	19	0.7	338	15.1	86	3.3	0	0.0	209	0.8	25	3.2	680	1.9
6.00–9.99	1	0.6	16	1.0	500	17.5	107	3.9	2	3.9	236	1.1	26	4.0	888	3.0
10.00–17.99	10	3.0	17	1.0	1,192	21.3	257	5.1	0	0.0	385	1.7	54	6.5	1,915	5.4
≥18	7	1.9	42	2.9	1,504	26.2	673	6.4	2	4.0	378	3.8	57	8.4	2,663	9.5
Median household income (U.S. $)
<42,000	9	2.3	23	2.8	1,760	24.8	524	7.6	3	8.5	398	3.3	70	10.6	2,787	10.2
42,000–56,999	4	1.4	20	1.7	823	20.9	296	5.4	0	0.0	358	1.7	36	5.4	1,537	4.8
57,000–77,999	5	2.5	20	1.1	567	18.7	181	3.8	1	1.6	251	1.1	31	4.1	1,056	3.1
≥78,000	3	2.3	31	0.8	383	16.4	122	3.2	0	0.0	199	0.8	25	2.9	763	2.1
Without health insurance (%)
<5	1	1.0	19	0.7	340	17.2	96	3.6	0	0.0	213	0.8	26	3.6	695	2.0
5.00–8.99	3	1.7	23	1.1	529	15.9	167	4.3	1	1.5	260	1.1	35	4.4	1,018	3.0
9.00–14.99	4	1.6	20	1.3	908	18.7	260	5.2	1	1.9	323	1.7	34	4.5	1,550	5.0
≥15	13	2.8	32	2.7	1,757	28.1	600	6.5	2	4.5	411	3.5	67	10.1	2,882	9.8
Gini index (%)
<38	3	1.7	22	1.1	601	17.9	185	3.6	0	0.0	258	1.3	29	3.9	1,098	3.5
38.00–41.99	7	2.8	23	1.2	834	22.2	284	5.1	1	1.7	320	1.4	34	4.4	1,503	4.2
42.00–45.99	5	2.0	23	1.4	824	21.7	266	5.6	2	4.0	293	1.5	29	4.4	1,442	4.8
≥46	6	1.9	26	1.4	1,275	23.2	388	7.1	1	2.3	335	1.8	70	9.2	2,101	6.6
Subtotal^b	21	2.1	97	1.3	3,599	21.9	1,140	5.5	4	1.8	1,240	1.5	164	5.6	6,265	4.8
Total^c	124	6.3	796	5.7	13,808	44.7	9,149	21.9	62	14.2	8,327	5.2	821	14.2	33,087	13.1

Abbreviations: ACS, American Community Survey (ACS) [footnotes only]; SDH, social determinants of health [footnotes only].
Note. Rates are per 100,000 population. Row entries indicate categories based on census tracts; data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Reported numbers less than 12, and rates based on these numbers, should be interpreted with caution. The ACS does not provide age- and sex-specific SDH variables stratified by race and ethnicity for racial groups except whites (i.e., white, not-Hispanic/Latino). Therefore, the denominators used for computing race-specific rates may include Hispanics/Latinos, and should be interpreted with caution; see Technical Notes for more details. For the definitions of SDH indicator variables used in this report, see http://www2.census.gov/programssurveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Hispanics/Latinos can be of any race.
^bBecause column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.
^cTotals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

**Table 2. Diagnoses of HIV infection among adults, by age at diagnosis, sex at birth, and selected social determinants of health, 2018—census tract level, United States and Puerto Rico**
	18–24 years		25–34 years		35–44 years		45–54 years		≥55 years
	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate
Male
Below federal poverty level (%)
<6	674	20.9	1,189	24.8	573	10.7	483	8.0	366	3.1
6.00–10.99	1,137	29.1	2,094	32.5	1,058	18.0	768	12.6	542	4.3
11.00–17.99	1,444	39.0	2,708	46.4	1,304	26.6	823	16.8	557	5.6
≥18	2,536	49.9	4,125	73.5	1,846	42.9	1,318	32.0	834	10.8
Less than high school diploma (%)
<6	936	19.6	1,749	30.2	849	15.4	613	10.3	462	3.8
6.00–9.99	951	28.9	1,677	33.7	774	17.0	550	11.4	420	4.1
10.00–17.99	1,694	41.8	2,862	46.2	1,355	24.7	938	16.4	637	5.4
≥18	2,212	56.8	3,833	66.2	1,807	36.5	1,294	27.4	781	9.5
Median household income (U.S. $)
<42,000	2,379	54.0	3,739	74.5	1,597	40.3	1,219	31.1	741	9.4
42,000–56,999	1,434	35.7	2,592	44.3	1,257	25.5	793	16.0	603	5.8
57,000–77,999	1,140	30.3	2,205	36.4	1,075	20.0	718	13.0	494	4.4
≥78,000	834	23.0	1,569	27.4	849	13.8	661	9.8	460	3.7
Without health insurance (%)
<5	684	17.1	1,227	23.5	663	12.5	512	8.5	406	3.2
5.00–8.99	1,067	26.6	1,861	32.8	890	17.2	664	12.2	477	4.2
9.00–14.99	1,485	38.5	2,671	46.8	1,201	24.4	850	17.1	561	5.7
≥15	2,557	62.4	4,359	71.6	2,027	40.0	1,366	28.7	855	10.4
Gini index (%)
<38	1,196	31.2	2,043	35.2	938	16.8	635	11.3	427	4.4
38.00–41.99	1,398	34.2	2,429	39.3	1,126	19.7	823	13.7	535	4.5
42.00–45.99	1,332	38.5	2,373	46.0	1,164	25.2	835	17.3	562	5.6
≥46	1,864	41.7	3,264	59.3	1,551	34.2	1,098	23.2	774	7.5
Subtotal^a	5,913	36.9	10,267	45.1	4,853	23.7	3,456	16.3	2,333	5.5
Female
Below federal poverty level (%)
<6	60	2.1	155	3.2	154	2.8	123	2.0	114	0.9
6.00–10.99	139	3.8	271	4.3	257	4.4	210	3.3	203	1.4
11.00–17.99	191	5.4	402	7.1	401	8.3	324	6.5	243	2.1
≥18	381	7.5	828	15.1	684	15.6	564	13.2	441	4.6
Less than high school diploma (%)
<6	75	1.6	185	3.2	163	2.9	127	2.0	130	0.9
6.00–9.99	105	3.3	243	4.9	205	4.4	182	3.6	153	1.3
10.00–17.99	249	6.5	503	8.2	460	8.2	404	6.8	299	2.2
≥18	342	9.6	726	13.5	668	14.0	508	10.9	419	4.3
Median household income (U.S. $)
<42,000	362	8.3	801	16.1	683	16.7	546	13.2	395	4.0
42,000–56,999	202	5.4	407	7.3	362	7.4	295	5.8	271	2.2
57,000–77,999	126	3.5	260	4.4	276	5.1	215	3.8	179	1.4
≥78,000	81	2.4	188	3.3	173	2.7	165	2.4	156	1.1
Without health insurance (%)
<5	73	1.9	172	3.3	170	3.1	139	2.2	141	1.0
5.00–8.99	114	3.0	260	4.6	258	4.9	207	3.7	179	1.4
9.00–14.99	197	5.3	419	7.5	378	7.6	314	6.1	242	2.1
≥15	387	9.9	805	13.8	690	13.7	561	11.6	439	4.5
Gini index (%)
<38	129	3.7	275	4.8	291	5.2	236	4.1	167	1.5
38.00–41.99	193	5.0	409	6.8	354	6.1	308	5.0	239	1.7
42.00–45.99	183	5.5	409	8.1	336	7.2	269	5.4	245	2.1
≥46	266	5.9	563	10.3	514	11.1	408	8.2	350	2.8
Subtotal^a	787	5.2	1,696	7.6	1,520	7.4	1,246	5.7	1,016	2.1
Total^b	6,700	21.4	11,963	26.6	6,373	15.5	4,702	10.9	3,349	3.7

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Rates are per 100,000 population. Row entries indicate categories based on census tracts; data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis.
For the definitions of SDH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aBecause column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.
^bTotals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

**Table 3. Diagnoses of HIV infection among adults, by transmission category, sex at birth, and selected social determinants of health, 2018—census tract level, United States and Puerto Rico**
	Male-to-male sexual contact		Injection drug use		Male-to-male sexual contact and injection drug use		Heterosexual contact^a
	No.	%	No.	%	No.	%	No.	%
Male
Below federal poverty level (%)
<6	2,723	12.6	111	10.6	147	13.3	301	11.9
6.00–10.99	4,685	21.6	189	18.1	247	22.4	473	18.7
11.00–17.99	5,703	26.3	258	24.7	286	26.0	587	23.2
≥18	8,571	39.5	486	46.6	422	38.3	1,171	46.3
Less than high school diploma (%)
<6	3,950	18.2	131	12.6	231	21.0	293	11.6
6.00–9.99	3,652	16.8	156	14.9	185	16.8	377	14.9
10.00–17.99	6,078	28.0	293	28.1	322	29.2	788	31.1
≥18	8,014	36.9	464	44.4	365	33.1	1,077	42.5
Median household income (U.S. $)
<42,000	7,749	35.8	449	43.2	374	33.9	1,097	43.3
42,000–56,999	5,492	25.3	245	23.6	298	27.0	640	25.3
57,000–77,999	4,736	21.9	198	19.0	225	20.4	468	18.5
≥78,000	3,690	17.0	147	14.2	206	18.7	326	12.9
Without health insurance (%)
<5	2,878	13.3	147	14.0	187	17.0	277	10.9
5.00–8.99	4,051	18.7	236	22.7	251	22.8	418	16.5
9.00–14.99	5,590	25.8	279	26.7	281	25.5	613	24.2
≥15	9,167	42.3	382	36.6	383	34.7	1,224	48.4
Gini index (%)
<38	4,372	20.2	185	17.8	217	19.7	462	18.3
38.00–41.99	5,199	24.0	257	24.7	262	23.8	588	23.2
42.00–45.99	5,146	23.7	253	24.3	241	21.8	622	24.6
≥46	6,957	32.1	346	33.3	383	34.7	859	33.9
Subtotal^b	22,055	100	1,065	100	1,123	100	2,559	100
Female
Below federal poverty level (%)
<6	—	—	76	9.1	—	—	526	10.0
6.00–10.99	—	—	169	20.2	—	—	906	17.1
11.00–17.99	—	—	180	21.6	—	—	1,378	26.1
≥18	—	—	410	49.1	—	—	2,472	46.8
Less than high school diploma (%)
<6	—	—	97	11.5	—	—	576	10.9
6.00–9.99	—	—	124	14.8	—	—	762	14.4
10.00–17.99	—	—	263	31.5	—	—	1,642	31.1
≥18	—	—	352	42.1	—	—	2,302	43.6
Median household income (U.S. $)
<42,000	—	—	373	44.6	—	—	2,400	45.5
42,000–56,999	—	—	220	26.4	—	—	1,312	24.8
57,000–77,999	—	—	143	17.1	—	—	910	17.2
≥78,000	—	—	99	11.9	—	—	658	12.5
Without health insurance (%)
<5	—	—	127	15.2	—	—	562	10.6
5.00–8.99	—	—	157	18.8	—	—	855	16.2
9.00–14.99	—	—	230	27.5	—	—	1,315	24.9
≥15	—	—	322	38.5	—	—	2,549	48.3
Gini index (%)
<38	—	—	139	16.6	—	—	955	18.1
38.00–41.99	—	—	187	22.4	—	—	1,309	24.8
42.00–45.99	—	—	208	25.0	—	—	1,228	23.3
≥46	—	—	301	36.0	—	—	1,789	33.9
Subtotal^b	—	—	852	100	—	—	5,383	100
Total^c	22,055	100	1,917	100	1,123	100	7,943	100

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Data have been statistically adjusted to account for missing transmission category. Row entries indicate categories based on census tracts; data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis.
For the definitions of SDH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aHeterosexual contact with a person known to have, or to be at high risk for, HIV infection.
^bBecause column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.
^cTotals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

**Table 4. Diagnoses of HIV infection among adults, by percentage living below federal poverty level, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Below federal poverty level (%)
	Male
	<6			6.00–10.99			11.00–17.99			≥18
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	13	5.5	35	54	12.1	22	114	21.1	21	194	33.9	21
Alaska	5	5.7	—	6	4.9	—	1	1.8	—	5	20.3	—
Arizona	62	11.2	15	90	12.6	20	133	24.2	17	265	33.3	22
Arkansas	14	14.8	9	35	13.2	16	49	12.2	31	62	17.8	35
California	394	12.0	14	829	18.8	11	978	25.8	13	1,229	38.0	17
Colorado	56	7.6	22	78	13.1	17	122	24.5	14	75	25.9	25
Connecticut	47	6.9	25	33	10.2	27	40	21.9	20	69	39.6	16
Delaware	11	11.6	—	16	11.4	24	23	27.2	11	17	45.4	12
District of Columbia	18	34.1	1	19	39.1	1	55	61.8	1	64	87.6	1
Florida	282	20.3	4	761	31.0	3	939	40.7	6	1,445	80.9	2
Georgia	164	23.4	2	337	34.1	2	486	45.8	4	683	69.6	4
Hawaii	14	6.5	29	18	9.5	28	18	18.0	23	9	17.6	—
Idaho	2	3.2	—	8	3.2	—	9	4.4	—	5	4.8	—
Illinois	124	8.7	20	187	12.6	19	233	22.8	18	421	48.4	10
Indiana	48	7.4	23	52	6.9	36	68	11.9	32	156	32.4	23
Iowa	13	4.5	36	29	6.0	38	18	7.2	40	22	13.8	38
Kansas	21	6.6	28	23	6.5	37	21	9.7	37	44	22.9	30
Kentucky	29	12.4	13	53	13.8	15	64	15.0	27	120	19.5	33
Louisiana	22	14.3	10	95	23.0	8	155	30.0	9	345	54.8	7
Maine	1	1.0	—	7	3.8	—	10	6.3	—	3	3.9	—
Maryland	190	19.2	5	191	28.6	5	164	46.1	3	145	74.4	3
Massachusetts	73	6.8	26	89	12.7	18	118	26.3	12	131	34.7	20
Michigan	36	3.7	37	76	7.3	32	77	8.4	38	205	25.1	26
Minnesota	48	5.9	33	51	7.0	33	56	17.1	24	47	22.0	32
Mississippi	16	17.2	7	42	24.8	7	80	22.1	19	186	40.6	14
Missouri	43	8.0	21	78	12.0	23	92	15.3	26	135	27.6	24
Montana	0	0.0	—	5	3.4	—	6	5.5	—	7	7.4	—
Nebraska	12	5.6	34	16	6.9	34	16	10.1	36	24	24.8	27
Nevada	46	18.7	6	103	26.5	6	100	40.9	5	153	62.7	5
New Hampshire	8	2.9	—	3	2.1	—	9	12.3	—	3	8.7	—
New Jersey	157	9.8	16	146	18.0	13	167	34.1	8	259	61.7	6
New Mexico	4	4.8	—	11	8.7	—	29	11.6	33	20	6.5	41
New York	175	8.7	19	341	16.8	14	462	28.8	10	883	50.7	9
North Carolina	15	2.2	39	32	3.1	40	42	3.7	41	45	5.0	42
North Dakota	6	8.1	—	6	4.8	—	5	7.8	—	3	8.8	—
Ohio	82	6.5	30	126	10.6	25	146	15.3	25	384	40.6	15
Oklahoma	25	9.8	17	24	6.9	35	54	11.3	34	90	24.4	28
Oregon	15	6.5	31	43	9.1	29	61	11.0	35	56	17.5	37
Pennsylvania	99	6.0	32	116	7.5	31	118	13.4	30	421	51.2	8
Puerto Rico	0	0.0	—	0	0.0	—	24	47.4	2	291	24.4	29
Rhode Island	13	9.5	18	13	12.3	21	10	14.5	—	18	19.2	34
South Carolina	52	15.6	8	88	18.3	12	132	24.2	16	196	41.1	13
South Dakota	1	1.3	—	2	2.0	—	10	11.1	—	7	12.4	—
Tennessee	52	12.8	12	128	19.6	10	136	18.8	22	256	37.1	18
Texas	509	20.6	3	770	28.9	4	867	34.9	7	1,147	46.2	11
Utah	27	6.6	27	27	8.3	30	26	14.3	28	19	13.4	39
Vermont	4	6.7	—	6	5.8	—	3	5.4	—	2	7.0	—
Virginia	157	13.0	11	181	19.9	9	159	24.3	15	143	36.1	19
Washington	55	7.1	24	107	10.3	26	87	13.6	29	64	17.6	36
West Virginia	2	3.9	—	4	2.6	—	9	3.5	—	16	6.6	40
Wisconsin	22	3.1	38	44	5.5	39	33	8.2	39	67	22.8	31
Wyoming	1	2.1	—	0	0.0	—	2	3.3	—	3	12.3	—
Total^b	3,285	10.5	—	5,599	16.0	—	6,836	23.4	—	10,659	39.7	—

**Table 4. Diagnoses of HIV infection among adults, by percentage living below federal poverty level, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Below federal poverty level (%)
	Female
	<6			6.00–10.99			11.00–17.99			≥18
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	3	1.2	—	14	2.9	13	12	2.1	27	61	9.5	16
Alaska	0	0.0	—	2	1.8	—	0	0.0	—	1	4.6	—
Arizona	8	1.4	—	17	2.2	15	14	2.5	25	45	5.8	25
Arkansas	1	1.0	—	5	1.8	—	8	1.9	—	23	6.0	23
California	45	1.3	13	82	1.8	18	113	2.9	20	190	5.7	26
Colorado	6	0.8	—	11	1.8	—	12	2.4	26	9	3.2	—
Connecticut	6	0.8	—	7	2.0	—	12	6.1	13	30	15.4	7
Delaware	4	4.0	—	5	3.3	—	7	7.3	—	6	14.0	—
District of Columbia	1	1.8	—	3	5.7	—	15	14.7	2	29	32.9	1
Florida	38	2.5	5	146	5.5	3	266	10.9	3	428	22.6	2
Georgia	38	5.1	2	69	6.4	2	115	9.9	5	240	22.4	3
Hawaii	1	0.5	—	1	0.5	—	2	1.9	—	2	3.9	—
Idaho	0	0.0	—	1	0.4	—	2	1.0	—	2	1.9	—
Illinois	20	1.3	12	24	1.5	20	49	4.6	16	99	10.3	14
Indiana	7	1.0	—	19	2.4	14	16	2.6	24	49	9.4	17
Iowa	1	0.3	—	8	1.6	—	9	3.4	—	9	5.7	—
Kansas	4	1.2	—	4	1.1	—	6	2.7	—	10	5.2	—
Kentucky	3	1.2	—	10	2.5	—	13	2.9	21	39	5.9	24
Louisiana	5	3.0	—	19	4.4	7	43	7.9	9	151	21.8	4
Maine	1	0.9	—	1	0.5	—	0	0.0	—	1	1.2	—
Maryland	64	6.0	1	88	11.9	1	62	15.6	1	46	20.3	6
Massachusetts	26	2.2	9	27	3.5	10	49	10.1	4	64	15.4	8
Michigan	8	0.8	—	9	0.8	—	20	2.0	28	66	7.4	21
Minnesota	18	2.1	10	13	1.7	19	14	4.1	17	18	8.4	19
Mississippi	1	1.0	—	6	3.3	—	20	5.1	15	67	13.1	10
Missouri	6	1.1	—	3	0.4	—	10	1.6	—	21	3.9	31
Montana	0	0.0	—	1	0.7	—	0	0.0	—	2	2.1	—
Nebraska	0	0.0	—	1	0.4	—	1	0.6	—	4	4.2	—
Nevada	4	1.6	—	11	2.8	—	14	5.8	14	29	12.6	11
New Hampshire	2	0.7	—	1	0.6	—	1	1.3	—	2	6.0	—
New Jersey	31	1.8	11	36	4.1	8	49	9.5	6	93	20.3	5
New Mexico	1	1.2	—	3	2.3	—	2	0.8	—	7	2.2	—
New York	52	2.4	6	78	3.5	9	109	6.4	12	234	11.8	12
North Carolina	3	0.4	—	7	0.6	—	11	0.9	—	14	1.4	32
North Dakota	2	2.8	—	4	3.4	—	5	8.0	—	1	3.3	—
Ohio	15	1.1	15	26	2.0	16	29	2.8	23	82	7.9	20
Oklahoma	2	0.8	—	6	1.6	—	14	2.8	22	20	5.3	29
Oregon	3	1.2	—	8	1.6	—	10	1.7	—	7	2.2	—
Pennsylvania	21	1.2	14	31	1.9	17	36	3.8	18	122	13.1	9
Puerto Rico	0	0.0	—	0	0.0	—	3	5.0	—	68	5.0	30
Rhode Island	1	0.7	—	1	0.9	—	3	3.9	—	8	7.9	—
South Carolina	15	4.2	3	26	5.0	5	50	8.4	7	52	9.7	15
South Dakota	1	1.3	—	1	1.0	—	1	1.1	—	1	1.8	—
Tennessee	8	1.8	—	22	3.1	11	24	3.1	19	70	9.2	18
Texas	81	3.1	4	128	4.7	6	213	8.3	8	297	11.6	13
Utah	1	0.2	—	3	0.9	—	0	0.0	—	4	3.0	—
Vermont	1	1.6	—	1	0.9	—	0	0.0	—	1	3.4	—
Virginia	29	2.3	7	53	5.5	4	48	6.9	10	31	7.3	22
Washington	18	2.3	8	31	2.9	12	42	6.6	11	20	5.5	28
West Virginia	0	0.0	—	3	1.9	—	4	1.5	—	5	2.0	—
Wisconsin	0	0.0	—	4	0.5	—	3	0.7	—	18	5.7	27
Wyoming	0	0.0	—	0	0.0	—	0	0.0	—	0	0.0	—
Total^b	606	1.8	—	1,080	2.9	—	1,561	5.1	—	2,898	10.1	—

**Table 4. Diagnoses of HIV infection among adults, by percentage living below federal poverty level, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Below federal poverty level (%)
	Total
	<6			6.00–10.99			11.00–17.99			≥18
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	16	3.2	35	68	7.3	19	126	11.2	21	255	21.0	21
Alaska	5	3.0	—	8	3.4	—	1	1.0	—	6	12.9	—
Arizona	70	6.2	16	107	7.2	20	147	13.1	20	310	19.7	23
Arkansas	15	7.7	10	40	7.3	18	57	7.0	34	85	11.7	35
California	439	6.5	15	911	10.1	13	1,091	14.2	15	1,419	21.7	19
Colorado	62	4.1	26	89	7.4	17	134	13.5	18	84	14.8	27
Connecticut	53	3.8	29	40	5.9	27	52	13.6	16	99	26.8	13
Delaware	15	7.7	11	21	7.2	21	30	16.7	12	23	28.6	11
District of Columbia	19	17.4	1	22	21.7	1	70	36.6	1	93	57.7	1
Florida	320	11.1	5	907	17.7	4	1,205	25.4	4	1,873	50.9	2
Georgia	202	13.9	2	406	19.7	3	601	27.0	3	923	44.9	4
Hawaii	15	3.5	33	19	5.0	30	20	9.7	25	11	10.8	—
Idaho	2	1.6	—	9	1.8	—	11	2.7	—	7	3.3	—
Illinois	144	4.9	21	211	6.9	22	282	13.6	17	520	28.5	12
Indiana	55	4.2	25	71	4.6	32	84	7.1	31	205	20.4	22
Iowa	14	2.4	37	37	3.8	37	27	5.2	39	31	9.8	38
Kansas	25	3.8	28	27	3.8	38	27	6.1	36	54	14.0	31
Kentucky	32	6.7	14	63	8.0	15	77	8.8	28	159	12.5	34
Louisiana	27	8.4	9	114	13.4	8	198	18.7	9	496	37.5	7
Maine	2	1.0	—	8	2.1	—	10	3.0	—	4	2.5	—
Maryland	254	12.3	3	279	19.8	2	226	30.0	2	191	45.3	3
Massachusetts	99	4.4	24	116	7.8	16	167	17.9	10	195	24.6	15
Michigan	44	2.2	38	85	4.0	36	97	5.1	40	271	15.9	24
Minnesota	66	4.0	27	64	4.3	34	70	10.5	23	65	15.2	25
Mississippi	17	8.7	8	48	13.7	7	100	13.3	19	253	26.1	14
Missouri	49	4.5	23	81	6.0	26	102	8.2	30	156	15.2	26
Montana	0	0.0	—	6	2.0	—	6	2.8	—	9	4.8	—
Nebraska	12	2.7	36	17	3.6	39	17	5.3	38	28	14.5	29
Nevada	50	10.0	6	114	14.5	6	114	23.5	6	182	38.4	6
New Hampshire	10	1.8	—	4	1.3	—	10	6.7	—	5	7.4	—
New Jersey	188	5.7	17	182	10.8	12	216	21.5	7	352	40.1	5
New Mexico	5	2.9	—	14	5.5	28	31	6.0	37	27	4.3	40
New York	227	5.4	18	419	9.9	14	571	17.2	11	1,117	29.9	9
North Carolina	18	1.3	40	39	1.8	41	53	2.2	43	59	3.1	42
North Dakota	8	5.5	—	10	4.1	—	10	7.9	—	4	6.2	—
Ohio	97	3.7	31	152	6.2	25	175	8.8	27	466	23.5	17
Oklahoma	27	5.2	19	30	4.2	35	68	7.0	33	110	14.7	28
Oregon	18	3.8	30	51	5.3	29	71	6.3	35	63	9.8	37
Pennsylvania	120	3.5	32	147	4.7	31	154	8.5	29	543	31.0	8
Puerto Rico	0	0.0	—	0	0.0	—	27	24.4	5	359	14.1	30
Rhode Island	14	4.9	20	14	6.3	24	13	8.9	26	26	13.3	33
South Carolina	67	9.7	7	114	11.4	10	182	16.0	13	248	24.5	16
South Dakota	2	1.3	—	3	1.5	—	11	6.1	—	8	7.2	—
Tennessee	60	7.1	13	150	11.1	11	160	10.8	22	326	22.5	18
Texas	590	11.7	4	898	16.6	5	1,080	21.4	8	1,444	28.7	10
Utah	28	3.4	34	30	4.6	33	26	7.0	32	23	8.4	39
Vermont	5	4.1	—	7	3.3	—	3	2.6	—	3	5.2	—
Virginia	186	7.5	12	234	12.4	9	207	15.3	14	174	21.2	20
Washington	73	4.7	22	138	6.6	23	129	10.2	24	84	11.5	36
West Virginia	2	1.9	—	7	2.2	—	13	2.4	42	21	4.2	41
Wisconsin	22	1.5	39	48	3.0	40	36	4.5	41	85	13.9	32
Wyoming	1	1.0	—	0	0.0	—	2	1.7	—	3	6.5	—
Total^b	3,891	6.1	—	6,679	9.3	—	8,397	14.0	—	13,557	24.4	—

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis, and the proportion of residents in the census tract who were living below the U.S. poverty level at any time during the 12 months before the survey response (individuals aged 18 years and older). Rates are per 100,000 population. Reported numbers less than 12, and rates based on these numbers, should be interpreted with caution. For the definitions of SDH indicator variables used in this report, see https://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aBased on rate. Ranks were not assigned to areas with rates that were based on reported numbers less than 12.
^bTotals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

**Table 5. Diagnoses of HIV infection among adults, by percentage with less than high school diploma, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Less than high school diploma (%)
	Male
	<6			6.00–9.99			10.00–17.99			≥18
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	47	15.4	12	55	18.6	14	134	22.1	17	140	23.8	29
Alaska	8	7.4	—	1	1.0	—	6	8.4	—	2	14.0	—
Arizona	102	12.8	19	85	16.9	15	134	21.5	19	229	32.9	18
Arkansas	41	24.9	7	25	13.8	19	44	8.9	40	50	18.7	36
California	553	15.0	13	417	16.8	16	705	21.7	18	1,755	32.4	19
Colorado	90	8.9	29	65	14.8	18	73	17.2	24	103	38.7	12
Connecticut	33	5.9	38	32	9.3	29	61	20.8	20	63	36.9	16
Delaware	12	13.0	18	13	12.8	23	27	23.6	13	15	31.7	20
District of Columbia	35	31.3	2	18	51.5	1	67	84.4	1	36	96.4	1
Florida	546	27.9	5	625	33.9	4	1,028	43.4	3	1,236	69.2	2
Georgia	269	37.7	1	333	45.0	2	616	49.5	2	452	43.5	8
Hawaii	25	10.5	26	12	7.7	33	20	14.7	27	2	7.3	—
Idaho	8	4.4	—	3	1.6	—	8	4.5	—	5	7.3	—
Illinois	193	12.3	21	156	13.0	21	272	23.9	12	344	38.7	13
Indiana	39	7.8	33	62	9.3	30	110	12.4	31	113	27.7	23
Iowa	25	5.2	40	16	3.9	39	22	10.8	35	19	20.6	33
Kansas	35	8.4	30	21	6.8	36	33	14.4	28	20	15.4	37
Kentucky	39	13.3	17	70	25.4	8	88	14.9	26	69	13.6	39
Louisiana	70	30.8	3	70	24.6	10	207	35.6	6	270	43.4	9
Maine	8	4.4	—	6	3.2	—	7	4.8	—	0	0.0	—
Maryland	140	18.5	9	176	27.7	7	197	37.4	5	177	57.4	3
Massachusetts	83	7.4	35	73	12.1	24	99	19.3	21	156	41.1	10
Michigan	59	5.0	41	83	7.4	35	153	14.3	29	99	24.6	26
Minnesota	68	7.2	36	53	7.7	34	36	10.7	36	45	37.6	15
Mississippi	27	28.5	4	46	29.4	5	122	28.9	8	129	31.5	21
Missouri	85	13.7	16	87	15.9	17	106	13.3	30	70	22.5	31
Montana	6	3.7	—	5	3.4	—	6	7.1	—	1	9.0	—
Nebraska	20	7.1	37	11	5.1	—	22	16.9	25	15	19.5	35
Nevada	39	18.4	10	74	25.4	9	136	42.9	4	153	50.5	5
New Hampshire	6	2.7	—	4	2.0	—	10	11.4	—	3	15.9	—
New Jersey	122	10.0	28	114	13.3	20	192	26.6	10	301	57.0	4
New Mexico	13	8.0	32	12	9.7	27	18	8.2	41	22	7.9	40
New York	230	11.6	23	207	12.9	22	471	24.7	11	955	50.4	6
North Carolina	21	2.4	42	23	3.3	40	47	3.7	42	43	4.7	41
North Dakota	12	11.9	22	3	2.3	—	5	8.5	—	0	0.0	—
Ohio	152	11.3	24	144	11.9	25	222	17.9	22	220	38.1	14
Oklahoma	41	14.5	15	34	9.9	26	51	9.6	38	67	22.7	30
Oregon	55	12.3	20	37	9.0	31	59	10.5	37	24	14.8	38
Pennsylvania	124	8.3	31	140	9.4	28	241	17.7	23	249	45.6	7
Puerto Rico	11	32.8	—	23	37.7	3	71	22.6	15	210	24.6	27
Rhode Island	12	11.2	25	12	9.9	—	12	11.7	34	18	23.9	28
South Carolina	71	16.7	11	67	18.9	13	165	28.7	9	165	33.4	17
South Dakota	2	1.9	—	4	3.3	—	10	13.5	—	4	14.5	—
Tennessee	100	19.6	8	108	23.9	11	205	22.4	16	159	26.4	24
Texas	585	26.9	6	471	27.8	6	765	30.7	7	1,475	39.1	11
Utah	34	7.5	34	15	5.6	37	28	12.0	32	22	21.2	32
Vermont	4	4.4	—	5	5.0	—	6	11.2	—	0	0.0	—
Virginia	148	14.6	14	145	20.3	12	223	23.1	14	124	25.2	25
Washington	105	10.2	27	67	8.7	32	89	11.9	33	52	19.6	34
West Virginia	4	4.3	—	8	6.2	—	12	3.4	43	7	5.2	—
Wisconsin	50	5.7	39	34	4.6	38	43	9.3	39	39	27.8	22
Wyoming	2	2.5	—	2	2.2	—	2	3.8	—	0	0.0	—
Total^b	4,609	13.5	—	4,372	15.7	—	7,486	22.6	—	9,927	36.0	—

**Table 5. Diagnoses of HIV infection among adults, by percentage with less than high school diploma, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Less than high school diploma (%)
	Female
	<6			6.00–9.99			10.00–17.99			≥18
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	9	2.7	—	11	3.3	—	34	5.0	18	36	5.7	26
Alaska	1	1.0	—	0	0.0	—	2	3.1	—	0	0.0	—
Arizona	13	1.5	14	16	3.0	12	15	2.3	30	40	6.0	24
Arkansas	4	2.3	—	2	1.0	—	15	2.9	26	16	5.8	25
California	42	1.1	17	49	1.9	18	92	2.7	28	247	4.6	29
Colorado	11	1.1	—	11	2.5	—	6	1.4	—	10	4.0	—
Connecticut	5	0.8	—	6	1.6	—	15	4.7	19	29	16.0	7
Delaware	1	1.0	—	8	7.1	—	6	4.7	—	7	15.2	—
District of Columbia	2	1.6	—	11	29.0	—	20	21.0	1	15	36.3	1
Florida	61	2.9	6	128	6.3	4	278	10.8	4	411	23.1	2
Georgia	40	5.3	2	72	8.7	1	182	13.0	3	168	15.6	8
Hawaii	2	0.9	—	2	1.2	—	1	0.7	—	1	3.7	—
Idaho	1	0.5	—	1	0.5	—	2	1.1	—	1	1.5	—
Illinois	27	1.6	12	39	3.0	13	63	5.1	17	63	7.1	22
Indiana	8	1.5	—	11	1.6	—	37	3.9	24	35	8.3	18
Iowa	6	1.2	—	8	1.9	—	3	1.4	—	10	10.7	—
Kansas	8	1.9	—	3	1.0	—	8	3.4	—	5	4.0	—
Kentucky	5	1.6	—	7	2.4	—	27	4.3	21	26	4.9	28
Louisiana	9	3.7	—	24	7.7	3	52	8.2	8	133	20.6	3
Maine	1	0.5	—	2	1.0	—	0	0.0	—	0	0.0	—
Maryland	51	6.1	1	59	8.4	2	90	15.4	2	60	19.5	5
Massachusetts	20	1.6	11	22	3.4	10	44	8.0	9	80	19.6	4
Michigan	12	1.0	18	16	1.3	19	43	3.8	25	32	7.7	20
Minnesota	21	2.1	8	14	2.0	16	15	4.4	20	13	11.0	11
Mississippi	3	2.9	—	4	2.2	—	45	9.7	5	42	9.6	15
Missouri	5	0.8	—	5	0.8	—	21	2.5	29	9	2.9	—
Montana	0	0.0	—	1	0.7	—	2	2.4	—	0	0.0	—
Nebraska	0	0.0	—	3	1.3	—	2	1.5	—	1	1.4	—
Nevada	3	1.4	—	6	2.0	—	20	6.3	10	29	10.4	13
New Hampshire	2	0.9	—	2	1.0	—	0	0.0	—	2	10.6	—
New Jersey	24	1.8	10	23	2.5	14	74	9.5	6	88	16.3	6
New Mexico	3	1.7	—	1	0.7	—	3	1.3	—	6	2.2	—
New York	35	1.6	13	61	3.5	9	129	6.2	11	249	12.0	10
North Carolina	4	0.4	—	8	1.1	—	13	0.9	31	10	1.0	—
North Dakota	4	4.1	—	4	3.3	—	4	7.1	—	0	0.0	—
Ohio	16	1.1	16	25	1.9	17	54	4.0	23	57	9.8	14
Oklahoma	6	2.0	—	0	0.0	—	16	2.9	27	20	7.0	23
Oregon	7	1.5	—	6	1.4	—	10	1.7	—	5	3.1	—
Pennsylvania	20	1.2	15	34	2.1	15	76	5.3	16	80	14.2	9
Puerto Rico	0	0.0	—	4	5.3	—	20	5.3	15	47	5.0	27
Rhode Island	0	0.0	—	1	0.7	—	2	1.8	—	10	12.6	—
South Carolina	20	4.4	3	21	5.4	5	57	8.9	7	45	8.6	16
South Dakota	1	1.0	—	1	0.8	—	1	1.4	—	1	3.8	—
Tennessee	14	2.5	7	23	4.7	6	40	4.1	22	47	7.5	21
Texas	89	3.9	4	73	4.0	7	158	6.0	12	399	10.7	12
Utah	2	0.4	—	0	0.0	—	2	0.9	—	4	4.1	—
Vermont	2	2.0	—	1	1.0	—	0	0.0	—	0	0.0	—
Virginia	33	3.1	5	24	3.1	11	62	6.0	13	42	8.4	17
Washington	22	2.1	9	29	3.7	8	40	5.3	14	20	7.8	19
West Virginia	1	1.0	—	2	1.5	—	7	1.9	—	2	1.4	—
Wisconsin	4	0.4	—	4	0.5	—	7	1.5	—	10	7.0	—
Wyoming	0	0.0	—	0	0.0	—	0	0.0	—	0	0.0	—
Total^b	680	1.9	—	888	3.0	—	1,915	5.4	—	2,663	9.5	—

**Table 5. Diagnoses of HIV infection among adults, by percentage with less than high school diploma, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Less than high school diploma (%)
	Total
	<6			6.00–9.99			10.00–17.99			≥18
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	56	8.8	12	66	10.6	14	168	13.0	17	176	14.5	30
Alaska	9	4.4	—	1	0.5	—	8	5.9	—	2	7.6	—
Arizona	115	7.0	19	101	9.7	16	149	11.8	21	269	19.7	20
Arkansas	45	13.2	7	27	7.0	24	59	5.8	39	66	12.1	35
California	595	7.9	16	466	9.2	17	797	12.0	20	2,002	18.6	21
Colorado	101	5.0	30	76	8.6	18	79	9.3	25	113	21.9	17
Connecticut	38	3.3	38	38	5.3	29	76	12.5	19	92	26.1	11
Delaware	13	6.7	22	21	9.8	15	33	13.6	14	22	23.6	15
District of Columbia	37	15.6	3	29	39.8	1	87	49.8	1	51	64.8	1
Florida	607	14.9	6	753	19.5	4	1,306	26.5	3	1,647	46.2	2
Georgia	309	21.0	1	405	25.9	2	798	30.2	2	620	29.3	10
Hawaii	27	5.8	26	14	4.4	35	21	7.6	32	3	5.5	—
Idaho	9	2.4	—	4	1.0	—	10	2.8	—	6	4.5	—
Illinois	220	6.8	20	195	7.8	21	335	14.1	13	407	23.0	16
Indiana	47	4.6	34	73	5.3	28	147	8.0	30	148	17.8	23
Iowa	31	3.2	39	24	2.9	39	25	6.1	38	29	15.6	28
Kansas	43	5.1	29	24	3.9	37	41	8.8	28	25	9.8	37
Kentucky	44	7.2	17	77	13.5	10	115	9.5	24	95	9.2	38
Louisiana	79	16.7	2	94	15.8	6	259	21.3	6	403	31.8	5
Maine	9	2.4	—	8	2.1	—	7	2.4	—	0	0.0	—
Maryland	191	12.0	8	235	17.6	5	287	25.8	4	237	38.5	3
Massachusetts	103	4.4	35	95	7.6	23	143	13.4	15	236	30.0	8
Michigan	71	2.9	41	99	4.3	36	196	8.9	27	131	16.0	27
Minnesota	89	4.6	33	67	4.8	33	51	7.5	33	58	24.4	13
Mississippi	30	15.1	4	50	14.9	8	167	18.8	7	171	20.1	19
Missouri	90	7.0	18	92	8.1	19	127	7.7	31	79	12.6	34
Montana	6	1.8	—	6	2.0	—	8	4.8	—	1	4.5	—
Nebraska	20	3.5	37	14	3.1	38	24	9.2	26	16	10.7	36
Nevada	42	9.7	11	80	13.4	11	156	24.5	5	182	31.4	6
New Hampshire	8	1.8	—	6	1.5	—	10	5.6	—	5	13.3	—
New Jersey	146	5.7	27	137	7.7	22	266	17.7	10	389	36.4	4
New Mexico	16	4.8	31	13	5.0	32	21	4.7	41	28	5.0	40
New York	265	6.4	23	268	8.0	20	600	15.0	11	1,204	30.3	7
North Carolina	25	1.4	42	31	2.1	42	60	2.2	43	53	2.8	41
North Dakota	16	8.0	15	7	2.8	—	9	7.8	—	0	0.0	—
Ohio	168	6.1	25	169	6.7	25	276	10.7	23	277	23.9	14
Oklahoma	47	8.1	14	34	4.8	34	67	6.2	36	87	15.0	29
Oregon	62	6.8	21	43	5.1	31	69	6.1	37	29	9.0	39
Pennsylvania	144	4.6	32	174	5.6	27	317	11.3	22	329	29.7	9
Puerto Rico	11	14.9	—	27	19.8	3	91	13.1	16	257	14.3	31
Rhode Island	12	5.4	28	13	5.1	30	14	6.5	34	28	18.1	22
South Carolina	91	10.3	10	88	11.8	12	222	18.3	8	210	20.6	18
South Dakota	3	1.4	—	5	2.0	—	11	7.6	—	5	9.3	—
Tennessee	114	10.6	9	131	13.9	9	245	12.9	18	206	16.7	26
Texas	674	15.1	5	544	15.5	7	923	17.9	9	1,874	25.0	12
Utah	36	3.9	36	15	2.8	40	30	6.4	35	26	12.9	33
Vermont	6	3.2	—	6	3.0	—	6	5.4	—	0	0.0	—
Virginia	181	8.7	13	169	11.4	13	285	14.2	12	166	16.8	25
Washington	127	6.1	24	96	6.2	26	129	8.6	29	72	13.8	32
West Virginia	5	2.7	—	10	3.8	—	19	2.6	42	9	3.3	—
Wisconsin	54	3.0	40	38	2.5	41	50	5.4	40	49	17.3	24
Wyoming	2	1.3	—	2	1.1	—	2	1.9	—	0	0.0	—
Total^b	5,289	7.5	—	5,260	9.1	—	9,401	13.7	—	12,590	22.6	—

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis, and the proportion of residents in the census tract with less than a high school diploma (individuals aged 18 years and older). Rates are per 100,000 population. Reported numbers less than 12, and rates based on these numbers, should be interpreted with caution. For the definitions of SDH indicator variables used in this report, see https://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aBased on rate. Ranks were not assigned to areas with rates that were based on reported numbers less than 12.
^bTotals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

**Table 6. Diagnoses of HIV infection among adults, by median household income, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Median household income (U.S. $)
	Male
	<42,000			42,000–56,999			57,000–77,999			≥78,000
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	225	35.0	19	88	15.2	24	45	12.6	24	17	7.9	23
Alaska	2	12.1	—	3	7.6	—	4	4.6	—	8	5.6	—
Arizona	225	32.2	21	139	20.3	22	114	18.0	15	72	12.2	14
Arkansas	79	18.2	36	40	10.0	37	34	16.3	17	6	10.0	—
California	783	40.6	13	853	30.4	11	872	24.0	7	920	14.5	9
Colorado	56	24.4	25	117	25.8	15	98	16.0	18	59	7.2	25
Connecticut	70	44.9	12	39	25.0	17	38	12.0	25	42	5.8	33
Delaware	10	44.6	—	29	29.5	12	19	14.2	21	9	8.9	—
District of Columbia	45	110.4	1	22	88.5	1	34	107.3	1	54	32.9	1
Florida	1,509	71.7	3	942	38.2	5	633	31.7	4	340	24.9	2
Georgia	651	67.0	5	433	44.4	3	385	41.5	2	201	23.4	3
Hawaii	3	9.8	—	21	33.2	9	14	8.9	31	21	6.9	27
Idaho	5	4.3	—	14	5.3	42	5	2.7	—	0	0.0	—
Illinois	363	47.5	9	238	21.3	20	206	15.1	20	158	10.2	17
Indiana	172	31.1	22	71	9.6	38	55	7.3	34	26	6.3	30
Iowa	16	11.2	38	42	10.2	35	12	2.6	40	12	7.1	26
Kansas	49	23.3	27	28	7.9	40	17	6.3	35	15	6.0	32
Kentucky	121	18.9	35	54	11.9	30	76	20.3	13	15	7.9	22
Louisiana	338	55.0	7	148	31.3	10	95	22.5	9	35	17.3	8
Maine	6	5.6	—	7	4.8	—	6	2.9	—	2	3.0	—
Maryland	115	77.3	2	147	51.9	2	177	34.6	3	251	19.9	5
Massachusetts	87	35.8	17	99	28.7	13	103	17.1	16	121	8.6	20
Michigan	213	24.3	26	90	8.4	39	56	5.3	37	35	4.7	34
Minnesota	36	19.3	34	55	12.5	29	63	8.4	32	48	6.7	28
Mississippi	202	39.4	14	66	21.1	21	44	23.0	8	12	18.1	6
Missouri	153	26.3	23	86	11.8	32	75	13.0	22	34	8.7	19
Montana	8	8.8	—	5	3.4	—	4	2.7	—	1	5.0	—
Nebraska	17	21.3	31	30	11.8	31	14	6.1	36	7	5.0	—
Nevada	172	67.3	4	88	36.3	7	99	25.9	6	43	17.8	7
New Hampshire	1	3.5	—	8	9.5	—	8	4.5	—	6	2.5	—
New Jersey	202	63.1	6	173	43.3	4	158	20.2	14	196	10.8	15
New Mexico	22	7.3	40	22	10.3	34	16	9.2	30	4	5.0	—
New York	610	52.1	8	431	28.7	14	414	21.8	10	402	14.5	10
North Carolina	49	4.5	42	44	3.5	43	33	4.0	39	8	1.4	—
North Dakota	4	10.9	—	4	5.9	—	6	5.3	—	6	7.6	—
Ohio	399	39.1	15	148	12.6	28	126	9.5	28	65	7.9	21
Oklahoma	93	21.9	30	57	11.1	33	30	9.3	29	12	6.4	—
Oregon	23	9.1	39	58	12.6	27	70	12.7	23	24	7.6	24
Pennsylvania	385	46.7	10	168	12.7	26	118	7.7	33	79	6.6	29
Puerto Rico	295	24.8	24	20	34.6	8	0	0.0	—	0	0.0	—
Rhode Island	15	22.4	29	18	21.9	19	8	6.8	—	13	9.3	18
South Carolina	229	39.0	16	133	25.3	16	71	15.2	19	35	14.1	11
South Dakota	12	20.9	32	5	4.6	—	1	0.9	—	2	4.6	—
Tennessee	265	33.3	20	149	19.0	23	114	21.0	11	44	12.8	13
Texas	1,052	46.1	11	916	36.3	6	754	29.5	5	570	21.0	4
Utah	19	19.8	33	22	10.1	36	34	9.6	27	24	6.1	31
Vermont	1	4.8	—	5	6.2	—	7	6.1	—	2	6.5	—
Virginia	147	35.2	18	166	24.3	18	143	20.9	12	184	13.3	12
Washington	37	15.7	37	77	13.1	25	83	9.8	26	116	10.3	16
West Virginia	16	5.4	41	11	4.1	—	3	2.6	—	1	3.5	—
Wisconsin	67	22.5	28	48	7.1	41	36	4.7	38	15	3.2	35
Wyoming	1	6.4	—	2	2.8	—	2	2.3	—	1	2.0	—
Total^b	9,675	38.4	—	6,679	22.1	—	5,632	17.6	—	4,373	12.6	—

**Table 6. Diagnoses of HIV infection among adults, by median household income, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Median household income (U.S. $)
	Female
	<42,000			42,000–56,999			57,000–77,999			≥78,000
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	60	8.3	18	15	2.4	25	10	2.6	—	5	2.2	—
Alaska	0	0.0	—	1	3.0	—	1	1.3	—	1	0.7	—
Arizona	42	6.0	23	19	2.7	23	16	2.4	14	7	1.1	—
Arkansas	20	4.3	28	15	3.6	18	1	0.5	—	1	1.6	—
California	119	6.0	24	123	4.3	15	102	2.7	13	86	1.3	11
Colorado	7	3.1	—	10	2.2	—	11	1.8	—	10	1.2	—
Connecticut	25	14.3	8	19	10.9	4	4	1.2	—	7	0.9	—
Delaware	5	19.2	—	8	7.2	—	7	4.8	—	2	1.9	—
District of Columbia	23	42.1	1	7	23.3	—	8	22.4	—	10	5.7	—
Florida	456	20.4	5	253	9.5	6	115	5.4	5	54	3.7	2
Georgia	230	21.3	3	112	10.5	5	89	8.9	2	31	3.4	4
Hawaii	1	3.3	—	0	0.0	—	1	0.6	—	4	1.3	—
Idaho	2	1.7	—	2	0.7	—	0	0.0	—	1	1.8	—
Illinois	94	11.1	14	51	4.3	14	26	1.8	16	21	1.3	12
Indiana	50	8.2	19	22	2.8	22	14	1.8	17	5	1.2	—
Iowa	7	4.9	—	15	3.5	19	4	0.9	—	1	0.6	—
Kansas	10	4.7	—	8	2.2	—	1	0.4	—	5	1.9	—
Kentucky	40	5.8	25	12	2.5	24	10	2.5	—	3	1.5	—
Louisiana	164	23.8	2	30	6.1	10	16	3.6	12	7	3.2	—
Maine	1	0.9	—	0	0.0	—	2	0.9	—	0	0.0	—
Maryland	36	20.1	6	56	17.2	1	72	12.7	1	96	7.1	1
Massachusetts	53	18.9	7	44	11.8	3	40	6.1	3	29	1.9	9
Michigan	69	7.2	22	18	1.6	27	7	0.6	—	9	1.2	—
Minnesota	19	9.8	16	14	3.1	21	15	2.0	15	15	2.0	8
Mississippi	73	12.7	11	13	3.9	17	6	2.9	—	2	2.7	—
Missouri	25	3.9	29	10	1.3	—	1	0.2	—	4	1.0	—
Montana	2	2.2	—	1	0.7	—	0	0.0	—	0	0.0	—
Nebraska	4	4.8	—	1	0.4	—	1	0.4	—	0	0.0	—
Nevada	30	12.6	13	13	5.3	13	12	3.1	—	3	1.2	—
New Hampshire	1	3.6	—	2	2.3	—	1	0.5	—	2	0.8	—
New Jersey	76	20.9	4	55	12.6	2	46	5.5	4	32	1.6	10
New Mexico	6	1.9	—	4	1.8	—	1	0.6	—	2	2.4	—
New York	179	12.8	10	110	6.8	9	99	4.9	6	85	2.8	6
North Carolina	18	1.5	31	12	0.9	28	4	0.4	—	1	0.2	—
North Dakota	2	6.1	—	4	6.0	—	4	3.7	—	2	2.7	—
Ohio	91	8.0	21	27	2.1	26	24	1.7	18	10	1.2	—
Oklahoma	24	5.5	26	10	1.9	—	6	1.8	—	2	1.0	—
Oregon	5	1.9	—	10	2.1	—	10	1.8	—	3	0.9	—
Pennsylvania	118	12.6	12	55	3.9	16	21	1.3	19	15	1.2	13
Puerto Rico	70	5.2	27	1	1.5	—	0	0.0	—	0	0.0	—
Rhode Island	9	12.5	—	2	2.2	—	2	1.5	—	0	0.0	—
South Carolina	70	10.5	15	41	7.3	8	23	4.5	8	9	3.4	—
South Dakota	1	1.7	—	1	0.9	—	1	0.9	—	1	2.2	—
Tennessee	70	8.0	20	26	3.1	20	23	3.9	11	5	1.3	—
Texas	308	12.9	9	197	7.7	7	121	4.6	7	93	3.3	5
Utah	4	4.3	—	1	0.5	—	2	0.5	—	1	0.3	—
Vermont	0	0.0	—	0	0.0	—	3	2.5	—	0	0.0	—
Virginia	41	8.9	17	39	5.4	12	29	4.0	10	52	3.6	3
Washington	10	4.1	—	33	5.5	11	39	4.5	9	29	2.5	7
West Virginia	5	1.6	—	4	1.4	—	3	2.6	—	0	0.0	—
Wisconsin	12	3.7	30	11	1.6	—	2	0.3	—	0	0.0	—
Wyoming	0	0.0	—	0	0.0	—	0	0.0	—	0	0.0	—
Total^b	2,787	10.2	—	1,537	4.8	—	1,056	3.1	—	763	2.1	—

**Table 6. Diagnoses of HIV infection among adults, by median household income, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Median household income (U.S. $)
	Total
	<42,000			42,000–56,999			57,000–77,999			≥78,000
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	285	20.8	20	103	8.5	25	55	7.4	22	22	4.9	19
Alaska	2	6.6	—	4	5.4	—	5	3.0	—	9	3.2	—
Arizona	267	19.1	22	158	11.4	22	130	10.0	16	79	6.5	14
Arkansas	99	10.9	37	55	6.7	32	35	8.1	21	7	5.7	—
California	902	23.0	17	976	17.2	13	974	13.2	7	1,006	7.8	12
Colorado	63	13.7	30	127	14.0	18	109	8.9	19	69	4.1	26
Connecticut	95	28.7	11	58	17.5	11	42	6.4	26	49	3.3	33
Delaware	15	31.0	8	37	17.7	10	26	9.3	18	11	5.3	—
District of Columbia	68	71.3	1	29	52.8	1	42	62.3	1	64	18.8	1
Florida	1,965	45.2	3	1,195	23.3	5	748	18.1	4	394	14.0	2
Georgia	881	43.0	4	545	26.7	4	474	24.6	2	232	13.1	4
Hawaii	4	6.5	—	21	16.8	14	15	4.8	31	25	4.1	27
Idaho	7	3.0	—	16	3.0	42	5	1.3	—	1	0.9	—
Illinois	457	28.3	13	289	12.6	19	232	8.3	20	179	5.6	17
Indiana	222	19.0	23	93	6.2	35	69	4.5	33	31	3.7	31
Iowa	23	8.0	39	57	6.8	31	16	1.7	40	13	3.8	30
Kansas	59	14.0	29	36	5.0	39	18	3.3	35	20	4.0	28
Kentucky	161	12.1	35	66	7.1	30	86	11.2	15	18	4.6	21
Louisiana	502	38.5	7	178	18.4	9	111	12.9	9	42	10.0	7
Maine	7	3.2	—	7	2.3	—	8	1.9	—	2	1.5	—
Maryland	151	46.1	2	203	33.3	2	249	23.1	3	347	13.2	3
Massachusetts	140	26.8	14	143	19.9	8	143	11.4	14	150	5.1	18
Michigan	282	15.3	25	108	4.9	40	63	2.9	37	44	2.9	35
Minnesota	55	14.5	27	69	7.7	27	78	5.2	29	63	4.3	24
Mississippi	275	25.3	15	79	12.3	20	50	12.6	11	14	10.1	6
Missouri	178	14.5	26	96	6.5	33	76	6.4	25	38	4.7	20
Montana	10	5.5	—	6	2.0	—	4	1.3	—	1	2.5	—
Nebraska	21	12.9	32	31	6.0	36	15	3.3	36	7	2.4	—
Nevada	202	40.9	5	101	20.6	7	111	14.4	6	46	9.3	8
New Hampshire	2	3.6	—	10	5.8	—	9	2.5	—	8	1.6	—
New Jersey	278	40.6	6	228	27.3	3	204	12.7	10	228	6.1	16
New Mexico	28	4.6	41	26	5.9	37	17	4.8	32	6	3.7	—
New York	789	30.8	9	541	17.3	12	513	13.1	8	487	8.4	10
North Carolina	67	2.9	43	56	2.1	44	37	2.2	39	9	0.7	—
North Dakota	6	8.6	—	8	5.9	—	10	4.5	—	8	5.2	—
Ohio	490	22.7	18	175	7.2	29	150	5.5	27	75	4.5	23
Oklahoma	117	13.5	31	67	6.4	34	36	5.4	28	14	3.6	32
Oregon	28	5.5	40	68	7.3	28	80	7.1	24	27	4.2	25
Pennsylvania	503	28.6	12	223	8.2	26	139	4.4	34	94	3.8	29
Puerto Rico	365	14.4	28	21	16.7	15	0	0.0	—	0	0.0	—
Rhode Island	24	17.3	24	20	11.5	21	10	4.0	—	13	4.5	22
South Carolina	299	23.9	16	174	15.9	16	94	9.6	17	44	8.5	9
South Dakota	13	11.3	36	6	2.8	—	2	0.9	—	3	3.4	—
Tennessee	335	20.0	21	175	10.8	23	137	12.2	13	49	6.8	13
Texas	1,360	29.1	10	1,113	21.9	6	875	16.9	5	663	11.9	5
Utah	23	12.1	34	23	5.3	38	36	5.0	30	25	3.2	34
Vermont	1	2.4	—	5	3.0	—	10	4.2	—	2	3.2	—
Virginia	188	21.4	19	205	14.6	17	172	12.2	12	236	8.3	11
Washington	47	9.9	38	110	9.3	24	122	7.2	23	145	6.4	15
West Virginia	21	3.4	42	15	2.7	43	6	2.6	—	1	1.7	—
Wisconsin	79	12.8	33	59	4.3	41	38	2.4	38	15	1.6	36
Wyoming	1	3.3	—	2	1.4	—	2	1.1	—	1	1.0	—
Total^b	12,462	23.7	—	8,216	13.3	—	6,688	10.2	—	5,136	7.2	—

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis, and the median income (based on all age groups) for a household within the census tract during the 12 months before the survey response. Reported numbers less than 12, and rates based on these numbers, should be interpreted with caution. For the definitions of SDH indicator variables used in this report, see https://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aBased on rate. Ranks were not assigned to areas with rates that were based on reported numbers less than 12.
^bTotals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

**Table 7. Diagnoses of HIV infection among adults, by percentage without health insurance, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Without health insurance (%)
	Male
	<5			5.00–8.99			9.00–14.99			≥15
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	20	9.6	23	63	15.7	18	118	17.5	26	175	34.3	19
Alaska	1	4.3	—	4	14.6	—	3	3.3	—	9	6.0	—
Arizona	57	10.0	19	97	15.4	19	122	18.3	25	274	36.7	15
Arkansas	14	11.6	14	41	10.5	30	80	19.3	24	25	13.9	34
California	545	13.4	8	776	19.4	12	972	27.4	14	1,137	36.3	16
Colorado	43	6.6	31	82	13.5	25	84	16.8	29	122	33.3	22
Connecticut	61	7.5	28	43	16.2	16	46	27.5	13	39	32.5	23
Delaware	18	12.5	12	26	19.5	11	16	25.5	18	7	43.3	—
District of Columbia	86	49.1	1	43	76.2	1	23	79.0	1	4	151.2	—
Florida	93	13.3	9	349	26.7	4	808	33.5	7	2,177	61.8	1
Georgia	66	23.7	3	176	33.6	2	356	31.5	9	1,072	59.5	2
Hawaii	31	9.0	25	20	12.1	28	8	16.7	—	0	0.0	—
Idaho	1	1.7	—	1	0.8	—	11	4.4	—	11	5.7	—
Illinois	174	9.6	22	193	14.8	23	298	32.4	8	300	39.2	13
Indiana	31	6.2	33	77	9.1	34	87	12.3	35	129	31.5	25
Iowa	23	3.5	37	33	9.1	35	18	14.0	32	8	20.5	—
Kansas	13	4.9	35	25	8.0	37	28	9.6	38	43	20.2	28
Kentucky	80	13.0	10	112	16.6	15	53	17.0	27	21	34.8	18
Louisiana	38	26.2	2	76	24.7	6	199	30.5	10	304	50.0	8
Maine	3	3.3	—	5	2.7	—	11	5.4	—	2	4.6	—
Maryland	202	19.7	5	185	31.2	3	175	47.2	2	128	58.3	4
Massachusetts	264	12.6	11	103	25.2	5	40	45.1	3	4	45.9	—
Michigan	81	5.8	34	143	9.9	31	127	16.9	28	43	24.2	27
Minnesota	83	6.6	32	48	8.1	36	51	27.4	15	20	34.0	20
Mississippi	9	18.9	—	22	18.3	14	91	25.9	17	202	35.9	17
Missouri	48	10.8	18	82	14.8	22	75	10.3	36	143	25.9	26
Montana	0	0.0	—	6	4.3	—	4	2.4	—	8	11.9	—
Nebraska	14	6.9	30	6	2.8	—	24	14.5	30	24	19.4	29
Nevada	21	14.6	7	49	19.2	13	119	33.7	6	213	57.4	6
New Hampshire	6	3.7	—	1	0.5	—	10	7.2	—	6	22.3	—
New Jersey	119	9.5	24	102	13.3	27	160	25.9	16	348	51.0	7
New Mexico	9	7.1	—	10	5.5	—	25	10.2	37	21	9.3	35
New York	333	10.8	17	479	23.1	9	577	41.0	4	473	57.4	5
North Carolina	6	1.5	—	20	2.4	41	44	3.4	41	64	5.1	36
North Dakota	7	7.0	—	7	6.0	—	5	7.5	—	1	7.5	—
Ohio	165	10.0	20	217	13.8	24	242	28.3	12	114	40.9	11
Oklahoma	9	11.6	—	19	9.3	33	36	8.7	39	129	17.1	31
Oregon	36	10.0	21	62	9.6	32	56	12.7	33	21	16.4	33
Pennsylvania	169	7.7	27	212	13.4	26	220	29.1	11	153	41.9	9
Puerto Rico	65	17.2	6	138	23.5	8	88	34.9	5	24	58.9	3
Rhode Island	17	7.3	29	21	22.4	10	12	23.7	20	4	13.5	—
South Carolina	20	11.3	16	51	14.8	21	162	22.1	21	235	40.2	12
South Dakota	2	3.4	—	5	3.9	—	3	3.7	—	10	17.0	—
Tennessee	35	11.9	13	88	14.9	20	192	19.8	23	257	41.6	10
Texas	135	20.8	4	316	24.1	7	521	24.6	19	2,322	38.5	14
Utah	12	6.2	—	23	7.3	38	20	6.9	40	44	16.8	32
Vermont	11	7.4	—	3	3.3	—	1	12.9	—	0	0.0	—
Virginia	82	11.4	15	132	16.1	17	215	21.3	22	211	33.7	21
Washington	78	8.5	26	111	10.9	29	79	12.4	34	45	18.8	30
West Virginia	7	4.5	—	12	3.4	40	9	4.6	—	3	27.3	—
Wisconsin	48	4.6	36	43	5.6	39	42	14.1	31	33	32.2	24
Wyoming	1	6.1	—	1	2.1	—	2	2.3	—	2	2.7	—
Total^b	3,492	10.5	—	4,959	15.7	—	6,768	23.1	—	11,164	39.5	—

**Table 7. Diagnoses of HIV infection among adults, by percentage without health insurance, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Without health insurance (%)
	Female
	<5			5.00–8.99			9.00–14.99			≥15
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	7	3.0	—	10	2.3	—	22	3.0	26	51	8.9	17
Alaska	0	0.0	—	0	0.0	—	1	1.2	—	2	1.5	—
Arizona	7	1.2	—	16	2.4	18	13	1.9	27	48	6.4	21
Arkansas	1	0.8	—	11	2.6	—	20	4.6	19	5	2.6	—
California	62	1.4	14	91	2.2	21	120	3.3	25	157	5.0	22
Colorado	6	0.9	—	7	1.1	—	11	2.2	—	14	4.0	24
Connecticut	10	1.2	—	12	4.1	9	16	8.7	6	17	13.7	8
Delaware	2	1.3	—	11	7.5	—	6	9.1	—	3	16.5	—
District of Columbia	28	13.8	1	13	20.0	1	7	23.7	—	0	0.0	—
Florida	17	2.2	9	56	3.9	10	167	6.4	13	638	17.3	3
Georgia	6	2.1	—	33	5.9	5	86	7.0	11	337	17.0	4
Hawaii	3	0.9	—	3	1.8	—	0	0.0	—	0	0.0	—
Idaho	0	0.0	—	2	1.6	—	1	0.4	—	2	1.0	—
Illinois	31	1.6	12	43	3.1	15	67	6.7	12	51	6.6	20
Indiana	8	1.5	—	14	1.6	24	30	4.0	22	39	8.9	18
Iowa	10	1.5	—	8	2.2	—	7	5.3	—	2	5.3	—
Kansas	3	1.1	—	4	1.2	—	8	2.7	—	9	4.2	—
Kentucky	17	2.6	6	21	2.9	16	19	5.7	15	8	12.7	—
Louisiana	3	2.0	—	27	7.9	4	65	9.4	4	123	18.7	2
Maine	0	0.0	—	2	1.0	—	1	0.5	—	0	0.0	—
Maryland	55	4.9	2	79	11.8	2	65	15.4	1	61	27.2	1
Massachusetts	101	4.4	4	51	11.7	3	13	14.3	2	1	14.4	—
Michigan	18	1.2	17	25	1.6	23	44	5.6	16	16	8.6	19
Minnesota	24	1.8	10	15	2.5	17	17	9.0	5	7	12.1	—
Mississippi	0	0.0	—	6	4.5	—	30	7.8	8	58	9.3	15
Missouri	4	0.8	—	3	0.5	—	11	1.4	—	22	3.7	25
Montana	0	0.0	—	0	0.0	—	1	0.6	—	2	2.9	—
Nebraska	1	0.5	—	1	0.5	—	0	0.0	—	4	3.2	—
Nevada	2	1.3	—	4	1.5	—	14	3.9	23	38	10.8	11
New Hampshire	1	0.6	—	1	0.5	—	3	2.1	—	1	3.7	—
New Jersey	21	1.5	13	28	3.3	13	52	7.7	9	108	15.3	5
New Mexico	2	1.5	—	2	1.0	—	5	1.9	—	4	1.7	—
New York	80	2.4	7	125	5.5	6	164	10.4	3	104	12.1	9
North Carolina	3	0.8	—	4	0.4	—	14	1.0	28	14	1.0	26
North Dakota	3	3.1	—	5	4.5	—	3	4.9	—	1	8.0	—
Ohio	23	1.3	15	39	2.3	19	50	5.5	17	40	13.7	7
Oklahoma	0	0.0	—	3	1.4	—	5	1.2	—	34	4.4	23
Oregon	6	1.6	—	10	1.5	—	7	1.6	—	5	3.7	—
Pennsylvania	29	1.3	16	59	3.5	12	69	8.3	7	53	13.8	6
Puerto Rico	21	4.8	3	29	4.4	8	16	5.4	18	5	11.7	—
Rhode Island	2	0.8	—	2	2.0	—	7	12.5	—	2	6.9	—
South Carolina	5	2.6	—	18	4.8	7	59	7.3	10	61	9.5	14
South Dakota	2	3.3	—	0	0.0	—	1	1.2	—	1	1.8	—
Tennessee	7	2.2	—	13	2.0	22	37	3.6	24	67	9.9	13
Texas	16	2.4	8	48	3.5	11	97	4.4	20	558	9.0	16
Utah	1	0.5	—	2	0.6	—	1	0.3	—	4	1.6	—
Vermont	3	1.9	—	0	0.0	—	0	0.0	—	0	0.0	—
Virginia	14	1.8	11	28	3.3	14	47	4.3	21	72	11.0	10
Washington	25	2.7	5	24	2.3	20	38	5.9	14	24	10.6	12
West Virginia	2	1.2	—	5	1.4	—	3	1.5	—	2	17.6	—
Wisconsin	3	0.3	—	5	0.6	—	10	3.2	—	7	6.7	—
Wyoming	0	0.0	—	0	0.0	—	0	0.0	—	0	0.0	—
Total^b	695	2.0	—	1,018	3.0	—	1,550	5.0	—	2,882	9.8	—

**Table 7. Diagnoses of HIV infection among adults, by percentage without health insurance, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Without health insurance (%)
	Total
	<5			5.00–8.99			9.00–14.99			≥15
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	27	6.2	17	73	8.7	21	140	10.0	28	226	20.9	21
Alaska	1	2.4	—	4	7.6	—	4	2.3	—	11	3.9	—
Arizona	64	5.4	24	113	8.7	19	135	10.1	27	322	21.5	20
Arkansas	15	6.0	18	52	6.4	30	100	11.7	23	30	8.1	34
California	607	7.3	11	867	10.6	13	1,092	15.2	19	1,294	20.6	22
Colorado	49	3.7	33	89	7.2	27	95	9.6	30	136	18.9	25
Connecticut	71	4.2	29	55	9.9	15	62	17.6	14	56	22.9	16
Delaware	20	6.6	14	37	13.2	10	22	17.1	15	10	29.1	—
District of Columbia	114	30.2	1	56	46.1	1	30	51.2	1	4	76.6	—
Florida	110	7.4	10	405	14.8	6	975	19.4	6	2,815	39.1	2
Georgia	72	12.8	3	209	19.3	3	442	18.7	10	1,409	37.2	3
Hawaii	34	5.0	26	23	6.9	28	8	8.4	—	0	0.0	—
Idaho	1	0.8	—	3	1.2	—	12	2.4	—	13	3.4	36
Illinois	205	5.5	23	236	8.7	20	365	19.0	7	351	22.8	17
Indiana	39	3.8	32	91	5.3	36	117	8.0	33	168	19.8	23
Iowa	33	2.5	38	41	5.6	32	25	9.6	29	10	13.1	—
Kansas	16	3.0	37	29	4.6	38	36	6.1	36	52	12.1	29
Kentucky	97	7.7	9	133	9.5	18	72	11.2	25	29	23.6	14
Louisiana	41	13.7	2	103	15.9	5	264	19.7	5	427	33.7	7
Maine	3	1.6	—	7	1.8	—	12	2.9	—	2	2.2	—
Maryland	257	12.0	4	264	20.9	2	240	30.3	2	189	42.6	1
Massachusetts	365	8.3	7	154	18.2	4	53	29.5	3	5	32.0	—
Michigan	99	3.5	35	168	5.6	31	171	11.1	26	59	16.2	26
Minnesota	107	4.2	30	63	5.3	34	68	18.1	12	27	23.2	15
Mississippi	9	9.4	—	28	11.0	12	121	16.5	16	260	22.0	19
Missouri	52	5.6	20	85	7.4	26	86	5.8	38	165	14.4	28
Montana	0	0.0	—	6	2.2	—	5	1.5	—	10	7.4	—
Nebraska	15	3.6	34	7	1.6	—	24	7.2	34	28	11.3	30
Nevada	23	7.8	8	53	10.2	14	133	18.7	9	251	34.8	4
New Hampshire	7	2.1	—	2	0.5	—	13	4.6	40	7	13.0	—
New Jersey	140	5.4	25	130	8.1	24	212	16.5	18	456	32.9	8
New Mexico	11	4.2	—	12	3.2	40	30	5.9	37	25	5.5	35
New York	413	6.4	16	604	13.9	7	741	24.8	4	577	34.3	6
North Carolina	9	1.1	—	24	1.4	43	58	2.1	43	78	3.0	37
North Dakota	10	5.1	—	12	5.3	35	8	6.3	—	2	7.7	—
Ohio	188	5.5	22	256	7.8	25	292	16.5	17	154	27.0	10
Oklahoma	9	5.8	—	22	5.2	37	41	4.9	39	163	10.6	31
Oregon	42	5.6	19	72	5.5	33	63	7.1	35	26	9.9	32
Pennsylvania	198	4.4	28	271	8.3	22	289	18.2	11	206	27.5	9
Puerto Rico	86	10.6	6	167	13.3	9	104	19.0	8	29	34.7	5
Rhode Island	19	3.9	31	23	11.9	11	19	17.8	13	6	10.2	—
South Carolina	25	6.8	13	69	9.6	16	221	14.4	20	296	24.2	12
South Dakota	4	3.3	—	5	2.0	—	4	2.5	—	11	9.5	—
Tennessee	42	6.8	12	101	8.2	23	229	11.4	24	324	25.0	11
Texas	151	11.4	5	364	13.6	8	618	14.2	21	2,880	23.6	13
Utah	13	3.3	36	25	3.9	39	21	3.6	41	48	9.3	33
Vermont	14	4.5	27	3	1.6	—	1	6.4	—	0	0.0	—
Virginia	96	6.5	15	160	9.6	17	262	12.5	22	283	22.1	18
Washington	103	5.5	21	135	6.5	29	117	9.2	31	69	14.8	27
West Virginia	9	2.8	—	17	2.4	42	12	3.0	42	5	22.4	—
Wisconsin	51	2.4	39	48	3.1	41	52	8.6	32	40	19.3	24
Wyoming	1	3.1	—	1	1.1	—	2	1.2	—	2	1.3	—
Total^b	4,187	6.1	—	5,977	9.2	—	8,318	13.8	—	14,046	24.4	—

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis, and the proportion of residents within the census tract without health insurance or health coverage plan (individuals aged 18 years and older).
Rates are per 100,000 population. Reported numbers less than 12, and rates based on these numbers, should be interpreted with caution. For the definitions of SDH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aBased on rate. Ranks were not assigned to areas with rates that were based on reported numbers less than 12.
^bTotals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

**Table 8. Diagnoses of HIV infection among adults, by GINI index percentage, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Gini index (%)
	Male
	<38			38.00–41.99			42.00–45.99			≥46
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	40	14.1	19	67	15.4	19	101	21.8	16	167	27.3	17
Alaska	5	4.8	—	5	5.1	—	1	1.8	—	6	20.2	—
Arizona	143	17.4	14	140	20.3	12	136	24.1	11	131	24.3	20
Arkansas	36	27.2	8	31	9.9	31	37	11.9	31	56	16.1	28
California	702	19.1	12	927	22.9	10	842	23.6	12	959	27.8	16
Colorado	94	12.7	22	93	17.1	17	62	14.7	25	81	19.6	25
Connecticut	28	10.0	29	47	11.4	27	50	16.3	23	64	18.0	27
Delaware	16	18.7	13	19	14.2	21	9	13.4	—	23	32.8	9
District of Columbia	8	42.5	—	15	59.8	1	31	48.2	1	101	65.9	1
Florida	568	35.7	3	874	38.1	3	839	44.0	4	1,145	53.3	2
Georgia	324	38.2	2	397	39.6	2	440	47.6	2	509	53.2	3
Hawaii	13	6.6	36	13	9.9	32	19	15.5	24	14	13.3	34
Idaho	5	3.4	—	10	5.4	—	0	0.0	—	9	6.4	—
Illinois	155	13.1	20	239	16.9	18	221	20.0	17	350	31.6	11
Indiana	72	9.1	30	102	12.5	25	68	14.1	27	82	22.0	23
Iowa	18	6.3	37	27	6.0	40	21	8.0	40	16	8.8	40
Kansas	38	10.0	28	27	8.9	33	21	10.3	35	23	11.7	39
Kentucky	48	15.0	17	79	20.2	13	58	13.5	28	81	15.4	31
Louisiana	39	24.4	10	96	25.1	8	172	36.9	5	310	44.0	5
Maine	2	1.8	—	2	1.4	—	13	9.3	37	4	3.3	—
Maryland	275	28.6	6	185	31.4	6	90	27.0	8	140	43.0	6
Massachusetts	43	10.1	27	92	11.5	26	131	18.5	19	144	21.3	24
Michigan	85	8.5	34	106	8.8	34	89	11.0	33	114	15.3	32
Minnesota	57	9.1	31	59	8.6	36	45	10.0	36	41	12.4	35
Mississippi	48	30.0	4	66	30.4	7	86	31.4	7	124	28.7	15
Missouri	76	11.7	23	82	12.5	22	88	17.1	22	102	22.3	22
Montana	1	1.9	—	5	4.6	—	2	1.6	—	10	8.3	—
Nebraska	21	9.0	32	19	8.1	38	16	11.8	32	12	11.9	38
Nevada	115	27.8	7	97	32.8	4	97	44.4	3	93	47.6	4
New Hampshire	7	4.4	—	14	7.1	39	2	2.1	—	0	0.0	—
New Jersey	122	15.8	16	172	17.7	16	189	23.2	13	246	32.5	10
New Mexico	8	6.5	—	21	11.0	29	20	10.5	34	15	5.7	41
New York	143	11.2	24	334	18.3	15	457	26.0	9	923	36.7	8
North Carolina	37	4.6	39	29	2.8	42	38	4.1	43	30	3.0	42
North Dakota	3	6.3	—	2	2.8	—	8	8.5	—	7	8.3	—
Ohio	146	11.2	25	159	12.5	24	173	19.2	18	260	29.9	14
Oklahoma	44	14.5	18	51	12.5	23	29	8.0	41	69	18.3	26
Oregon	46	12.8	21	54	11.0	28	36	9.0	38	39	12.1	36
Pennsylvania	95	8.8	33	144	8.7	35	203	17.9	21	309	30.7	12
Puerto Rico	12	39.5	1	15	14.8	20	56	22.8	14	232	26.3	19
Rhode Island	11	14.2	—	8	9.2	—	14	12.9	29	21	15.7	29
South Carolina	90	25.4	9	111	23.3	9	109	22.5	15	158	30.6	13
South Dakota	3	3.4	—	5	5.4	—	5	7.3	—	7	9.0	—
Tennessee	126	24.3	11	140	22.6	11	112	18.5	20	194	26.7	18
Texas	887	29.4	5	822	32.1	5	730	32.9	6	853	37.3	7
Utah	40	7.1	35	22	10.3	30	22	14.6	26	15	11.9	37
Vermont	3	7.2	—	5	7.0	—	4	4.8	—	3	6.1	—
Virginia	213	17.0	15	159	20.1	14	143	24.3	10	125	23.2	21
Washington	92	10.4	26	71	8.5	37	76	12.4	30	74	15.5	30
West Virginia	1	1.2	—	7	3.5	—	12	5.5	42	11	5.3	—
Wisconsin	34	5.2	38	43	5.7	41	41	8.8	39	48	14.2	33
Wyoming	1	1.5	—	2	3.1	—	2	4.0	—	1	2.4	—
Total^b	5,239	17.2	—	6,311	18.6	—	6,266	22.3	—	8,551	28.9	—

**Table 8. Diagnoses of HIV infection among adults, by GINI index percentage, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Gini index (%)
	Female
	<38			38.00–41.99			42.00–45.99			≥46
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	9	2.9	—	24	5.1	9	14	2.8	24	43	6.2	17
Alaska	0	0.0	—	2	2.3	—	1	2.0	—	0	0.0	—
Arizona	22	2.6	14	25	3.5	16	21	3.6	19	16	2.9	28
Arkansas	4	2.8	—	11	3.3	—	7	2.2	—	15	3.9	25
California	83	2.2	17	134	3.2	18	95	2.6	26	118	3.3	26
Colorado	12	1.6	—	15	2.7	20	3	0.7	—	8	1.9	—
Connecticut	2	0.7	—	10	2.3	—	21	6.2	9	22	5.6	19
Delaware	8	9.0	—	6	4.1	—	2	2.6	—	6	7.6	—
District of Columbia	2	11.2	—	2	7.5	—	11	15.6	—	33	18.1	1
Florida	144	8.5	2	250	10.2	1	214	10.5	3	270	11.8	5
Georgia	77	8.5	3	106	9.8	3	119	11.8	1	160	15.1	2
Hawaii	1	0.5	—	1	0.7	—	1	0.8	—	3	2.7	—
Idaho	0	0.0	—	3	1.6	—	0	0.0	—	2	1.4	—
Illinois	19	1.6	18	42	2.9	19	54	4.6	16	77	6.3	16
Indiana	12	1.5	19	35	4.1	13	18	3.5	20	26	6.4	15
Iowa	1	0.4	—	10	2.1	—	7	2.6	—	9	4.8	—
Kansas	8	2.1	—	6	1.9	—	4	1.9	—	6	3.0	—
Kentucky	16	4.8	7	15	3.6	15	19	4.2	17	15	2.7	29
Louisiana	8	4.9	—	41	10.1	2	55	10.8	2	114	14.9	3
Maine	0	0.0	—	2	1.3	—	0	0.0	—	1	0.7	—
Maryland	132	12.7	1	61	9.5	4	21	5.5	11	46	12.4	4
Massachusetts	11	2.5	—	39	4.5	10	54	7.0	7	62	8.1	10
Michigan	14	1.4	20	22	1.7	25	29	3.3	21	38	4.7	23
Minnesota	17	2.7	13	15	2.1	22	12	2.6	25	19	5.5	20
Mississippi	5	2.9	—	14	6.0	8	22	7.4	5	53	11.0	6
Missouri	9	1.3	—	14	2.0	23	8	1.4	—	9	1.8	—
Montana	0	0.0	—	1	0.9	—	0	0.0	—	2	1.6	—
Nebraska	1	0.4	—	0	0.0	—	5	3.6	—	0	0.0	—
Nevada	18	4.3	8	10	3.4	—	13	5.9	10	17	8.9	8
New Hampshire	2	1.2	—	2	1.0	—	0	0.0	—	2	2.4	—
New Jersey	27	3.3	10	43	4.1	12	62	7.1	6	77	9.2	7
New Mexico	4	3.1	—	3	1.5	—	2	1.0	—	4	1.5	—
New York	42	3.2	11	84	4.3	11	100	5.2	14	247	8.6	9
North Carolina	8	0.9	—	7	0.6	—	12	1.2	27	8	0.7	—
North Dakota	1	2.3	—	5	7.4	—	2	2.2	—	4	5.1	—
Ohio	31	2.3	16	35	2.6	21	36	3.7	18	50	5.3	21
Oklahoma	7	2.2	—	11	2.6	—	11	2.9	—	13	3.3	27
Oregon	9	2.4	—	8	1.6	—	6	1.4	—	5	1.5	—
Pennsylvania	26	2.3	15	35	2.0	24	64	5.2	15	84	7.4	13
Puerto Rico	2	5.3	—	7	6.1	—	15	5.4	13	47	4.7	24
Rhode Island	1	1.3	—	2	2.2	—	4	3.3	—	6	4.0	—
South Carolina	20	5.2	6	40	7.7	5	37	7.0	8	46	7.9	12
South Dakota	1	1.1	—	1	1.1	—	0	0.0	—	2	2.5	—
Tennessee	31	5.6	4	22	3.3	17	19	3.0	22	52	6.4	14
Texas	165	5.3	5	188	7.1	6	175	7.5	4	191	8.0	11
Utah	4	0.7	—	0	0.0	—	2	1.3	—	2	1.6	—
Vermont	0	0.0	—	0	0.0	—	1	1.1	—	2	3.8	—
Virginia	39	3.0	12	51	6.0	7	35	5.5	12	36	6.1	18
Washington	38	4.3	9	31	3.7	14	18	2.9	23	24	4.9	22
West Virginia	2	2.3	—	4	1.9	—	4	1.8	—	2	0.9	—
Wisconsin	3	0.5	—	8	1.0	—	7	1.4	—	7	2.0	—
Wyoming	0	0.0	—	0	0.0	—	0	0.0	—	0	0.0	—
Total^b	1,098	3.5	—	1,503	4.2	—	1,442	4.8	—	2,101	6.6	—

**Table 8. Diagnoses of HIV infection among adults, by GINI index percentage, sex at birth, and area of residence, 2018—census tract level, United States and Puerto Rico**
	Gini index (%)
	Total
	<38			38.00–41.99			42.00–45.99			≥46
Area of residence	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a	No.	Rate	Rank^a
Alabama	49	8.3	18	91	10.1	18	115	11.8	18	210	16.1	16
Alaska	5	2.5	—	7	3.8	—	2	1.9	—	6	10.6	—
Arizona	165	9.9	15	165	11.8	13	157	13.7	13	147	13.5	23
Arkansas	40	14.6	9	42	6.5	28	44	6.9	33	71	9.7	30
California	785	10.6	13	1,061	12.9	10	937	12.9	15	1,077	15.3	18
Colorado	106	7.1	23	108	9.8	19	65	7.7	29	89	10.8	26
Connecticut	30	5.3	32	57	6.6	27	71	11.0	21	86	11.5	25
Delaware	24	13.7	12	25	8.9	21	11	7.7	—	29	19.5	10
District of Columbia	10	27.2	—	17	32.8	1	42	31.2	1	134	39.9	1
Florida	712	21.7	2	1,124	23.7	3	1,053	26.7	3	1,415	31.8	3
Georgia	401	22.8	1	503	24.1	2	559	29.0	2	669	33.2	2
Hawaii	14	3.7	37	14	5.2	35	20	8.1	26	17	7.8	35
Idaho	5	1.7	—	13	3.5	41	0	0.0	—	11	3.9	—
Illinois	174	7.3	22	281	9.8	20	275	12.1	17	427	18.3	14
Indiana	84	5.3	31	137	8.2	22	86	8.6	25	108	13.9	22
Iowa	19	3.3	38	37	4.0	40	28	5.3	38	25	6.7	38
Kansas	46	6.0	28	33	5.3	33	25	6.0	35	29	7.3	36
Kentucky	64	9.8	16	94	11.7	14	77	8.7	24	96	8.8	33
Louisiana	47	14.6	11	137	17.4	8	227	23.3	5	424	28.9	4
Maine	2	0.9	—	4	1.3	—	13	4.5	41	5	2.0	—
Maryland	407	20.4	4	246	19.9	4	111	15.6	8	186	26.7	6
Massachusetts	54	6.2	27	131	7.9	23	185	12.5	16	206	14.3	21
Michigan	99	4.9	33	128	5.2	36	118	7.0	32	152	9.8	29
Minnesota	74	5.9	29	74	5.4	32	57	6.2	34	60	8.9	32
Mississippi	53	15.9	7	80	17.8	7	108	18.9	7	177	19.4	11
Missouri	85	6.4	26	96	7.1	26	96	9.0	23	111	11.6	24
Montana	1	1.0	—	6	2.8	—	2	0.8	—	12	4.9	41
Nebraska	22	4.7	35	19	4.0	38	21	7.6	30	12	5.8	40
Nevada	133	16.0	6	107	18.1	6	110	25.1	4	110	28.5	5
New Hampshire	9	2.8	—	16	4.0	39	2	1.0	—	2	1.2	—
New Jersey	149	9.4	17	215	10.7	16	251	14.8	10	323	20.2	9
New Mexico	12	4.8	34	24	6.1	30	22	5.7	36	19	3.5	42
New York	185	7.1	24	418	11.1	15	557	15.2	9	1,170	21.7	8
North Carolina	45	2.7	40	36	1.7	43	50	2.6	43	38	1.8	44
North Dakota	4	4.4	—	7	5.1	—	10	5.4	—	11	6.7	—
Ohio	177	6.6	25	194	7.3	25	209	11.2	20	310	17.0	15
Oklahoma	51	8.3	19	62	7.5	24	40	5.4	37	82	10.6	27
Oregon	55	7.5	20	62	6.2	29	42	5.1	39	44	6.6	39
Pennsylvania	121	5.5	30	179	5.3	34	267	11.3	19	393	18.4	13
Puerto Rico	14	20.5	3	22	10.2	17	71	13.6	14	279	14.8	19
Rhode Island	12	7.7	—	10	5.6	—	18	7.8	28	27	9.6	31
South Carolina	110	15.0	8	151	15.2	9	146	14.4	12	204	18.6	12
South Dakota	4	2.3	—	6	3.3	—	5	3.7	—	9	5.7	—
Tennessee	157	14.6	10	162	12.6	12	131	10.5	22	246	16.0	17
Texas	1,052	17.2	5	1,010	19.4	5	905	20.0	6	1,044	22.4	7
Utah	44	3.9	36	22	5.1	37	24	7.9	27	17	6.8	37
Vermont	3	3.6	—	5	3.4	—	5	2.9	—	5	4.9	—
Virginia	252	9.9	14	210	12.9	11	178	14.5	11	161	14.3	20
Washington	130	7.3	21	102	6.1	31	94	7.6	31	98	10.2	28
West Virginia	3	1.7	—	11	2.7	—	16	3.6	42	13	3.0	43
Wisconsin	37	2.8	39	51	3.3	42	48	5.1	40	55	7.9	34
Wyoming	1	0.7	—	2	1.6	—	2	2.0	—	1	1.2	—
Total^b	6,337	10.2	—	7,814	11.2	—	7,708	13.3	—	10,652	17.3	—

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis, and the proportion of household income distribution within the census tract during the 12 months before the survey response.
Rates are per 100,000 population. Reported numbers less than 12, and rates based on these numbers, should be interpreted with caution.
For the definitions of SDH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aBased on rate. Ranks were not assigned to areas with rates that were based on reported numbers less than 12.
^bTotals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

9a. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by race/ethnicity, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
Black/African American
			≤1 month		≤3 months
	Total diagnoses		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^c	No.	%	No.	%
Male
Below federal poverty level (%)
<6	792	8.7	618	78.0	690	87.1
6.00–10.99	1,533	16.9	1,175	76.6	1,309	85.4
11.00–17.99	2,328	25.6	1,810	77.7	1,993	85.6
≥18	4,436	48.8	3,362	75.8	3,742	84.4
Less than high school diploma (%)
<6	1,163	12.8	920	79.1	1,012	87.0
6.00–9.99	1,410	15.5	1,101	78.1	1,215	86.2
10.00–17.99	2,970	32.7	2,218	74.7	2,489	83.8
≥18	3,551	39.0	2,729	76.9	3,022	85.1
Median household income (U.S. $)
<42,000	4,317	47.5	3,257	75.4	3,646	84.5
42,000–56,999	2,194	24.2	1,701	77.5	1,876	85.5
57,000–77,999	1,556	17.1	1,209	77.7	1,326	85.2
≥78,000	1,014	11.2	793	78.2	880	86.8
Without health insurance (%)
<5	827	9.1	649	78.5	721	87.2
5.00–8.99	1,424	15.7	1,135	79.7	1,239	87.0
9.00–14.99	2,418	26.6	1,876	77.6	2,076	85.9
≥15	4,423	48.6	3,306	74.7	3,700	83.7
Gini index (%)
<38	1,667	18.3	1,279	76.7	1,429	85.7
38.00–41.99	2,047	22.5	1,539	75.2	1,724	84.2
42.00–45.99	2,087	23.0	1,605	76.9	1,765	84.6
≥46	3,284	36.1	2,538	77.3	2,812	85.6
Subtotal^d	9,236	100	7,068	76.5	7,852	85.0
Female
Below federal poverty level (%)
<6	276	8.7	224	81.2	249	90.2
6.00–10.99	507	15.9	414	81.7	458	90.3
11.00–17.99	832	26.1	695	83.5	757	91.0
≥18	1,567	49.2	1,232	78.6	1,374	87.7
Less than high school diploma (%)
<6	306	9.6	262	85.6	284	92.8
6.00–9.99	453	14.2	369	81.5	413	91.2
10.00–17.99	1,064	33.4	847	79.6	950	89.3
≥18	1,359	42.7	1,087	80.0	1,191	87.6
Median household income (U.S. $)
<42,000	1,570	49.4	1,231	78.4	1,372	87.4
42,000–56,999	733	23.0	591	80.6	663	90.5
57,000–77,999	520	16.3	441	84.8	477	91.7
≥78,000	358	11.3	301	84.1	325	90.8
Without health insurance (%)
<5	303	9.5	253	83.5	279	92.1
5.00–8.99	459	14.4	392	85.4	420	91.5
9.00–14.99	794	25.0	648	81.6	717	90.3
≥15	1,626	51.1	1,272	78.2	1,422	87.5
Gini index (%)
<38	556	17.5	464	83.5	505	90.8
38.00–41.99	769	24.2	633	82.3	685	89.1
42.00–45.99	723	22.7	576	79.7	648	89.6
≥46	1,134	35.6	892	78.7	1,000	88.2
Subtotal^d	3,243	100	2,608	80.4	2,887	89.0
Total	12,479	100	9,676	77.5	10,739	86.1

9a. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by race/ethnicity, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
Hispanic/Latino^a
			≤1 month		≤3 months
	Total diagnoses		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^c	No.	%	No.	%
Male
Below federal poverty level (%)
<6	638	9.4	534	83.7	573	89.8
6.00–10.99	1,503	22.1	1,248	83.0	1,359	90.4
11.00–17.99	1,937	28.5	1,649	85.1	1,768	91.3
≥18	2,725	40.1	2,238	82.1	2,427	89.1
Less than high school diploma (%)
<6	842	12.4	707	84.0	765	90.9
6.00–9.99	860	12.6	736	85.6	793	92.2
10.00–17.99	1,586	23.3	1,341	84.6	1,449	91.4
≥18	3,523	51.7	2,891	82.1	3,127	88.8
Median household income (U.S. $)
<42,000	2,251	33.1	1,833	81.4	1,988	88.3
42,000–56,999	1,914	28.1	1,617	84.5	1,736	90.7
57,000–77,999	1,552	22.8	1,299	83.7	1,407	90.7
≥78,000	1,083	15.9	918	84.8	994	91.8
Without health insurance (%)
<5	558	8.2	471	84.4	511	91.6
5.00–8.99	965	14.2	824	85.4	892	92.4
9.00–14.99	1,592	23.4	1,345	84.5	1,450	91.1
≥15	3,689	54.2	3,029	82.1	3,274	88.8
Gini index (%)
<38	1,425	20.9	1,176	82.5	1,282	90.0
38.00–41.99	1,806	26.6	1,487	82.3	1,604	88.8
42.00–45.99	1,666	24.5	1,378	82.7	1,495	89.7
≥46	1,905	28.0	1,628	85.5	1,746	91.7
Subtotal^d	6,879	100	5,725	83.2	6,187	89.9
Female
Below federal poverty level (%)
<6	76	8.3	63	82.9	68	89.5
6.00–10.99	158	17.2	133	84.2	144	91.1
11.00–17.99	246	26.7	214	87.0	227	92.3
≥18	440	47.8	347	78.9	393	89.3
Less than high school diploma (%)
<6	78	8.5	62	79.5	70	89.7
6.00–9.99	96	10.4	85	88.5	91	94.8
10.00–17.99	197	21.4	170	86.3	181	91.9
≥18	549	59.7	440	80.1	490	89.3
Median household income (U.S. $)
<42,000	390	42.4	315	80.8	351	90.0
42,000–56,999	258	28.0	215	83.3	230	89.1
57,000–77,999	159	17.3	134	84.3	148	93.1
≥78,000	113	12.3	93	82.3	103	91.2
Without health insurance (%)
<5	69	7.5	60	87.0	63	91.3
5.00–8.99	117	12.7	100	85.5	111	94.9
9.00–14.99	218	23.7	179	82.1	197	90.4
≥15	516	56.1	418	81.0	461	89.3
Gini index (%)
<38	168	18.3	141	83.9	149	88.7
38.00–41.99	246	26.7	197	80.1	219	89.0
42.00–45.99	206	22.4	168	81.6	190	92.2
≥46	300	32.6	251	83.7	274	91.3
Subtotal^d	932	100	767	82.3	842	90.3
Total	7,811	100	6,492	83.1	7,029	90.0

9a. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by race/ethnicity, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
White
			≤1 month		≤3 months
	Total diagnoses		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^c	No.	%	No.	%
Male
Below federal poverty level (%)
<6	1,200	19.9	1,008	84.0	1,090	90.8
6.00–10.99	1,712	28.3	1,449	84.6	1,564	91.4
11.00–17.99	1,569	26.0	1,341	85.5	1,430	91.1
≥18	1,559	25.8	1,274	81.7	1,382	88.6
Less than high school diploma (%)
<6	1,771	29.3	1,502	84.8	1,610	90.9
6.00–9.99	1,329	22.0	1,138	85.6	1,217	91.6
10.00–17.99	1,681	27.8	1,399	83.2	1,509	89.8
≥18	1,260	20.9	1,034	82.1	1,131	89.8
Median household income (U.S. $)
<42,000	1,383	22.9	1,126	81.4	1,219	88.1
42,000–56,999	1,556	25.8	1,318	84.7	1,423	91.5
57,000–77,999	1,605	26.6	1,349	84.0	1,456	90.7
≥78,000	1,495	24.8	1,278	85.5	1,367	91.4
Without health insurance (%)
<5	1,243	20.6	1,056	85.0	1,126	90.6
5.00–8.99	1,484	24.6	1,259	84.8	1,359	91.6
9.00–14.99	1,619	26.8	1,367	84.4	1,474	91.0
≥15	1,694	28.0	1,390	82.1	1,507	89.0
Gini index (%)
<38	1,309	21.7	1,105	84.4	1,192	91.1
38.00–41.99	1,481	24.5	1,238	83.6	1,331	89.9
42.00–45.99	1,455	24.1	1,212	83.3	1,316	90.4
≥46	1,794	29.7	1,516	84.5	1,626	90.6
Subtotal^d	6,136	100	5,155	84.0	5,556	90.5
Female
Below federal poverty level (%)
<6	148	14.4	121	81.8	137	92.6
6.00–10.99	246	23.9	193	78.5	215	87.4
11.00–17.99	278	27.0	223	80.2	244	87.8
≥18	359	34.8	262	73.0	304	84.7
Less than high school diploma (%)
<6	173	16.8	144	83.2	158	91.3
6.00–9.99	205	19.9	164	80.0	185	90.2
10.00–17.99	329	31.9	260	79.0	282	85.7
≥18	325	31.5	232	71.4	276	84.9
Median household income (U.S. $)
<42,000	331	32.1	245	74.0	286	86.4
42,000–56,999	305	29.6	234	76.7	261	85.6
57,000–77,999	225	21.8	178	79.1	195	86.7
≥78,000	170	16.5	142	83.5	158	92.9
Without health insurance (%)
<5	171	16.6	143	83.6	156	91.2
5.00–8.99	207	20.1	148	71.5	177	85.5
9.00–14.99	275	26.7	223	81.1	240	87.3
≥15	378	36.7	285	75.4	327	86.5
Gini index (%)
<38	220	21.3	181	82.3	198	90.0
38.00–41.99	273	26.5	210	76.9	236	86.4
42.00–45.99	247	24.0	185	74.9	211	85.4
≥46	291	28.2	223	76.6	255	87.6
Subtotal^d	1,058	100	820	77.5	924	87.3
Total	7,194	100	5,975	83.1	6,480	90.1

9a. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by race/ethnicity, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
Other^b
			≤1 month		≤3 months
	Total diagnoses		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^c	No.	%	No.	%
Male
Below federal poverty level (%)
<6	220	16.5	185	84.1	196	89.1
6.00–10.99	341	25.5	291	85.3	312	91.5
11.00–17.99	374	28.0	310	82.9	335	89.6
≥18	401	30.0	336	83.8	363	90.5
Less than high school diploma (%)
<6	314	23.5	265	84.4	279	88.9
6.00–9.99	255	19.1	220	86.3	236	92.5
10.00–17.99	371	27.7	311	83.8	338	91.1
≥18	397	29.7	326	82.1	353	88.9
Median household income (U.S. $)
<42,000	292	21.9	246	84.2	266	91.1
42,000–56,999	335	25.1	275	82.1	300	89.6
57,000–77,999	352	26.4	297	84.4	320	90.9
≥78,000	354	26.6	303	85.6	318	89.8
Without health insurance (%)
<5	274	20.5	238	86.9	251	91.6
5.00–8.99	312	23.4	264	84.6	283	90.7
9.00–14.99	330	24.7	278	84.2	297	90.0
≥15	420	31.4	342	81.4	375	89.3
Gini index (%)
<38	308	23.1	262	85.1	276	89.6
38.00–41.99	307	23.0	259	84.4	281	91.5
42.00–45.99	304	22.8	251	82.6	273	89.8
≥46	414	31.1	349	84.3	374	90.3
Subtotal^d	1,362	100	1,140	83.7	1,225	89.9
Female
Below federal poverty level (%)
<6	31	12.4	23	74.2	26	83.9
6.00–10.99	57	22.9	47	82.5	52	91.2
11.00–17.99	62	24.9	53	85.5	56	90.3
≥18	99	39.8	81	81.8	84	84.8
Less than high school diploma (%)
<6	41	16.5	33	80.5	37	90.2
6.00–9.99	37	14.9	34	91.9	35	94.6
10.00–17.99	73	29.3	56	76.7	59	80.8
≥18	98	39.4	81	82.7	87	88.8
Median household income (U.S. $)
<42,000	93	37.3	77	82.8	79	84.9
42,000–56,999	55	22.1	42	76.4	47	85.5
57,000–77,999	50	20.1	46	92.0	48	96.0
≥78,000	51	20.5	39	76.5	44	86.3
Without health insurance (%)
<5	40	16.1	33	82.5	35	87.5
5.00–8.99	53	21.3	45	84.9	49	92.5
9.00–14.99	49	19.7	38	77.6	43	87.8
≥15	107	43.0	88	82.2	91	85.0
Gini index (%)
<38	47	18.9	37	78.7	42	89.4
38.00–41.99	60	24.1	48	80.0	51	85.0
42.00–45.99	52	20.9	44	84.6	46	88.5
≥46	90	36.1	75	83.3	79	87.8
Subtotal^d	254	100	207	81.5	222	87.4
Total	1,616	100	1,347	83.4	1,447	89.5

9a. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by race/ethnicity, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
Total
			≤1 month		≤3 months
	Total diagnoses		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^c	No.	%	No.	%
Male
Below federal poverty level (%)
<6	2,850	12.2	2,345	82.3	2,549	89.4
6.00–10.99	5,089	21.9	4,163	81.8	4,544	89.3
11.00–17.99	6,208	26.7	5,110	82.3	5,526	89.0
≥18	9,121	39.2	7,210	79.0	7,914	86.8
Less than high school diploma (%)
<6	4,090	17.6	3,394	83.0	3,666	89.6
6.00–9.99	3,854	16.6	3,195	82.9	3,461	89.8
10.00–17.99	6,608	28.4	5,269	79.7	5,785	87.5
≥18	8,731	37.5	6,980	79.9	7,633	87.4
Median household income (U.S. $)
<42,000	8,243	35.4	6,462	78.4	7,119	86.4
42,000–56,999	5,999	25.8	4,911	81.9	5,335	88.9
57,000–77,999	5,065	21.8	4,154	82.0	4,509	89.0
≥78,000	3,946	17.0	3,292	83.4	3,559	90.2
Without health insurance (%)
<5	2,902	12.5	2,414	83.2	2,609	89.9
5.00–8.99	4,185	18.0	3,482	83.2	3,773	90.2
9.00–14.99	5,959	25.6	4,866	81.7	5,297	88.9
≥15	10,226	43.9	8,067	78.9	8,856	86.6
Gini index (%)
<38	4,709	20.2	3,822	81.2	4,179	88.7
38.00–41.99	5,641	24.3	4,523	80.2	4,940	87.6
42.00–45.99	5,512	23.7	4,446	80.7	4,849	88.0
≥46	7,397	31.8	6,031	81.5	6,558	88.7
Subtotal^d	23,613	100	19,088	80.8	20,820	88.2
Female
Below federal poverty level (%)
<6	531	9.9	431	81.2	480	90.4
6.00–10.99	968	18.0	787	81.3	869	89.8
11.00–17.99	1,418	26.3	1,185	83.6	1,284	90.6
≥18	2,465	45.8	1,922	78.0	2,155	87.4
Less than high school diploma (%)
<6	598	11.1	501	83.8	549	91.8
6.00–9.99	791	14.7	652	82.4	724	91.5
10.00–17.99	1,663	30.9	1,333	80.2	1,472	88.5
≥18	2,331	43.3	1,840	78.9	2,044	87.7
Median household income (U.S. $)
<42,000	2,384	44.3	1,868	78.4	2,088	87.6
42,000–56,999	1,351	25.1	1,082	80.1	1,201	88.9
57,000–77,999	954	17.7	799	83.8	868	91.0
≥78,000	692	12.9	575	83.1	630	91.0
Without health insurance (%)
<5	583	10.8	489	83.9	533	91.4
5.00–8.99	836	15.5	685	81.9	757	90.6
9.00–14.99	1,336	24.8	1,088	81.4	1,197	89.6
≥15	2,627	48.8	2,063	78.5	2,301	87.6
Gini index (%)
<38	991	18.4	823	83.0	894	90.2
38.00–41.99	1,348	25.0	1,088	80.7	1,191	88.4
42.00–45.99	1,228	22.8	973	79.2	1,095	89.2
≥46	1,815	33.7	1,441	79.4	1,608	88.6
Subtotal^d	5,487	100	4,402	80.2	4,875	88.8
Total	29,100	100	23,490	80.7	25,695	88.3

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, Centers for Disease Control and Prevention [footnotes only]; SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Linkage to HIV medical care was measured by documentation of ≥1 CD4 or VL tests ≤1 month or ≤3 months after HIV diagnosis. Data not provided for states and associated census tracts that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.
Definitions for the SDH indicator variables used in this report can be found at http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aHispanics/Latinos can be of any race.
^bIncludes American Indian/Alaska Native, Asian, Native Hawaiian/other Pacific Islander, and multiple races.
^cRepresents percentage of the sum of each SDH subpopulation.
^dBecause column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.

Table 9b. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by age at diagnosis, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
18‒24
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^a	No.	%	No.	%
Male
Below federal poverty level (%)
<6	581	11.3	457	78.7	505	86.9
6.00–10.99	1,037	20.2	825	79.6	915	88.2
11.00–17.99	1,310	25.6	1,032	78.8	1,141	87.1
≥18	2,193	42.8	1,671	76.2	1,872	85.4
Less than high school diploma (%)
<6	830	16.2	666	80.2	727	87.6
6.00–9.99	843	16.5	662	78.5	732	86.8
10.00–17.99	1,488	29.0	1,158	77.8	1,294	87.0
≥18	1,962	38.3	1,500	76.5	1,682	85.7
Median household income (U.S. $)
<42,000	2,051	40.1	1,539	75.0	1,748	85.2
42,000–56,999	1,285	25.1	1,017	79.1	1,119	87.1
57,000–77,999	1,024	20.0	808	78.9	887	86.6
≥78,000	758	14.8	619	81.7	676	89.2
Without health insurance (%)
<5	562	11.0	448	79.7	497	88.4
5.00–8.99	906	17.7	731	80.7	792	87.4
9.00–14.99	1,296	25.3	1,028	79.3	1,141	88.0
≥15	2,359	46.0	1,779	75.4	2,005	85.0
Gini index (%)
<38	1,076	21.0	844	78.4	945	87.8
38.00–41.99	1,273	24.9	982	77.1	1,091	85.7
42.00–45.99	1,163	22.7	905	77.8	1,005	86.4
≥46	1,608	31.4	1,253	77.9	1,391	86.5
Subtotal^b	5,208	100	4,046	77.7	4,503	86.5
Female
Below federal poverty level (%)
<6	55	7.9	45	81.8	53	96.4
6.00–10.99	124	17.9	97	78.2	108	87.1
11.00–17.99	181	26.1	139	76.8	158	87.3
≥18	333	48.1	254	76.3	289	86.8
Less than high school diploma (%)
<6	65	9.4	53	81.5	60	92.3
6.00–9.99	98	14.1	78	79.6	88	89.8
10.00–17.99	226	32.6	174	77.0	199	88.1
≥18	304	43.9	230	75.7	261	85.9
Median household income (U.S. $)
<42,000	317	45.7	244	77.0	279	88.0
42,000–56,999	186	26.8	143	76.9	159	85.5
57,000–77,999	118	17.0	93	78.8	106	89.8
≥78,000	72	10.4	55	76.4	64	88.9
Without health insurance (%)
<5	59	8.5	45	76.3	53	89.8
5.00–8.99	100	14.4	77	77.0	90	90.0
9.00–14.99	176	25.4	142	80.7	156	88.6
≥15	358	51.7	271	75.7	309	86.3
Gini index (%)
<38	122	17.6	97	79.5	108	88.5
38.00–41.99	177	25.5	135	76.3	155	87.6
42.00–45.99	158	22.8	121	76.6	136	86.1
≥46	236	34.1	182	77.1	209	88.6
Subtotal^b	704	100	544	77.3	617	87.6
Total	5,912	100	4,590	77.6	5,120	86.6

Table 9b. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by age at diagnosis, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
25–34
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^a	No.	%	No.	%
Male
Below federal poverty level (%)
<6	1,050	11.7	863	82.2	942	89.7
6.00–10.99	1,903	21.2	1,522	80.0	1,669	87.7
11.00–17.99	2,482	27.6	2,016	81.2	2,189	88.2
≥18	3,551	39.5	2,830	79.7	3,090	87.0
Less than high school diploma (%)
<6	1,551	17.3	1,267	81.7	1,384	89.2
6.00–9.99	1,495	16.6	1,228	82.1	1,336	89.4
10.00–17.99	2,557	28.4	2,012	78.7	2,213	86.5
≥18	3,388	37.7	2,726	80.5	2,959	87.3
Median household income (U.S. $)
<42,000	3,220	35.9	2,528	78.5	2,765	85.9
42,000–56,999	2,326	25.9	1,902	81.8	2,070	89.0
57,000–77,999	1,989	22.2	1,607	80.8	1,756	88.3
≥78,000	1,443	16.1	1,190	82.5	1,294	89.7
Without health insurance (%)
<5	1,032	11.5	849	82.3	926	89.7
5.00–8.99	1,582	17.6	1,305	82.5	1,427	90.2
9.00–14.99	2,374	26.4	1,907	80.3	2,073	87.3
≥15	4,000	44.5	3,170	79.2	3,464	86.6
Gini index (%)
<38	1,857	20.7	1,484	79.9	1,633	87.9
38.00–41.99	2,176	24.2	1,745	80.2	1,902	87.4
42.00–45.99	2,100	23.4	1,668	79.4	1,819	86.6
≥46	2,848	31.7	2,331	81.8	2,532	88.9
Subtotal^b	9,102	100	7,314	80.4	7,983	87.7
Female
Below federal poverty level (%)
<6	139	9.5	111	79.9	123	88.5
6.00–10.99	251	17.2	204	81.3	226	90.0
11.00–17.99	360	24.7	304	84.4	326	90.6
≥18	707	48.5	547	77.4	620	87.7
Less than high school diploma (%)
<6	164	11.2	136	82.9	145	88.4
6.00–9.99	222	15.2	182	82.0	205	92.3
10.00–17.99	435	29.8	351	80.7	385	88.5
≥18	637	43.7	498	78.2	561	88.1
Median household income (U.S. $)
<42,000	692	47.5	533	77.0	604	87.3
42,000–56,999	357	24.5	288	80.7	314	88.0
57,000–77,999	236	16.2	205	86.9	223	94.5
≥78,000	172	11.8	140	81.4	154	89.5
Without health insurance (%)
<5	144	9.9	119	82.6	130	90.3
5.00–8.99	216	14.8	179	82.9	196	90.7
9.00–14.99	359	24.6	289	80.5	319	88.9
≥15	738	50.7	579	78.5	650	88.1
Gini index (%)
<38	252	17.3	202	80.2	227	90.1
38.00–41.99	370	25.4	307	83.0	325	87.8
42.00–45.99	343	23.5	268	78.1	302	88.0
≥46	492	33.8	389	79.1	441	89.6
Subtotal^b	1,493	100	1,188	79.6	1,322	88.5
Total	10,595	100	8,502	80.2	9,305	87.8

Table 9b. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by age at diagnosis, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
35–44
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^a	No.	%	No.	%
Male
Below federal poverty level (%)
<6	501	11.8	420	83.8	453	90.4
6.00–10.99	966	22.8	814	84.3	879	91.0
11.00–17.99	1,173	27.7	1,007	85.8	1,060	90.4
≥18	1,588	37.6	1,280	80.6	1,396	87.9
Less than high school diploma (%)
<6	763	18.0	648	84.9	694	91.0
6.00–9.99	680	16.1	583	85.7	620	91.2
10.00–17.99	1,203	28.4	986	82.0	1,063	88.4
≥18	1,586	37.5	1,307	82.4	1,415	89.2
Median household income (U.S. $)
<42,000	1,346	31.9	1,092	81.1	1,186	88.1
42,000–56,999	1,133	26.8	951	83.9	1,012	89.3
57,000–77,999	986	23.3	835	84.7	894	90.7
≥78,000	761	18.0	642	84.4	695	91.3
Without health insurance (%)
<5	563	13.3	478	84.9	513	91.1
5.00–8.99	755	17.9	635	84.1	679	89.9
9.00–14.99	1,057	25.0	899	85.1	966	91.4
≥15	1,853	43.8	1,509	81.4	1,630	88.0
Gini index (%)
<38	851	20.1	723	85.0	767	90.1
38.00–41.99	1,005	23.8	836	83.2	898	89.4
42.00–45.99	1,019	24.1	837	82.1	911	89.4
≥46	1,352	32.0	1,125	83.2	1,212	89.6
Subtotal^b	4,290	100	3,569	83.2	3,841	89.5
Female
Below federal poverty level (%)
<6	137	10.5	111	81.0	124	90.5
6.00–10.99	228	17.4	191	83.8	205	89.9
11.00–17.99	367	28.0	312	85.0	335	91.3
≥18	579	44.2	460	79.4	512	88.4
Less than high school diploma (%)
<6	142	10.8	114	80.3	127	89.4
6.00–9.99	181	13.8	159	87.8	169	93.4
10.00–17.99	411	31.4	332	80.8	370	90.0
≥18	577	44.0	469	81.3	510	88.4
Median household income (U.S. $)
<42,000	581	44.4	462	79.5	511	88.0
42,000–56,999	322	24.6	269	83.5	295	91.6
57,000–77,999	251	19.2	217	86.5	230	91.6
≥78,000	156	11.9	125	80.1	139	89.1
Without health insurance (%)
<5	144	11.0	122	84.7	130	90.3
5.00–8.99	213	16.2	177	83.1	196	92.0
9.00–14.99	326	24.9	274	84.0	295	90.5
≥15	628	47.9	501	79.8	555	88.4
Gini index (%)
<38	264	20.1	222	84.1	236	89.4
38.00–41.99	312	23.8	255	81.7	283	90.7
42.00–45.99	286	21.8	228	79.7	258	90.2
≥46	449	34.2	369	82.2	399	88.9
Subtotal^b	1,331	100	1,090	81.9	1,193	89.6
Total	5,621	100	4,659	82.9	5,034	89.6

Table 9b. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by age at diagnosis, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
45–54
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^a	No.	%	No.	%
Male
Below federal poverty level (%)
<6	410	13.9	344	83.9	368	89.8
6.00–10.99	701	23.8	596	85.0	642	91.6
11.00–17.99	738	25.0	638	86.4	677	91.7
≥18	1,101	37.3	881	80.0	957	86.9
Less than high school diploma (%)
<6	545	18.5	468	85.9	490	89.9
6.00–9.99	478	16.2	409	85.6	439	91.8
10.00–17.99	809	27.4	673	83.2	734	90.7
≥18	1,121	38.0	912	81.4	984	87.8
Median household income (U.S. $)
<42,000	1,012	34.3	807	79.7	877	86.7
42,000–56,999	718	24.3	615	85.7	662	92.2
57,000–77,999	635	21.5	542	85.4	577	90.9
≥78,000	584	19.8	494	84.6	527	90.2
Without health insurance (%)
<5	423	14.3	358	84.6	377	89.1
5.00–8.99	544	18.4	470	86.4	503	92.5
9.00–14.99	743	25.2	626	84.3	672	90.4
≥15	1,240	42.0	1,005	81.0	1,092	88.1
Gini index (%)
<38	549	18.6	466	84.9	501	91.3
38.00–41.99	730	24.8	592	81.1	644	88.2
42.00–45.99	729	24.7	619	84.9	660	90.5
≥46	941	31.9	781	83.0	838	89.1
Subtotal^b	3,002	100	2,502	83.3	2,689	89.6
Female
Below federal poverty level (%)
<6	105	9.9	80	76.2	90	85.7
6.00–10.99	191	18.1	154	80.6	174	91.1
11.00–17.99	293	27.7	241	82.3	265	90.4
≥18	469	44.3	367	78.3	407	86.8
Less than high school diploma (%)
<6	112	10.6	96	85.7	108	96.4
6.00–9.99	158	14.9	127	80.4	143	90.5
10.00–17.99	345	32.6	272	78.8	298	86.4
≥18	443	41.9	347	78.3	387	87.4
Median household income (U.S. $)
<42,000	458	43.3	366	79.9	400	87.3
42,000–56,999	253	23.9	190	75.1	222	87.7
57,000–77,999	192	18.1	155	80.7	170	88.5
≥78,000	155	14.7	131	84.5	144	92.9
Without health insurance (%)
<5	122	11.5	100	82.0	110	90.2
5.00–8.99	169	16.0	138	81.7	152	89.9
9.00–14.99	263	24.9	214	81.4	237	90.1
≥15	504	47.6	390	77.4	437	86.7
Gini index (%)
<38	212	20.0	179	84.4	193	91.0
38.00–41.99	280	26.5	220	78.6	243	86.8
42.00–45.99	229	21.6	182	79.5	207	90.4
≥46	337	31.9	261	77.4	293	86.9
Subtotal^b	1,081	100	858	79.4	956	88.4
Total	4,083	100	3,360	82.3	3,645	89.3

Table 9b. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by age at diagnosis, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
≥55
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^a	No.	%	No.	%
Male
Below federal poverty level (%)
<6	308	15.5	261	84.7	281	91.2
6.00–10.99	482	24.3	406	84.2	439	91.1
11.00–17.99	505	25.5	417	82.6	459	90.9
≥18	688	34.7	548	79.7	599	87.1
Less than high school diploma (%)
<6	401	20.2	345	86.0	371	92.5
6.00–9.99	358	18.0	313	87.4	334	93.3
10.00–17.99	551	27.8	440	79.9	481	87.3
≥18	674	34.0	535	79.4	593	88.0
Median household income (U.S. $)
<42,000	614	31.0	496	80.8	543	88.4
42,000–56,999	537	27.1	426	79.3	472	87.9
57,000–77,999	431	21.7	362	84.0	395	91.6
≥78,000	400	20.2	347	86.8	367	91.8
Without health insurance (%)
<5	322	16.2	281	87.3	296	91.9
5.00–8.99	398	20.1	341	85.7	372	93.5
9.00–14.99	489	24.7	406	83.0	445	91.0
≥15	774	39.0	604	78.0	665	85.9
Gini index (%)
<38	376	19.0	305	81.1	333	88.6
38.00–41.99	457	23.1	368	80.5	405	88.6
42.00–45.99	501	25.3	417	83.2	454	90.6
≥46	648	32.7	541	83.5	585	90.3
Subtotal^b	2,011	100	1,657	82.4	1,804	89.7
Female
Below federal poverty level (%)
<6	95	11.0	84	88.4	90	94.7
6.00–10.99	174	20.2	141	81.0	156	89.7
11.00–17.99	217	25.1	189	87.1	200	92.2
≥18	377	43.7	294	78.0	327	86.7
Less than high school diploma (%)
<6	115	13.3	102	88.7	109	94.8
6.00–9.99	132	15.3	106	80.3	119	90.2
10.00–17.99	246	28.5	204	82.9	220	89.4
≥18	370	42.9	296	80.0	325	87.8
Median household income (U.S. $)
<42,000	336	38.9	263	78.3	294	87.5
42,000–56,999	233	27.0	192	82.4	211	90.6
57,000–77,999	157	18.2	129	82.2	139	88.5
≥78,000	137	15.9	124	90.5	129	94.2
Without health insurance (%)
<5	114	13.2	103	90.4	110	96.5
5.00–8.99	138	16.0	114	82.6	123	89.1
9.00–14.99	212	24.6	169	79.7	190	89.6
≥15	399	46.2	322	80.7	350	87.7
Gini index (%)
<38	141	16.3	123	87.2	130	92.2
38.00–41.99	209	24.2	171	81.8	185	88.5
42.00–45.99	212	24.6	174	82.1	192	90.6
≥46	301	34.9	240	79.7	266	88.4
Subtotal^b	878	100	722	82.2	787	89.6
Total	2,889	100	2,379	82.3	2,591	89.7

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, Centers for Disease Control and Prevention [footnotes only]; SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Linkage to HIV medical care was measured by documentation of ≥1 CD4 or VL tests ≤1 month or ≤3 months after HIV diagnosis. Data not provided for states and associated census tracts that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.
Definitions for the SDH indicator variables used in this report can be found at http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aRepresents percentage of the sum of each SDH subpopulation.
^bBecause column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.

Table 9c. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by transmission category, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
Male-to-male sexual contact
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^b	No.	%	No.	%
Male
Below federal poverty level (%)
<6	2,392	12.4	1,984	82.9	2,141	89.5
6.00–10.99	4,280	22.2	3,504	81.9	3,828	89.5
11.00–17.99	5,202	27.0	4,321	83.1	4,656	89.5
≥18	7,407	38.4	5,915	79.9	6,472	87.4
Less than high school diploma (%)
<6	3,521	18.2	2,938	83.4	3,159	89.7
6.00–9.99	3,250	16.8	2,705	83.2	2,926	90.0
10.00–17.99	5,417	28.1	4,353	80.4	4,772	88.1
≥18	7,104	36.8	5,735	80.7	6,249	88.0
Median household income (U.S. $)
<42,000	6,672	34.6	5,283	79.2	5,805	87.0
42,000–56,999	4,952	25.7	4,086	82.5	4,423	89.3
57,000–77,999	4,278	22.2	3,520	82.3	3,820	89.3
≥78,000	3,365	17.5	2,828	84.0	3,038	90.3
Without health insurance (%)
<5	2,428	12.6	2,034	83.8	2,186	90.0
5.00–8.99	3,452	17.9	2,893	83.8	3,124	90.5
9.00–14.99	4,972	25.8	4,078	82.0	4,436	89.2
≥15	8,432	43.7	6,721	79.7	7,353	87.2
Gini index (%)
<38	3,961	20.6	3,217	81.2	3,514	88.7
38.00–41.99	4,676	24.3	3,773	80.7	4,108	87.9
42.00–45.99	4,568	23.7	3,712	81.3	4,045	88.5
≥46	6,068	31.5	5,018	82.7	5,424	89.4
Subtotal^c	19,569	100	15,943	81.5	17,336	88.6
Female
Below federal poverty level (%)
<6	—	—	—	—	—	—
6.00–10.99	—	—	—	—	—	—
11.00–17.99	—	—	—	—	—	—
≥18	—	—	—	—	—	—
Less than high school diploma (%)
<6	—	—	—	—	—	—
6.00–9.99	—	—	—	—	—	—
10.00–17.99	—	—	—	—	—	—
≥18	—	—	—	—	—	—
Median household income (U.S. $)
<42,000	—	—	—	—	—	—
42,000–56,999	—	—	—	—	—	—
57,000–77,999	—	—	—	—	—	—
≥78,000	—	—	—	—	—	—
Without health insurance (%)
<5	—	—	—	—	—	—
5.00–8.99	—	—	—	—	—	—
9.00–14.99	—	—	—	—	—	—
≥15	—	—	—	—	—	—
Gini index (%)
<38	—	—	—	—	—	—
38.00–41.99	—	—	—	—	—	—
42.00–45.99	—	—	—	—	—	—
≥46	—	—	—	—	—	—
Subtotal^c	—	—	—	—	—	—
Total	19,569	100	15,943	81.5	17,336	88.6

Table 9c. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by transmission category, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
Injection drug use
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^b	No.	%	No.	%
Male
Below federal poverty level (%)
<6	83	10.1	63	76.6	71	85.4
6.00–10.99	158	19.3	129	81.7	137	87.1
11.00–17.99	217	26.5	166	76.6	183	84.5
≥18	361	44.1	260	72.0	298	82.7
Less than high school diploma (%)
<6	108	13.3	85	78.5	94	86.6
6.00–9.99	118	14.4	93	78.7	101	85.4
10.00–17.99	228	27.9	173	76.0	193	84.5
≥18	363	44.4	267	73.4	302	83.1
Median household income (U.S. $)
<42,000	338	41.4	239	70.7	274	81.2
42,000–56,999	202	24.8	158	78.0	177	87.5
57,000–77,999	156	19.1	127	81.7	134	86.1
≥78,000	121	14.8	94	77.9	103	85.8
Without health insurance (%)
<5	104	12.7	83	80.5	90	87.1
5.00–8.99	183	22.3	141	77.0	156	85.7
9.00–14.99	211	25.8	160	76.1	178	84.7
≥15	321	39.2	233	72.8	264	82.3
Gini index (%)
<38	147	18.0	115	77.8	126	85.5
38.00–41.99	205	25.1	164	79.9	179	87.2
42.00–45.99	199	24.4	145	72.6	161	81.0
≥46	265	32.5	195	73.5	223	84.1
Subtotal^c	836	100	632	75.6	706	84.5
Female
Below federal poverty level (%)
<6	66	9	50	77	58	87
6.00–10.99	144	21	115	80	129	90
11.00–17.99	159	23	129	81	139	88
≥18	330	47	236	71	280	85
Less than high school diploma (%)
<6	84	12	70	83	77	93
6.00–9.99	107	15	84	78	93	86
10.00–17.99	218	31	167	77	189	87
≥18	291	42	210	72	247	85
Median household income (U.S. $)
<42,000	301	43	219	73	258	86
42,000–56,999	187	27	141	75	158	84
57,000–77,999	125	18	102	81	113	91
≥78,000	86	12	68	79	76	89
Without health insurance (%)
<5	105	15	88	83	95	90
5.00–8.99	124	18	89	72	109	88
9.00–14.99	190	27	152	80	164	86
≥15	279	40	202	72	238	85
Gini index (%)
<38	121	17	96	80	106	88
38.00–41.99	159	23	122	77	136	85
42.00–45.99	166	24	120	72	143	86
≥46	253	36	192	76	221	87
Subtotal^c	716	100	539	75	618	86
Total	1,552	100	1,171	75.5	1,324	85.3

Table 9c. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by transmission category, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
Male-to-male sexual contact and injection drug use
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^b	No.	%	No.	%
Male
Below federal poverty level (%)
<6	124	12.7	101	82.0	114	92.2
6.00–10.99	224	23.0	182	81.2	203	90.8
11.00–17.99	258	26.6	202	78.4	221	85.5
≥18	366	37.6	293	80.0	324	88.5
Less than high school diploma (%)
<6	202	20.8	169	83.7	187	92.3
6.00–9.99	164	16.9	137	83.4	150	91.4
10.00–17.99	285	29.3	224	78.5	245	85.9
≥18	320	33.0	248	77.5	280	87.5
Median household income (U.S. $)
<42,000	313	32.2	248	79.3	275	87.9
42,000–56,999	272	28.0	210	77.2	233	85.7
57,000–77,999	202	20.8	167	82.3	182	89.9
≥78,000	183	18.9	153	83.3	171	93.1
Without health insurance (%)
<5	158	16.3	132	83.6	146	92.0
5.00–8.99	221	22.7	185	84.0	204	92.4
9.00–14.99	247	25.4	207	83.7	224	90.9
≥15	346	35.6	254	73.4	288	83.2
Gini index (%)
<38	191	19.7	152	79.3	174	90.9
38.00–41.99	239	24.6	192	80.6	208	86.9
42.00–45.99	206	21.2	166	80.9	183	88.8
≥46	336	34.6	268	79.7	298	88.7
Subtotal^c	986	100	790	80.1	874	88.6
Female
Below federal poverty level (%)
<6	—	—	—	—	—	—
6.00–10.99	—	—	—	—	—	—
11.00–17.99	—	—	—	—	—	—
≥18	—	—	—	—	—	—
Less than high school diploma (%)
<6	—	—	—	—	—	—
6.00–9.99	—	—	—	—	—	—
10.00–17.99	—	—	—	—	—	—
≥18	—	—	—	—	—	—
Median household income (U.S. $)
<42,000	—	—	—	—	—	—
42,000–56,999	—	—	—	—	—	—
57,000–77,999	—	—	—	—	—	—
≥78,000	—	—	—	—	—	—
Without health insurance (%)
<5	—	—	—	—	—	—
5.00–8.99	—	—	—	—	—	—
9.00–14.99	—	—	—	—	—	—
≥15	—	—	—	—	—	—
Gini index (%)
<38	—	—	—	—	—	—
38.00–41.99	—	—	—	—	—	—
42.00–45.99	—	—	—	—	—	—
≥46	—	—	—	—	—	—
Subtotal^c	—	—	—	—	—	—
Total	986	100	790	80.1	874	88.6

Table 9c. Linkage to HIV medical care after HIV diagnosis during 2018 among adults, by transmission category, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
Heterosexual contact^a
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^b	No.	%	No.	%
Male
Below federal poverty level (%)
<6	249	11.4	194	78.0	221	88.9
6.00–10.99	425	19.5	346	81.4	373	87.8
11.00–17.99	529	24.2	419	79.2	465	87.9
≥18	980	44.9	737	75.2	815	83.1
Less than high school diploma (%)
<6	255	11.7	199	78.1	224	87.8
6.00–9.99	320	14.6	259	80.9	282	88.2
10.00–17.99	673	30.8	515	76.5	572	84.9
≥18	937	42.9	726	77.4	798	85.2
Median household income (U.S. $)
<42,000	913	41.9	688	75.3	759	83.1
42,000–56,999	569	26.1	455	80.0	499	87.7
57,000–77,999	426	19.5	338	79.2	370	86.9
≥78,000	273	12.5	215	78.6	244	89.4
Without health insurance (%)
<5	209	9.6	162	77.4	185	88.3
5.00–8.99	326	14.9	261	79.9	285	87.5
9.00–14.99	525	24.1	418	79.6	455	86.6
≥15	1,122	51.4	855	76.2	948	84.5
Gini index (%)
<38	407	18.6	337	82.8	364	89.4
38.00–41.99	518	23.7	391	75.6	442	85.5
42.00–45.99	535	24.5	420	78.4	457	85.4
≥46	722	33.1	547	75.8	609	84.4
Subtotal^c	2,205	100	1,711	77.6	1,892	85.8
Female
Below federal poverty level (%)
<6	462	10	378	82	419	91
6.00–10.99	819	18	668	82	735	90
11.00–17.99	1,256	27	1,054	84	1,142	91
≥18	2,122	46	1,675	79	1,863	88
Less than high school diploma (%)
<6	508	11	425	84	465	92
6.00–9.99	682	15	567	83	630	92
10.00–17.99	1,436	31	1,158	81	1,274	89
≥18	2,034	44	1,624	80	1,791	88
Median household income (U.S. $)
<42,000	2,072	44	1,639	79	1,819	88
42,000–56,999	1,160	25	937	81	1,039	90
57,000–77,999	826	18	694	84	752	91
≥78,000	601	13	503	84	549	91
Without health insurance (%)
<5	472	10	396	84	433	92
5.00–8.99	707	15	592	84	644	91
9.00–14.99	1,142	25	933	82	1,029	90
≥15	2,338	50	1,852	79	2,054	88
Gini index (%)
<38	866	19	723	83	784	90
38.00–41.99	1,183	25	961	81	1,050	89
42.00–45.99	1,058	23	850	80	948	90
≥46	1,552	33	1,240	80	1,378	89
Subtotal^c	4,747	100	3,842	81	4,235	89
Total	6,952	100	5,553	79.9	6,127	88.1

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, Centers for Disease Control and Prevention [footnotes only]; SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Linkage to HIV medical care was measured by documentation of ≥1 CD4 or VL tests ≤1 month or ≤3 months after HIV diagnosis. Data not provided for states and associated census tracts that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.
Definitions for the SDH indicator variables used in this report can be found at http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aHeterosexual contact with a person known to have, or to be at high risk for, HIV infection.
^bRepresents percentage of the sum of each SDH subpopulation.
^cBecause column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.

Table 9d. Linkage to HIV medical care after HIV diagnosis during 2018 among male adults with infection attributed to male-to-male sexual contact, by race/ethnicity and selected social determinants of health—census tract level, 41 states and the District of Columbia
Black/African American
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^c	No.	%	No.	%
Male
Below federal poverty level (%)
<6	635	8.7	501	78.8	551	86.7
6.00–10.99	1,236	17.0	944	76.4	1,058	85.6
11.00–17.99	1,888	26.0	1,471	77.9	1,619	85.8
≥18	3,517	48.3	2,692	76.6	2,990	85.0
Less than high school diploma (%)
<6	974	13.4	772	79.2	848	87.1
6.00–9.99	1,182	16.2	928	78.5	1,020	86.3
10.00–17.99	2,380	32.7	1,788	75.1	2,007	84.3
≥18	2,743	37.7	2,120	77.3	2,345	85.5
Median household income (U.S. $)
<42,000	3,431	47.2	2,606	76.0	2,916	85.0
42,000–56,999	1,755	24.1	1,371	78.1	1,510	86.0
57,000–77,999	1,261	17.3	986	78.2	1,080	85.7
≥78,000	822	11.3	640	77.9	707	86.1
Without health insurance (%)
<5	647	8.9	513	79.2	566	87.6
5.00–8.99	1,153	15.8	922	79.9	1,007	87.3
9.00–14.99	1,973	27.1	1,537	77.9	1,698	86.1
≥15	3,505	48.2	2,637	75.2	2,949	84.1
Gini index (%)
<38	1,366	18.8	1,045	76.5	1,170	85.6
38.00–41.99	1,649	22.7	1,247	75.6	1,391	84.4
42.00–45.99	1,661	22.8	1,280	77.1	1,409	84.8
≥46	2,597	35.7	2,032	78.2	2,246	86.5
Total^d	7,396	100	5,692	77.0	6,315	85.4

Table 9d. Linkage to HIV medical care after HIV diagnosis during 2018 among male adults with infection attributed to male-to-male sexual contact, by race/ethnicity and selected social determinants of health—census tract level, 41 states and the District of Columbia
Hispanic/Latino^a
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^c	No.	%	No.	%
Male
Below federal poverty level (%)
<6	562	9.5	475	84.5	508	90.3
6.00–10.99	1,323	22.3	1,100	83.2	1,194	90.2
11.00–17.99	1,714	28.9	1,468	85.7	1,570	91.6
≥18	2,337	39.4	1,922	82.3	2,091	89.5
Less than high school diploma (%)
<6	752	12.7	635	84.4	684	90.9
6.00–9.99	753	12.7	645	85.6	695	92.4
10.00–17.99	1,390	23.4	1,181	85.0	1,275	91.7
≥18	3,047	51.3	2,509	82.4	2,714	89.1
Median household income (U.S. $)
<42,000	1,928	32.5	1,575	81.7	1,714	88.9
42,000–56,999	1,669	28.1	1,413	84.7	1,514	90.7
57,000–77,999	1,383	23.3	1,157	83.6	1,251	90.5
≥78,000	953	16.1	819	85.9	881	92.4
Without health insurance (%)
<5	487	8.2	414	85.0	447	91.6
5.00–8.99	827	13.9	710	85.8	768	92.9
9.00–14.99	1,388	23.4	1,172	84.5	1,263	91.0
≥15	3,235	54.5	2,670	82.5	2,885	89.2
Gini index (%)
<38	1,255	21.1	1,040	82.9	1,130	90.1
38.00–41.99	1,568	26.4	1,296	82.6	1,395	89.0
42.00–45.99	1,453	24.5	1,206	83.0	1,313	90.4
≥46	1,660	28.0	1,424	85.8	1,525	91.9
Total^d	6,002	100	5,014	83.5	5,414	90.2

Table 9d. Linkage to HIV medical care after HIV diagnosis during 2018 among male adults with infection attributed to male-to-male sexual contact, by race/ethnicity and selected social determinants of health—census tract level, 41 states and the District of Columbia
White
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^c	No.	%	No.	%
Male
Below federal poverty level (%)
<6	1,000	20.3	842	84.3	908	90.8
6.00–10.99	1,428	29.0	1,210	84.7	1,308	91.5
11.00–17.99	1,273	25.9	1,107	87.0	1,171	92.0
≥18	1,220	24.8	1,017	83.3	1,089	89.2
Less than high school diploma (%)
<6	1,509	30.7	1,289	85.4	1,373	91.0
6.00–9.99	1,092	22.2	936	85.8	1,003	91.9
10.00–17.99	1,338	27.2	1,126	84.2	1,209	90.3
≥18	983	20.0	825	84.0	892	90.7
Median household income (U.S. $)
<42,000	1,074	21.8	895	83.3	956	89.0
42,000–56,999	1,244	25.3	1,066	85.7	1,144	92.0
57,000–77,999	1,329	27.0	1,116	84.0	1,208	91.0
≥78,000	1,275	25.9	1,098	86.2	1,167	91.6
Without health insurance (%)
<5	1,049	21.3	892	85.1	948	90.4
5.00–8.99	1,202	24.4	1,031	85.7	1,104	91.9
9.00–14.99	1,328	27.0	1,128	84.9	1,217	91.6
≥15	1,342	27.3	1,125	83.8	1,207	89.9
Gini index (%)
<38	1,071	21.8	903	84.4	974	91.0
38.00–41.99	1,201	24.4	1,007	83.9	1,082	90.1
42.00–45.99	1,204	24.5	1,015	84.3	1,095	91.0
≥46	1,444	29.4	1,249	86.5	1,323	91.6
Total^d	5,002	100	4,247	84.9	4,551	91.0

Table 9d. Linkage to HIV medical care after HIV diagnosis during 2018 among male adults with infection attributed to male-to-male sexual contact, by race/ethnicity and selected social determinants of health—census tract level, 41 states and the District of Columbia
Other^b
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^c	No.	%	No.	%
Male
Below federal poverty level (%)
<6	195	16.9	166	85.2	174	89.6
6.00–10.99	293	25.5	251	85.8	269	91.9
11.00–17.99	327	28.5	276	84.3	295	90.2
≥18	334	29.1	284	85.1	303	90.7
Less than high school diploma (%)
<6	285	24.8	242	84.9	254	89.0
6.00–9.99	224	19.5	196	87.7	208	93.0
10.00–17.99	309	26.8	257	83.4	281	91.1
≥18	332	28.9	281	84.7	298	89.9
Median household income (U.S. $)
<42,000	240	21.0	207	86.0	220	91.4
42,000–56,999	285	24.9	236	82.7	256	89.9
57,000–77,999	305	26.6	262	85.9	280	92.0
≥78,000	316	27.6	271	85.8	283	89.5
Without health insurance (%)
<5	245	21.3	215	87.9	225	91.9
5.00–8.99	270	23.5	231	85.6	245	90.6
9.00–14.99	283	24.7	241	85.1	259	91.2
≥15	350	30.5	289	82.6	313	89.4
Gini index (%)
<38	270	23.5	229	85.0	240	88.8
38.00–41.99	259	22.6	223	86.2	241	93.1
42.00–45.99	251	21.9	211	83.9	228	91.0
≥46	367	32.0	313	85.3	330	90.0
Total^d	1,169	100	990	84.7	1,056	90.3

Table 9d. Linkage to HIV medical care after HIV diagnosis during 2018 among male adults with infection attributed to male-to-male sexual contact, by race/ethnicity and selected social determinants of health—census tract level, 41 states and the District of Columbia
Total
			≤1 month		≤3 months
	Total		≥1 CD4 or VL tests		≥1 CD4 or VL tests
	No.	%^c	No.	%	No.	%
Male
Below federal poverty level (%)
<6	2,392	12.4	1,984	82.9	2,141	89.5
6.00–10.99	4,280	22.2	3,504	81.9	3,828	89.5
11.00–17.99	5,202	27.0	4,321	83.1	4,656	89.5
≥18	7,407	38.4	5,915	79.9	6,472	87.4
Less than high school diploma (%)
<6	3,521	18.2	2,938	83.4	3,159	89.7
6.00–9.99	3,250	16.8	2,705	83.2	2,926	90.0
10.00–17.99	5,417	28.1	4,353	80.4	4,772	88.1
≥18	7,104	36.8	5,735	80.7	6,249	88.0
Median household income (U.S. $)
<42,000	6,672	34.6	5,283	79.2	5,805	87.0
42,000–56,999	4,952	25.7	4,086	82.5	4,423	89.3
57,000–77,999	4,278	22.2	3,520	82.3	3,820	89.3
≥78,000	3,365	17.5	2,828	84.0	3,038	90.3
Without health insurance (%)
<5	2,428	12.6	2,034	83.8	2,186	90.0
5.00–8.99	3,452	17.9	2,893	83.8	3,124	90.5
9.00–14.99	4,972	25.8	4,078	82.0	4,436	89.2
≥15	8,432	43.7	6,721	79.7	7,353	87.2
Gini index (%)
<38	3,961	20.6	3,217	81.2	3,514	88.7
38.00–41.99	4,676	24.3	3,773	80.7	4,108	87.9
42.00–45.99	4,568	23.7	3,712	81.3	4,045	88.5
≥46	6,068	31.5	5,018	82.7	5,424	89.4
Total^d	19,569	100	15,943	81.5	17,336	88.6

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, Centers for Disease Control and Prevention [footnotes only]; SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Linkage to HIV medical care was measured by documentation of ≥1 CD4 or VL tests ≤1 month or ≤3 months after HIV diagnosis. Data not provided for states and associated census tracts that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.
Definitions for the SDH indicator variables used in this report can be found at http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^aHispanics/Latinos can be of any race.
^bIncludes American Indian/Alaska Native, Asian, Native Hawaiian/other Pacific Islander, and multiple races.
^cRepresents percentage of the sum of each SDH subpopulation.
^dBecause column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.

Table 10a. HIV viral suppression within 6 months of diagnosis among adults with HIV infection diagnosed during 2018, by race/ethnicity, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
	Black/African American
	Total diagnoses	VL <200 copies/mL
	No.	No.	%
Male
Below federal poverty level (%)
<6	792	528	66.7
6.00–10.99	1,533	972	63.4
11.00–17.99	2,328	1,463	62.8
≥18	4,436	2,676	60.3
Less than high school diploma (%)
<6	1,163	771	66.3
6.00–9.99	1,410	888	63.0
10.00–17.99	2,970	1,830	61.6
≥18	3,551	2,153	60.6
Median household income (U.S. $)
<42,000	4,317	2,587	59.9
42,000–56,999	2,194	1,397	63.7
57,000–77,999	1,556	963	61.9
≥78,000	1,014	687	67.8
Without health insurance (%)
<5	827	556	67.2
5.00–8.99	1,424	951	66.8
9.00–14.99	2,418	1,534	63.4
≥15	4,423	2,599	58.8
Gini index (%)
<38	1,667	1,042	62.5
38.00–41.99	2,047	1,265	61.8
42.00–45.99	2,087	1,267	60.7
≥46	3,284	2,062	62.8
Subtotal^c	9,236	5,724	62.0
Female
Below federal poverty level (%)
<6	276	207	75.0
6.00–10.99	507	378	74.6
11.00–17.99	832	594	71.4
≥18	1,567	993	63.4
Less than high school diploma (%)
<6	306	232	75.8
6.00–9.99	453	326	72.0
10.00–17.99	1,064	733	68.9
≥18	1,359	881	64.8
Median household income (U.S. $)
<42,000	1,570	993	63.2
42,000–56,999	733	504	68.8
57,000–77,999	520	402	77.3
≥78,000	358	272	76.0
Without health insurance (%)
<5	303	236	77.9
5.00–8.99	459	343	74.7
9.00–14.99	794	562	70.8
≥15	1,626	1,031	63.4
Gini index (%)
<38	556	406	73.0
38.00–41.99	769	545	70.9
42.00–45.99	723	489	67.6
≥46	1,134	732	64.6
Subtotal^c	3,243	2,206	68.0
Total	12,479	7,930	63.5

Table 10a. HIV viral suppression within 6 months of diagnosis among adults with HIV infection diagnosed during 2018, by race/ethnicity, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
	Hispanic/Latino^a
	Total diagnoses	VL <200 copies/mL
	No.	No.	%
Male
Below federal poverty level (%)
<6	638	458	71.8
6.00–10.99	1,503	1,108	73.7
11.00–17.99	1,937	1,436	74.1
≥18	2,725	1,937	71.1
Less than high school diploma (%)
<6	842	646	76.7
6.00–9.99	860	650	75.6
10.00–17.99	1,586	1,167	73.6
≥18	3,523	2,481	70.4
Median household income (U.S. $)
<42,000	2,251	1,561	69.3
42,000–56,999	1,914	1,418	74.1
57,000–77,999	1,552	1,163	74.9
≥78,000	1,083	795	73.4
Without health insurance (%)
<5	558	424	76.0
5.00–8.99	965	734	76.1
9.00–14.99	1,592	1,178	74.0
≥15	3,689	2,603	70.6
Gini index (%)
<38	1,425	1,019	71.5
38.00–41.99	1,806	1,295	71.7
42.00–45.99	1,666	1,219	73.2
≥46	1,905	1,406	73.8
Subtotal^c	6,879	4,988	72.5
Female
Below federal poverty level (%)
<6	76	55	72.4
6.00–10.99	158	120	75.9
11.00–17.99	246	183	74.4
≥18	440	298	67.7
Less than high school diploma (%)
<6	78	55	70.5
6.00–9.99	96	75	78.1
10.00–17.99	197	153	77.7
≥18	549	373	67.9
Median household income (U.S. $)
<42,000	390	257	65.9
42,000–56,999	258	200	77.5
57,000–77,999	159	120	75.5
≥78,000	113	79	69.9
Without health insurance (%)
<5	69	50	72.5
5.00–8.99	117	87	74.4
9.00–14.99	218	168	77.1
≥15	516	351	68.0
Gini index (%)
<38	168	118	70.2
38.00–41.99	246	178	72.4
42.00–45.99	206	145	70.4
≥46	300	215	71.7
Subtotal^c	932	666	71.5
Total	7,811	5,654	72.4

Table 10a. HIV viral suppression within 6 months of diagnosis among adults with HIV infection diagnosed during 2018, by race/ethnicity, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
	White
	Total diagnoses	VL <200 copies/mL
	No.	No.	%
Male
Below federal poverty level (%)
<6	1,200	871	72.6
6.00–10.99	1,712	1,259	73.5
11.00–17.99	1,569	1,113	70.9
≥18	1,559	1,047	67.2
Less than high school diploma (%)
<6	1,771	1,310	74.0
6.00–9.99	1,329	965	72.6
10.00–17.99	1,681	1,156	68.8
≥18	1,260	860	68.3
Median household income (U.S. $)
<42,000	1,383	922	66.7
42,000–56,999	1,556	1,105	71.0
57,000–77,999	1,605	1,151	71.7
≥78,000	1,495	1,111	74.3
Without health insurance (%)
<5	1,243	924	74.3
5.00–8.99	1,484	1,068	72.0
9.00–14.99	1,619	1,154	71.3
≥15	1,694	1,144	67.5
Gini index (%)
<38	1,309	924	70.6
38.00–41.99	1,481	1,051	71.0
42.00–45.99	1,455	1,043	71.7
≥46	1,794	1,271	70.8
Subtotal^c	6,136	4,353	70.9
Female
Below federal poverty level (%)
<6	148	104	70.3
6.00–10.99	246	159	64.6
11.00–17.99	278	169	60.8
≥18	359	197	54.9
Less than high school diploma (%)
<6	173	115	66.5
6.00–9.99	205	141	68.8
10.00–17.99	329	191	58.1
≥18	325	182	56.0
Median household income (U.S. $)
<42,000	331	188	56.8
42,000–56,999	305	186	61.0
57,000–77,999	225	139	61.8
≥78,000	170	116	68.2
Without health insurance (%)
<5	171	119	69.6
5.00–8.99	207	125	60.4
9.00–14.99	275	162	58.9
≥15	378	223	59.0
Gini index (%)
<38	220	146	66.4
38.00–41.99	273	166	60.8
42.00–45.99	247	141	57.1
≥46	291	176	60.5
Subtotal^c	1,058	646	61.1
Total	7,194	4,999	69.5

Table 10a. HIV viral suppression within 6 months of diagnosis among adults with HIV infection diagnosed during 2018, by race/ethnicity, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
	Other^b
	Total diagnoses	VL <200 copies/mL
	No.	No.	%
Male
Below federal poverty level (%)
<6	220	167	75.9
6.00–10.99	341	256	75.1
11.00–17.99	374	272	72.7
≥18	401	277	69.1
Less than high school diploma (%)
<6	314	235	74.8
6.00–9.99	255	187	73.3
10.00–17.99	371	273	73.6
≥18	397	277	69.8
Median household income (U.S. $)
<42,000	292	201	68.8
42,000–56,999	335	249	74.3
57,000–77,999	352	252	71.6
≥78,000	354	268	75.7
Without health insurance (%)
<5	274	212	77.4
5.00–8.99	312	235	75.3
9.00–14.99	330	235	71.2
≥15	420	290	69.0
Gini index (%)
<38	308	230	74.7
38.00–41.99	307	221	72.0
42.00–45.99	304	224	73.7
≥46	414	295	71.3
Subtotal^c	1,362	986	72.4
Female
Below federal poverty level (%)
<6	31	25	80.6
6.00–10.99	57	40	70.2
11.00–17.99	62	44	71.0
≥18	99	68	68.7
Less than high school diploma (%)
<6	41	29	70.7
6.00–9.99	37	29	78.4
10.00–17.99	73	51	69.9
≥18	98	68	69.4
Median household income (U.S. $)
<42,000	93	61	65.6
42,000–56,999	55	35	63.6
57,000–77,999	50	42	84.0
≥78,000	51	39	76.5
Without health insurance (%)
<5	40	28	70.0
5.00–8.99	53	45	84.9
9.00–14.99	49	33	67.3
≥15	107	71	66.4
Gini index (%)
<38	47	36	76.6
38.00–41.99	60	42	70.0
42.00–45.99	52	36	69.2
≥46	90	63	70.0
Subtotal^c	254	180	70.9
Total	1,616	1,166	72.2

Table 10a. HIV viral suppression within 6 months of diagnosis among adults with HIV infection diagnosed during 2018, by race/ethnicity, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
	Total
	Total diagnoses	VL <200 copies/mL
	No.	No.	%
Male
Below federal poverty level (%)
<6	2,850	2,024	71.0
6.00–10.99	5,089	3,595	70.6
11.00–17.99	6,208	4,284	69.0
≥18	9,121	5,937	65.1
Less than high school diploma (%)
<6	4,090	2,962	72.4
6.00–9.99	3,854	2,690	69.8
10.00–17.99	6,608	4,426	67.0
≥18	8,731	5,771	66.1
Median household income (U.S. $)
<42,000	8,243	5,271	63.9
42,000–56,999	5,999	4,169	69.5
57,000–77,999	5,065	3,529	69.7
≥78,000	3,946	2,861	72.5
Without health insurance (%)
<5	2,902	2,116	72.9
5.00–8.99	4,185	2,988	71.4
9.00–14.99	5,959	4,101	68.8
≥15	10,226	6,636	64.9
Gini index (%)
<38	4,709	3,215	68.3
38.00–41.99	5,641	3,832	67.9
42.00–45.99	5,512	3,753	68.1
≥46	7,397	5,034	68.1
Subtotal^c	23,613	16,051	68.0
Female
Below federal poverty level (%)
<6	531	391	73.6
6.00–10.99	968	697	72.0
11.00–17.99	1,418	990	69.8
≥18	2,465	1,556	63.1
Less than high school diploma (%)
<6	598	431	72.1
6.00–9.99	791	571	72.2
10.00–17.99	1,663	1,128	67.8
≥18	2,331	1,504	64.5
Median household income (U.S. $)
<42,000	2,384	1,499	62.9
42,000–56,999	1,351	925	68.5
57,000–77,999	954	703	73.7
≥78,000	692	506	73.1
Without health insurance (%)
<5	583	433	74.3
5.00–8.99	836	600	71.8
9.00–14.99	1,336	925	69.2
≥15	2,627	1,676	63.8
Gini index (%)
<38	991	706	71.2
38.00–41.99	1,348	931	69.1
42.00–45.99	1,228	811	66.0
≥46	1,815	1,186	65.3
Subtotal^c	5,487	3,698	67.4
Total	29,100	19,749	67.9

Abbreviations: VL, viral load (copies/mL); CD4, CD4+ T-lymphocyte count (cells/µL) or percentage [footnotes only]; CDC, Centers for Disease Control and Prevention [footnotes only]; SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Viral suppression was measured by documentation of a VL test result of <200 copies/ml at any time within 6 months of diagnosis of HIV infection during 2018. Data not provided for states and associated census tracts that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.
Definitions for the SDH indicator variables used in this report can be found at http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Hispanics/Latinos can be of any race.
^b Includes American Indian/Alaska Native, Asian, Native Hawaiian/other Pacific Islander, and multiple races.
^c Because column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.

Table 10b. HIV Viral Suppression within 6 Months of Diagnosis among Adults with HIV Infection Diagnosed During 2018, by age at Diagnosis, Sex at Birth, and Selected Social Determinants of Health—Census Tract Level, 41 States and the District of Columbia
	18‒24 years			25–34 years			35–44 years			45–54 years			≥55 years
	Total diagnoses	VL <200 copies/mL		Total diagnoses	VL <200 copies/mL		Total diagnoses	VL <200 copies/mL		Total diagnoses	VL <200 copies/mL		Total diagnoses	VL <200 copies/mL
	No.	No.	%	No.	No.	%	No.	No.	%	No.	No.	%	No.	No.	%
Male
Below federal poverty level (%)
<6	581	394	67.8	1,050	753	71.7	501	359	71.7	410	297	72.4	308	221	71.8
6.00–10.99	1,037	694	66.9	1,903	1,314	69.0	966	725	75.1	701	520	74.2	482	342	71.0
11.00–17.99	1,310	863	65.9	2,482	1,737	70.0	1,173	833	71.0	738	499	67.6	505	352	69.7
≥18	2,193	1,383	63.1	3,551	2,339	65.9	1,588	1,082	68.1	1,101	712	64.7	688	421	61.2
Less than high school diploma (%)
<6	830	573	69.0	1,551	1,112	71.7	763	571	74.8	545	406	74.5	401	300	74.8
6.00–9.99	843	552	65.5	1,495	1,042	69.7	680	495	72.8	478	340	71.1	358	261	72.9
10.00–17.99	1,488	949	63.8	2,557	1,716	67.1	1,203	849	70.6	809	554	68.5	551	358	65.0
≥18	1,962	1,261	64.3	3,388	2,275	67.1	1,586	1,086	68.5	1,121	731	65.2	674	418	62.0
Median household income (U.S. $)
<42,000	2,051	1,274	62.1	3,220	2,070	64.3	1,346	907	67.4	1,012	643	63.5	614	377	61.4
42,000–56,999	1,285	857	66.7	2,326	1,642	70.6	1,133	794	70.1	718	507	70.6	537	369	68.7
57,000–77,999	1,024	677	66.1	1,989	1,384	69.6	986	727	73.7	635	449	70.7	431	292	67.7
≥78,000	758	523	69.0	1,443	1,042	72.2	761	570	74.9	584	428	73.3	400	298	74.5
Without health insurance (%)
<5	562	399	71.0	1,032	748	72.5	563	424	75.3	423	316	74.7	322	229	71.1
5.00–8.99	906	615	67.9	1,582	1,136	71.8	755	548	72.6	544	390	71.7	398	299	75.1
9.00–14.99	1,296	862	66.5	2,374	1,620	68.2	1,057	766	72.5	743	515	69.3	489	338	69.1
≥15	2,359	1,459	61.8	4,000	2,639	66.0	1,853	1,261	68.1	1,240	807	65.1	774	470	60.7
Gini index (%)
<38	1,076	691	64.2	1,857	1,265	68.1	851	613	72.0	549	385	70.1	376	261	69.4
38.00–41.99	1,273	840	66.0	2,176	1,482	68.1	1,005	696	69.3	730	514	70.4	457	300	65.6
42.00–45.99	1,163	759	65.3	2,100	1,436	68.4	1,019	724	71.1	729	495	67.9	501	339	67.7
≥46	1,608	1,043	64.9	2,848	1,956	68.7	1,352	966	71.4	941	633	67.3	648	436	67.3
Subtotal^a	5,208	3,383	65.0	9,102	6,212	68.2	4,290	3,037	70.8	3,002	2,062	68.7	2,011	1,357	67.5
Female
Below federal poverty level (%)
<6	55	42	76.4	139	102	73.4	137	101	73.7	105	76	72.4	95	70	73.7
6.00–10.99	124	88	71.0	251	179	71.3	228	170	74.6	191	142	74.3	174	118	67.8
11.00–17.99	181	123	68.0	360	245	68.1	367	263	71.7	293	199	67.9	217	160	73.7
≥18	333	211	63.4	707	440	62.2	579	367	63.4	469	308	65.7	377	230	61.0
Less than high school diploma (%)
<6	65	45	69.2	164	111	67.7	142	98	69.0	112	88	78.6	115	89	77.4
6.00–9.99	98	73	74.5	222	169	76.1	181	133	73.5	158	115	72.8	132	81	61.4
10.00–17.99	226	154	68.1	435	292	67.1	411	288	70.1	345	223	64.6	246	171	69.5
≥18	304	192	63.2	637	394	61.9	577	382	66.2	443	299	67.5	370	237	64.1
Median household income (U.S. $)
<42,000	317	200	63.1	692	431	62.3	581	370	63.7	458	298	65.1	336	200	59.5
42,000–56,999	186	128	68.8	357	240	67.2	322	231	71.7	253	162	64.0	233	164	70.4
57,000–77,999	118	87	73.7	236	173	73.3	251	192	76.5	192	143	74.5	157	108	68.8
≥78,000	72	49	68.1	172	122	70.9	156	107	68.6	155	122	78.7	137	106	77.4
Without health insurance (%)
<5	59	46	78.0	144	104	72.2	144	108	75.0	122	88	72.1	114	87	76.3
5.00–8.99	100	70	70.0	216	156	72.2	213	154	72.3	169	126	74.6	138	94	68.1
9.00–14.99	176	119	67.6	359	249	69.4	326	227	69.6	263	184	70.0	212	146	68.9
≥15	358	229	64.0	738	457	61.9	628	412	65.6	504	327	64.9	399	251	62.9
Gini index (%)
<38	122	83	68.0	252	174	69.0	264	187	70.8	212	162	76.4	141	100	70.9
38.00–41.99	177	123	69.5	370	245	66.2	312	229	73.4	280	190	67.9	209	144	68.9
42.00–45.99	158	107	67.7	343	227	66.2	286	186	65.0	229	154	67.2	212	137	64.6
≥46	236	151	64.0	492	320	65.0	449	299	66.6	337	219	65.0	301	197	65.4
Subtotal^a	704	468	66.5	1,493	986	66.0	1,331	913	68.6	1,081	741	68.5	878	590	67.2
Total	5,912	3,851	65.1	10,595	7,198	67.9	5,621	3,950	70.3	4,083	2,803	68.7	2,889	1,947	67.4

Abbreviations: VL, viral load (copies/mL); CD4, CD4+ T-lymphocyte count (cells/µL) or percentage [footnotes only]; CDC, Centers for Disease Control and Prevention [footnotes only]; SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Viral suppression was measured by documentation of a VL test result of <200 copies/ml at any time within 6 months of diagnosis of HIV infection during 2018. Data not provided for states and associated census tracts that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.
Definitions for the SDH indicator variables used in this report can be found at http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Because column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.

Table 10c. HIV viral suppression within 6 months of diagnosis among adults with HIV diagnosed during 2018, by transmission category, sex at birth, and selected social determinants of health—census tract level, 41 states and the District of Columbia
	Male-to-male sexual contact			Injection drug use			Male-to-male sexual contact and injection drug use			Heterosexual contact^a
	Total diagnoses	VL <200 copies/mL		Total diagnoses	VL <200 copies/mL		Total diagnoses	VL <200 copies/mL		Total diagnoses	VL <200 copies/mL
	No.	No.	%	No.	No.	%	No.	No.	%	No.	No.	%
Male
Below federal poverty level (%)
<6	2,392	1,720	71.9	83	54	65.4	124	83	67.0	249	165	66.2
6.00–10.99	4,280	3,051	71.3	158	92	58.6	224	152	67.9	425	299	70.3
11.00–17.99	5,202	3,659	70.3	217	106	49.1	258	170	65.8	529	348	65.8
≥18	7,407	4,937	66.7	361	182	50.5	366	233	63.7	980	580	59.2
Less than high school diploma (%)
<6	3,521	2,588	73.5	108	64	59.0	202	135	66.7	255	173	67.8
6.00–9.99	3,250	2,296	70.6	118	66	55.9	164	114	69.5	320	214	66.7
10.00–17.99	5,417	3,700	68.3	228	116	50.8	285	174	61.1	673	433	64.4
≥18	7,104	4,789	67.4	363	189	52.1	320	215	67.1	937	575	61.3
Median household income (U.S. $)
<42,000	6,672	4,363	65.4	338	170	50.2	313	198	63.3	913	537	58.8
42,000–56,999	4,952	3,500	70.7	202	110	54.5	272	172	63.2	569	384	67.6
57,000–77,999	4,278	3,030	70.8	156	81	52.2	202	138	68.0	426	279	65.4
≥78,000	3,365	2,464	73.2	121	74	61.1	183	130	70.6	273	191	69.9
Without health insurance (%)
<5	2,428	1,787	73.6	104	65	62.5	158	116	73.3	209	147	70.1
5.00–8.99	3,452	2,514	72.8	183	100	55.0	221	153	69.5	326	218	66.9
9.00–14.99	4,972	3,473	69.9	211	112	53.3	247	159	64.4	525	354	67.4
≥15	8,432	5,594	66.3	321	157	49.0	346	209	60.6	1,122	673	60.0
Gini index (%)
<38	3,961	2,726	68.8	147	84	57.0	191	130	67.9	407	273	67.2
38.00–41.99	4,676	3,233	69.1	205	109	53.2	239	153	64.0	518	336	64.9
42.00–45.99	4,568	3,183	69.7	199	101	50.6	206	143	69.3	535	324	60.5
≥46	6,068	4,219	69.5	265	141	53.3	336	212	63.3	722	458	63.5
Subtotalb	19,569	13,546	69.2	836	445	53.3	986	645	65.4	2,205	1,406	63.8
Female
Below federal poverty level (%)
<6	—	—	—	66	40	60.8	—	—	—	462	349	75.5
6.00–10.99	—	—	—	144	94	65.1	—	—	—	819	600	73.2
11.00–17.99	—	—	—	159	90	56.5	—	—	—	1,256	898	71.5
≥18	—	—	—	330	168	50.9	—	—	—	2,122	1,378	64.9
Less than high school diploma (%)
<6	—	—	—	84	54	64.0	—	—	—	508	372	73.3
6.00–9.99	—	—	—	107	69	64.5	—	—	—	682	501	73.4
10.00–17.99	—	—	—	218	112	51.2	—	—	—	1,436	1,010	70.3
≥18	—	—	—	291	157	54.1	—	—	—	2,034	1,341	66.0
Median household income (U.S. $)
<42,000	—	—	—	301	153	50.7	—	—	—	2,072	1,338	64.6
42,000–56,999	—	—	—	187	108	57.8	—	—	—	1,160	814	70.2
57,000–77,999	—	—	—	125	77	61.4	—	—	—	826	624	75.6
≥78,000	—	—	—	86	54	62.6	—	—	—	601	448	74.5
Without health insurance (%)
<5	—	—	—	105	68	64.6	—	—	—	472	360	76.3
5.00–8.99	—	—	—	124	69	55.2	—	—	—	707	528	74.6
9.00–14.99	—	—	—	190	110	57.7	—	—	—	1,142	813	71.2
≥15	—	—	—	279	145	52.0	—	—	—	2,338	1,524	65.2
Gini index (%)
<38	—	—	—	121	75	62.1	—	—	—	866	628	72.5
38.00–41.99	—	—	—	159	92	57.9	—	—	—	1,183	835	70.6
42.00–45.99	—	—	—	166	83	50.3	—	—	—	1,058	724	68.5
≥46	—	—	—	253	141	55.7	—	—	—	1,552	1,038	66.9
Subtotal^b	—	—	—	716	398	55.6	—	—	—	4,747	3,282	69.1
Total	19,569	13,546	69.2	1,552	843	54.4	986	645	65.4	6,952	4,688	67.4

Abbreviations: VL, viral load (copies/mL); CD4, CD4+ T-lymphocyte count (cells/µL) or percentage [footnotes only]; CDC, Centers for Disease Control and Prevention [footnotes only]; SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Viral suppression was measured by documentation of a VL test result of <200 copies/ml at any time within 6 months of diagnosis of HIV infection during 2018. Data not provided for states and associated census tracts that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.
Definitions for the SDH indicator variables used in this report can be found at http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
^b Because column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.

Table 10d. HIV viral suppression within 6 months of diagnosis among male adults with HIV infection attributed to male-to-male sexual contact with infection diagnosed during 2018, by race/ethnicity and selected social determinants of health—census tract level, 41 states and the District of Columbia
	Black/African American
	Total diagnoses	VL <200 copies/mL
	No.	No.	%
Male
Below federal poverty level (%)
<6	635	428	67.3
6.00–10.99	1,236	791	64.0
11.00–17.99	1,888	1,193	63.2
≥18	3,517	2,163	61.5
Less than high school diploma (%)
<6	974	648	66.5
6.00–9.99	1,182	758	64.1
10.00–17.99	2,380	1,488	62.5
≥18	2,743	1,683	61.4
Median household income (U.S. $)
<42,000	3,431	2,087	60.8
42,000–56,999	1,755	1,129	64.3
57,000–77,999	1,261	798	63.2
≥78,000	822	557	67.7
Without health insurance (%)
<5	647	435	67.3
5.00–8.99	1,153	781	67.7
9.00–14.99	1,973	1,266	64.2
≥15	3,505	2,094	59.7
Gini index (%)
<38	1,366	860	63.0
38.00–41.99	1,649	1,030	62.5
42.00–45.99	1,661	1,028	61.9
≥46	2,597	1,654	63.7
Total^c	7,396	4,643	62.8

Table 10d. HIV viral suppression within 6 months of diagnosis among male adults with HIV infection attributed to male-to-male sexual contact with infection diagnosed during 2018, by race/ethnicity and selected social determinants of health—census tract level, 41 states and the District of Columbia
	Hispanic/Latino^a
	Total diagnoses	VL <200 copies/mL
	No.	No.	%
Male
Below federal poverty level (%)
<6	562	407	72.4
6.00–10.99	1,323	983	74.3
11.00–17.99	1,714	1,288	75.1
≥18	2,337	1,690	72.3
Less than high school diploma (%)
<6	752	584	77.6
6.00–9.99	753	578	76.7
10.00–17.99	1,390	1,032	74.2
≥18	3,047	2,178	71.5
Median household income (U.S. $)
<42,000	1,928	1,362	70.7
42,000–56,999	1,669	1,251	75.0
57,000–77,999	1,383	1,042	75.3
≥78,000	953	710	74.5
Without health insurance (%)
<5	487	377	77.3
5.00–8.99	827	636	76.9
9.00–14.99	1,388	1,035	74.6
≥15	3,235	2,320	71.7
Gini index (%)
<38	1,255	902	71.9
38.00–41.99	1,568	1,147	73.2
42.00–45.99	1,453	1,076	74.1
≥46	1,660	1,243	74.9
Total^c	6,002	4,410	73.5

Table 10d. HIV viral suppression within 6 months of diagnosis among male adults with HIV infection attributed to male-to-male sexual contact with infection diagnosed during 2018, by race/ethnicity and selected social determinants of health—census tract level, 41 states and the District of Columbia
	White
	Total diagnoses	VL <200 copies/mL
	No.	No.	%
Male
Below federal poverty level (%)
<6	1,000	739	73.9
6.00–10.99	1,428	1,056	73.9
11.00–17.99	1,273	935	73.4
≥18	1,220	846	69.4
Less than high school diploma (%)
<6	1,509	1,142	75.7
6.00–9.99	1,092	794	72.7
10.00–17.99	1,338	951	71.0
≥18	983	690	70.2
Median household income (U.S. $)
<42,000	1,074	742	69.2
42,000–56,999	1,244	905	72.8
57,000–77,999	1,329	966	72.7
≥78,000	1,275	962	75.5
Without health insurance (%)
<5	1,049	785	74.8
5.00–8.99	1,202	889	74.0
9.00–14.99	1,328	967	72.9
≥15	1,342	935	69.7
Gini index (%)
<38	1,071	766	71.5
38.00–41.99	1,201	867	72.2
42.00–45.99	1,204	887	73.6
≥46	1,444	1,055	73.1
Total^c	5,002	3,633	72.6

Table 10d. HIV viral suppression within 6 months of diagnosis among male adults with HIV infection attributed to male-to-male sexual contact with infection diagnosed during 2018, by race/ethnicity and selected social determinants of health—census tract level, 41 states and the District of Columbia
	Other^b
	Total diagnoses	VL <200 copies/mL
	No.	No.	%
Male
Below federal poverty level (%)
<6	195	147	75.5
6.00–10.99	293	221	75.4
11.00–17.99	327	243	74.3
≥18	334	238	71.2
Less than high school diploma (%)
<6	285	214	75.2
6.00–9.99	224	166	74.4
10.00–17.99	309	229	74.3
≥18	332	239	71.8
Median household income (U.S. $)
<42,000	240	171	71.1
42,000–56,999	285	215	75.4
57,000–77,999	305	225	73.8
≥78,000	316	236	74.6
Without health insurance (%)
<5	245	190	77.7
5.00–8.99	270	208	76.9
9.00–14.99	283	205	72.5
≥15	350	245	70.1
Gini index (%)
<38	270	199	73.7
38.00–41.99	259	188	72.6
42.00–45.99	251	193	76.9
≥46	367	267	72.8
Total^c	1,169	860	73.5

Table 10d. HIV viral suppression within 6 months of diagnosis among male adults with HIV infection attributed to male-to-male sexual contact with infection diagnosed during 2018, by race/ethnicity and selected social determinants of health—census tract level, 41 states and the District of Columbia
	Total
	Total diagnoses	VL <200 copies/mL
	No.	No.	%
Male
Below federal poverty level (%)
<6	2,392	1,720	71.9
6.00–10.99	4,280	3,051	71.3
11.00–17.99	5,202	3,659	70.3
≥18	7,407	4,937	66.7
Less than high school diploma (%)
<6	3,521	2,588	73.5
6.00–9.99	3,250	2,296	70.6
10.00–17.99	5,417	3,700	68.3
≥18	7,104	4,789	67.4
Median household income (U.S. $)
<42,000	6,672	4,363	65.4
42,000–56,999	4,952	3,500	70.7
57,000–77,999	4,278	3,030	70.8
≥78,000	3,365	2,464	73.2
Without health insurance (%)
<5	2,428	1,787	73.6
5.00–8.99	3,452	2,514	72.8
9.00–14.99	4,972	3,473	69.9
≥15	8,432	5,594	66.3
Gini index (%)
<38	3,961	2,726	68.8
38.00–41.99	4,676	3,233	69.1
42.00–45.99	4,568	3,183	69.7
≥46	6,068	4,219	69.5
Total^c	19,569	13,546	69.2

Abbreviations: VL, viral load (copies/mL); CD4, CD4+ T-lymphocyte count (cells/µL) or percentage [footnotes only]; CDC, Centers for Disease Control and Prevention [footnotes only]; SDH, social determinants of health [footnotes only].
Note. Data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Viral suppression was measured by documentation of a VL test result of <200 copies/ml at any time within 6 months of diagnosis of HIV infection during 2018. Data not provided for states and associated census tracts that do not have laws requiring reporting of all CD4 and viral loads, or that have incomplete reporting of laboratory data to CDC. Areas without laws: Idaho, New Jersey, and Pennsylvania. Areas with incomplete reporting: Arizona, Arkansas, Connecticut, Kansas, Kentucky, Vermont, and Puerto Rico.
Definitions for the SDH indicator variables used in this report can be found at http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Hispanics/Latinos can be of any race.
^b Includes American Indian/Alaska Native, Asian, Native Hawaiian/other Pacific Islander, and multiple races.
^c Because column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.

Table S1. Adults living below federal poverty level, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Below federal poverty level (%)
	Male
	<6		6.00–10.99		11.00–17.99		≥18
Area of residence	No.	%^a	No.	%^a	No.	%^a	No.	%^a
Alabama	236,108	13.2	447,071	24.9	540,431	30.1	571,468	31.8
Alaska	88,114	30.4	121,665	42.0	55,483	19.1	24,625	8.5
Arizona	551,199	21.1	715,611	27.4	550,155	21.0	796,696	30.5
Arkansas	94,672	8.6	264,345	23.9	400,246	36.2	347,866	31.4
California	3,293,505	22.3	4,414,899	30.0	3,789,894	25.7	3,238,111	22.0
Colorado	738,495	34.8	595,246	28.1	498,782	23.5	289,226	13.6
Connecticut	680,078	50.0	322,995	23.7	182,808	13.4	174,447	12.8
Delaware	94,637	26.6	139,897	39.3	84,407	23.7	37,474	10.5
District of Columbia	52,755	20.0	48,626	18.5	88,992	33.8	73,032	27.7
Florida	1,388,222	17.5	2,457,038	30.9	2,308,046	29.1	1,787,080	22.5
Georgia	702,332	18.8	988,776	26.5	1,061,513	28.4	981,952	26.3
Hawaii	215,486	38.8	189,026	34.0	100,003	18.0	51,038	9.2
Idaho	63,262	10.2	247,316	39.8	206,474	33.2	104,269	16.8
Illinois	1,425,745	29.7	1,483,305	30.9	1,023,922	21.3	869,365	18.1
Indiana	648,481	26.3	758,773	30.8	572,680	23.3	482,062	19.6
Iowa	290,417	24.6	481,010	40.7	250,802	21.2	159,558	13.5
Kansas	318,814	29.4	355,178	32.8	217,003	20.0	192,362	17.8
Kentucky	234,721	14.1	385,347	23.2	427,541	25.7	614,747	37.0
Louisiana	154,035	9.0	412,708	24.1	516,943	30.2	628,995	36.7
Maine	98,733	18.9	186,426	35.7	159,025	30.5	77,421	14.8
Maryland	989,605	44.8	668,968	30.3	355,979	16.1	194,998	8.8
Massachusetts	1,080,543	41.4	701,541	26.9	448,164	17.2	377,478	14.5
Michigan	981,279	26.1	1,037,535	27.6	917,588	24.4	817,660	21.8
Minnesota	818,485	39.2	729,447	34.9	327,320	15.7	213,606	10.2
Mississippi	93,184	8.6	169,089	15.6	361,864	33.4	458,295	42.3
Missouri	534,831	23.5	651,647	28.6	603,028	26.5	489,793	21.5
Montana	56,510	13.9	147,614	36.3	108,415	26.7	94,086	23.1
Nebraska	216,110	30.7	231,943	33.0	158,122	22.5	96,911	13.8
Nevada	245,568	21.9	388,559	34.6	244,458	21.8	243,943	21.7
New Hampshire	277,714	52.3	145,972	27.5	72,927	13.7	34,293	6.5
New Jersey	1,595,848	48.1	811,268	24.5	489,434	14.8	420,004	12.7
New Mexico	83,829	10.9	125,877	16.4	250,619	32.6	308,020	40.1
New York	2,004,566	27.2	2,028,725	27.5	1,601,870	21.7	1,742,372	23.6
North Carolina	682,092	18.1	1,040,661	27.7	1,148,625	30.5	892,302	23.7
North Dakota	74,178	25.0	124,195	41.8	64,269	21.6	34,235	11.5
Ohio	1,269,215	29.1	1,189,763	27.3	955,073	21.9	946,970	21.7
Oklahoma	256,265	17.7	349,667	24.1	476,379	32.8	368,454	25.4
Oregon	232,491	14.7	472,036	29.9	553,145	35.1	320,288	20.3
Pennsylvania	1,646,421	33.7	1,542,340	31.6	877,662	18.0	821,551	16.8
Puerto Rico	1,722	0.1	13,665	1.1	50,621	4.0	1,193,431	94.8
Rhode Island	137,249	33.8	106,061	26.1	69,068	17.0	93,910	23.1
South Carolina	333,632	18.2	481,130	26.2	545,299	29.7	477,220	26.0
South Dakota	79,230	24.3	100,505	30.8	89,924	27.6	56,579	17.3
Tennessee	406,817	16.5	652,265	26.4	721,594	29.2	689,632	27.9
Texas	2,465,728	24.4	2,664,841	26.4	2,481,131	24.6	2,482,207	24.6
Utah	409,885	38.7	324,586	30.7	182,337	17.2	141,654	13.4
Vermont	59,746	24.2	102,815	41.6	55,776	22.6	28,620	11.6
Virginia	1,211,971	38.2	910,128	28.7	653,383	20.6	396,015	12.5
Washington	769,235	27.4	1,038,989	37.0	637,675	22.7	364,024	13.0
West Virginia	51,672	7.2	156,830	22.0	260,842	36.6	243,449	34.2
Wisconsin	720,975	32.6	796,442	36.0	400,161	18.1	294,109	13.3
Wyoming	48,207	21.3	92,786	41.1	60,551	26.8	24,371	10.8
Total	31,204,614	25.5	35,013,148	28.6	29,258,453	23.9	26,862,274	22.0

Table S1. Adults living below federal poverty level, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Below federal poverty level (%)
	Female
	<6		6.00–10.99		11.00–17.99		≥18
Area of residence	No.	%^b	No.	%^b	No.	%^b	No.	%^b
Alabama	256,824	13.0	483,200	24.5	584,681	29.7	645,227	32.8
Alaska	79,592	30.3	112,871	43.0	48,130	18.3	21,898	8.3
Arizona	584,881	21.7	761,745	28.3	568,406	21.1	774,363	28.8
Arkansas	99,441	8.4	282,385	24.0	415,341	35.3	380,432	32.3
California	3,418,435	22.4	4,616,948	30.3	3,907,064	25.6	3,304,644	21.7
Colorado	755,884	35.4	604,665	28.4	492,444	23.1	279,444	13.1
Connecticut	717,829	48.9	355,300	24.2	198,328	13.5	195,253	13.3
Delaware	100,885	25.9	150,566	38.6	95,279	24.5	42,924	11.0
District of Columbia	56,527	18.9	52,574	17.6	102,039	34.1	88,216	29.5
Florida	1,491,260	17.6	2,666,792	31.4	2,443,258	28.8	1,891,619	22.3
Georgia	748,140	18.4	1,074,994	26.5	1,163,417	28.7	1,071,914	26.4
Hawaii	211,081	37.8	190,140	34.0	106,637	19.1	51,046	9.1
Idaho	64,096	10.2	254,510	40.6	203,322	32.4	105,384	16.8
Illinois	1,511,962	29.7	1,568,651	30.8	1,054,026	20.7	957,520	18.8
Indiana	674,397	26.0	785,398	30.3	614,365	23.7	520,971	20.1
Iowa	300,005	24.6	494,663	40.5	267,949	22.0	158,063	12.9
Kansas	331,798	29.9	360,416	32.5	223,789	20.2	193,871	17.5
Kentucky	243,978	13.9	406,802	23.1	451,067	25.6	658,616	37.4
Louisiana	165,554	9.0	436,597	23.7	543,993	29.6	693,826	37.7
Maine	106,282	19.1	198,244	35.6	170,392	30.6	81,629	14.7
Maryland	1,067,154	43.9	741,065	30.5	398,317	16.4	226,948	9.3
Massachusetts	1,159,048	40.8	778,314	27.4	485,677	17.1	416,636	14.7
Michigan	1,024,578	25.7	1,087,146	27.3	976,083	24.5	891,362	22.4
Minnesota	841,110	39.2	749,082	34.9	340,335	15.9	213,110	9.9
Mississippi	101,458	8.6	182,162	15.4	389,519	32.8	512,790	43.2
Missouri	563,192	23.2	692,890	28.6	633,577	26.1	536,041	22.1
Montana	57,143	14.0	150,301	36.9	106,041	26.1	93,453	23.0
Nebraska	223,592	31.0	237,490	32.9	164,207	22.8	96,348	13.4
Nevada	256,778	22.8	397,729	35.3	241,616	21.5	229,709	20.4
New Hampshire	285,846	52.0	154,158	28.0	77,009	14.0	33,140	6.0
New Jersey	1,729,192	48.3	877,785	24.5	515,281	14.4	457,171	12.8
New Mexico	85,728	10.7	129,005	16.1	266,321	33.3	318,005	39.8
New York	2,164,364	26.8	2,198,984	27.3	1,710,130	21.2	1,990,016	24.7
North Carolina	730,854	17.9	1,122,492	27.5	1,241,800	30.4	990,816	24.2
North Dakota	70,732	25.1	117,673	41.8	62,792	22.3	30,409	10.8
Ohio	1,319,144	28.3	1,269,621	27.3	1,036,609	22.3	1,033,522	22.2
Oklahoma	263,767	17.5	372,371	24.7	491,829	32.6	380,699	25.2
Oregon	243,541	14.9	491,895	30.1	577,063	35.3	323,306	19.8
Pennsylvania	1,734,258	33.2	1,614,969	30.9	940,433	18.0	932,683	17.9
Puerto Rico	2,191	0.2	15,716	1.1	59,810	4.2	1,359,795	94.6
Rhode Island	147,391	33.4	115,520	26.2	77,136	17.5	101,407	23.0
South Carolina	358,706	17.9	520,720	25.9	594,222	29.6	534,869	26.6
South Dakota	78,230	24.1	100,678	31.0	91,570	28.2	54,507	16.8
Tennessee	443,565	16.6	699,269	26.2	766,006	28.7	761,332	28.5
Texas	2,583,936	24.7	2,751,631	26.3	2,565,216	24.5	2,549,928	24.4
Utah	410,347	38.5	334,395	31.4	187,204	17.6	133,583	12.5
Vermont	63,441	24.4	107,185	41.3	59,812	23.0	29,236	11.3
Virginia	1,264,362	37.7	970,431	28.9	695,994	20.7	426,671	12.7
Washington	787,951	27.6	1,066,833	37.4	632,750	22.2	364,004	12.8
West Virginia	53,745	7.2	161,005	21.7	273,370	36.8	254,768	34.3
Wisconsin	732,484	32.2	820,418	36.0	408,210	17.9	315,547	13.9
Wyoming	47,386	21.7	89,837	41.2	59,354	27.2	21,625	9.9
Total	32,814,065	25.4	36,976,231	28.6	30,779,220	23.8	28,730,296	22.2

Table S1. Adults living below federal poverty level, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Below federal poverty level (%)
	Total
	<6			6.00–10.99			11.00–17.99			≥18
Area of residence	No.	%^c	%^d	No.	%^c	%^d	No.	%^c	%^d	No.	%^c	%^d
Alabama	492,932	13.1	0.8	930,271	24.7	1.3	1,125,112	29.9	1.9	1,216,695	32.3	2.2
Alaska	167,706	30.4	0.3	234,536	42.5	0.3	103,613	18.8	0.2	46,523	8.4	0.1
Arizona	1,136,080	21.4	1.8	1,477,356	27.9	2.1	1,118,561	21.1	1.9	1,571,059	29.6	2.8
Arkansas	194,113	8.5	0.3	546,730	23.9	0.8	815,587	35.7	1.4	728,298	31.9	1.3
California	6,711,940	22.4	10.5	9,031,847	30.1	12.5	7,696,958	25.7	12.8	6,542,755	21.8	11.8
Colorado	1,494,379	35.1	2.3	1,199,911	28.2	1.7	991,226	23.3	1.7	568,670	13.4	1.0
Connecticut	1,397,907	49.4	2.2	678,295	24.0	0.9	381,136	13.5	0.6	369,700	13.1	0.7
Delaware	195,522	26.2	0.3	290,463	38.9	0.4	179,686	24.1	0.3	80,398	10.8	0.1
District of Columbia	109,282	19.4	0.2	101,200	18.0	0.1	191,031	33.9	0.3	161,248	28.7	0.3
Florida	2,879,482	17.5	4.5	5,123,830	31.2	7.1	4,751,304	28.9	7.9	3,678,699	22.4	6.6
Georgia	1,450,472	18.6	2.3	2,063,770	26.5	2.9	2,224,930	28.6	3.7	2,053,866	26.4	3.7
Hawaii	426,567	38.3	0.7	379,166	34.0	0.5	206,640	18.5	0.3	102,084	9.2	0.2
Idaho	127,358	10.2	0.2	501,826	40.2	0.7	409,796	32.8	0.7	209,653	16.8	0.4
Illinois	2,937,707	29.7	4.6	3,051,956	30.8	4.2	2,077,948	21.0	3.5	1,826,885	18.5	3.3
Indiana	1,322,878	26.2	2.1	1,544,171	30.5	2.1	1,187,045	23.5	2.0	1,003,033	19.8	1.8
Iowa	590,422	24.6	0.9	975,673	40.6	1.4	518,751	21.6	0.9	317,621	13.2	0.6
Kansas	650,612	29.7	1.0	715,594	32.6	1.0	440,792	20.1	0.7	386,233	17.6	0.7
Kentucky	478,699	14.0	0.7	792,149	23.1	1.1	878,608	25.7	1.5	1,273,363	37.2	2.3
Louisiana	319,589	9.0	0.5	849,305	23.9	1.2	1,060,936	29.9	1.8	1,322,821	37.2	2.4
Maine	205,015	19.0	0.3	384,670	35.7	0.5	329,417	30.6	0.5	159,050	14.8	0.3
Maryland	2,056,759	44.3	3.2	1,410,033	30.4	2.0	754,296	16.2	1.3	421,946	9.1	0.8
Massachusetts	2,239,591	41.1	3.5	1,479,855	27.2	2.1	933,841	17.1	1.6	794,114	14.6	1.4
Michigan	2,005,857	25.9	3.1	2,124,681	27.5	3.0	1,893,671	24.5	3.2	1,709,022	22.1	3.1
Minnesota	1,659,595	39.2	2.6	1,478,529	34.9	2.1	667,655	15.8	1.1	426,716	10.1	0.8
Mississippi	194,642	8.6	0.3	351,251	15.5	0.5	751,383	33.1	1.3	971,085	42.8	1.7
Missouri	1,098,023	23.3	1.7	1,344,537	28.6	1.9	1,236,605	26.3	2.1	1,025,834	21.8	1.8
Montana	113,653	14.0	0.2	297,915	36.6	0.4	214,456	26.4	0.4	187,539	23.1	0.3
Nebraska	439,702	30.9	0.7	469,433	32.9	0.7	322,329	22.6	0.5	193,259	13.6	0.3
Nevada	502,346	22.3	0.8	786,288	35.0	1.1	486,074	21.6	0.8	473,652	21.1	0.9
New Hampshire	563,560	52.1	0.9	300,130	27.8	0.4	149,936	13.9	0.2	67,433	6.2	0.1
New Jersey	3,325,040	48.2	5.2	1,689,053	24.5	2.3	1,004,715	14.6	1.7	877,175	12.7	1.6
New Mexico	169,557	10.8	0.3	254,882	16.3	0.4	516,940	33.0	0.9	626,025	39.9	1.1
New York	4,168,930	27.0	6.5	4,227,709	27.4	5.9	3,312,000	21.4	5.5	3,732,388	24.2	6.7
North Carolina	1,412,946	18.0	2.2	2,163,153	27.6	3.0	2,390,425	30.5	4.0	1,883,118	24.0	3.4
North Dakota	144,910	25.1	0.2	241,868	41.8	0.3	127,061	22.0	0.2	64,644	11.2	0.1
Ohio	2,588,359	28.7	4.0	2,459,384	27.3	3.4	1,991,682	22.1	3.3	1,980,492	22.0	3.6
Oklahoma	520,032	17.6	0.8	722,038	24.4	1.0	968,208	32.7	1.6	749,153	25.3	1.3
Oregon	476,032	14.8	0.7	963,931	30.0	1.3	1,130,208	35.2	1.9	643,594	20.0	1.2
Pennsylvania	3,380,679	33.4	5.3	3,157,309	31.2	4.4	1,818,095	18.0	3.0	1,754,234	17.4	3.2
Puerto Rico	3,913	0.1	0.0	29,381	1.1	0.0	110,431	4.1	0.2	2,553,226	94.7	4.6
Rhode Island	284,640	33.6	0.4	221,581	26.1	0.3	146,204	17.2	0.2	195,317	23.0	0.4
South Carolina	692,338	18.0	1.1	1,001,850	26.1	1.4	1,139,521	29.6	1.9	1,012,089	26.3	1.8
South Dakota	157,460	24.2	0.2	201,183	30.9	0.3	181,494	27.9	0.3	111,086	17.1	0.2
Tennessee	850,382	16.5	1.3	1,351,534	26.3	1.9	1,487,600	28.9	2.5	1,450,964	28.2	2.6
Texas	5,049,664	24.6	7.9	5,416,472	26.4	7.5	5,046,347	24.6	8.4	5,032,135	24.5	9.1
Utah	820,232	38.6	1.3	658,981	31.0	0.9	369,541	17.4	0.6	275,237	13.0	0.5
Vermont	123,187	24.3	0.2	210,000	41.5	0.3	115,588	22.8	0.2	57,856	11.4	0.1
Virginia	2,476,333	37.9	3.9	1,880,559	28.8	2.6	1,349,377	20.7	2.2	822,686	12.6	1.5
Washington	1,557,186	27.5	2.4	2,105,822	37.2	2.9	1,270,425	22.4	2.1	728,028	12.9	1.3
West Virginia	105,417	7.2	0.2	317,835	21.8	0.4	534,212	36.7	0.9	498,217	34.2	0.9
Wisconsin	1,453,459	32.4	2.3	1,616,860	36.0	2.2	808,371	18.0	1.3	609,656	13.6	1.1
Wyoming	95,593	21.5	0.1	182,623	41.1	0.3	119,905	27.0	0.2	45,996	10.4	0.1
Total	64,018,679	25.4	100	71,989,379	28.6	100	60,037,673	23.9	100	55,592,570	22.1	100

Abbreviations: ACS, American Community Survey; SDH, social determinants of health [footnotes only].
Note. Proportion of residents in the census tract who were living below the U.S. poverty level at any time during the 12 months before the survey response (individuals aged 18 years and older).
^a Percentage of male residents of area.
^b Percentage of female residents of area.
^c Percentage of residents of area.
^d Percentage of SDH subpopulation total.

Table S2. Adults with less than high school diploma, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Less than high school diploma (%)
	Male
	<6		6.00–9.99		10.00–17.99		≥18
Area of residence	No.	%^a	No.	%^a	No.	%^a	No.	%^a
Alabama	304,415	17.0	295,349	16.5	607,094	33.8	588,433	32.8
Alaska	108,345	37.4	95,803	33.0	71,416	24.6	14,323	4.9
Arizona	795,685	30.4	503,978	19.2	624,235	23.8	696,448	26.6
Arkansas	164,768	14.9	181,530	16.4	493,281	44.6	267,550	24.2
California	3,678,133	24.8	2,475,093	16.7	3,254,500	22.0	5,410,019	36.5
Colorado	1,006,250	47.1	440,166	20.6	423,628	19.8	266,018	12.5
Connecticut	554,810	40.7	343,904	25.2	292,701	21.5	170,754	12.5
Delaware	92,599	26.0	101,906	28.6	114,527	32.1	47,383	13.3
District of Columbia	111,806	42.4	34,935	13.3	79,337	30.1	37,327	14.2
Florida	1,956,229	24.6	1,843,782	23.2	2,367,245	29.8	1,786,051	22.5
Georgia	713,718	19.1	740,084	19.8	1,245,613	33.3	1,038,235	27.8
Hawaii	237,452	42.7	155,517	27.9	135,911	24.4	27,550	5.0
Idaho	182,201	29.3	191,614	30.8	179,198	28.8	68,308	11.0
Illinois	1,571,913	32.7	1,204,449	25.1	1,137,060	23.7	889,298	18.5
Indiana	498,270	20.2	669,688	27.2	889,070	36.1	408,387	16.6
Iowa	476,779	40.3	409,072	34.6	203,729	17.2	92,207	7.8
Kansas	416,635	38.5	307,095	28.3	229,451	21.2	130,176	12.0
Kentucky	293,632	17.6	275,090	16.5	592,174	35.5	506,602	30.4
Louisiana	227,167	13.2	284,622	16.6	581,833	33.9	621,489	36.2
Maine	181,237	34.7	187,035	35.9	144,404	27.7	8,929	1.7
Maryland	755,410	34.0	634,316	28.5	526,254	23.7	308,480	13.9
Massachusetts	1,115,175	42.7	600,858	23.0	513,717	19.7	379,341	14.5
Michigan	1,180,319	31.3	1,124,874	29.8	1,068,586	28.3	401,728	10.6
Minnesota	943,112	45.1	690,418	33.0	337,633	16.1	119,838	5.7
Mississippi	94,793	8.8	156,657	14.5	421,654	39.0	409,421	37.8
Missouri	621,589	27.3	547,278	24.0	799,163	35.1	311,269	13.7
Montana	162,793	40.0	149,116	36.6	84,173	20.7	11,117	2.7
Nebraska	282,315	39.9	217,808	30.8	130,313	18.4	76,853	10.9
Nevada	211,614	18.9	291,134	25.9	316,988	28.2	302,805	27.0
New Hampshire	223,635	42.1	200,400	37.7	87,993	16.6	18,878	3.6
New Jersey	1,222,198	36.7	855,820	25.7	723,046	21.7	527,780	15.9
New Mexico	162,471	20.7	124,026	15.8	219,236	28.0	278,151	35.5
New York	1,988,662	26.9	1,609,704	21.7	1,908,835	25.8	1,895,867	25.6
North Carolina	878,385	23.3	690,054	18.3	1,284,885	34.0	920,890	24.4
North Dakota	101,091	34.1	131,361	44.2	59,039	19.9	5,386	1.8
Ohio	1,340,917	30.7	1,208,769	27.7	1,236,981	28.3	578,148	13.2
Oklahoma	282,060	19.4	342,601	23.6	531,498	36.6	294,606	20.3
Oregon	445,828	28.3	410,806	26.0	559,546	35.5	161,780	10.3
Pennsylvania	1,489,058	30.4	1,494,904	30.5	1,363,116	27.9	546,430	11.2
Puerto Rico	33,582	2.7	61,046	4.8	313,867	24.9	852,985	67.6
Rhode Island	107,446	26.4	120,633	29.7	102,757	25.3	75,452	18.6
South Carolina	424,645	23.0	353,737	19.1	575,015	31.1	493,867	26.7
South Dakota	104,428	32.0	120,454	36.9	73,818	22.6	27,538	8.4
Tennessee	509,528	20.6	451,195	18.2	913,485	36.9	602,873	24.3
Texas	2,176,177	21.5	1,694,467	16.7	2,491,406	24.6	3,767,784	37.2
Utah	456,270	43.0	268,144	25.3	232,670	21.9	103,557	9.8
Vermont	91,801	37.2	99,090	40.1	53,762	21.8	2,304	0.9
Virginia	1,011,618	31.8	714,195	22.4	967,401	30.4	491,274	15.4
Washington	1,025,702	36.5	768,734	27.4	750,412	26.7	265,075	9.4
West Virginia	92,371	13.0	129,576	18.2	355,029	49.8	135,817	19.1
Wisconsin	874,925	39.5	734,972	33.2	462,569	20.9	140,326	6.3
Wyoming	78,788	34.9	89,735	39.7	52,700	23.3	4,692	2.1
Total	34,060,750	27.8	27,827,594	22.7	33,183,954	27.1	27,587,799	22.5

Table S2. Adults with less than high school diploma, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Less than high school diploma (%)
	Female
	<6		6.00–9.99		10.00–17.99		≥18
Area of residence	No.	%^b	No.	%^b	No.	%^b	No.	%^b
Alabama	334,133	17.0	329,318	16.7	680,850	34.6	626,295	31.8
Alaska	97,833	37.3	87,334	33.3	65,310	24.9	12,014	4.6
Arizona	850,609	31.6	534,176	19.8	641,506	23.8	666,265	24.7
Arkansas	176,357	15.0	203,727	17.3	519,422	44.1	278,093	23.6
California	3,864,628	25.3	2,606,712	17.1	3,403,921	22.3	5,382,099	35.3
Colorado	1,019,635	47.8	442,317	20.7	423,444	19.8	249,864	11.7
Connecticut	592,378	40.4	375,958	25.6	317,032	21.6	181,342	12.4
Delaware	101,859	26.1	113,350	29.1	128,517	33.0	45,928	11.8
District of Columbia	124,777	41.7	37,915	12.7	95,299	31.8	41,365	13.8
Florida	2,128,377	25.1	2,019,089	23.8	2,567,140	30.2	1,781,674	21.0
Georgia	760,614	18.7	824,640	20.3	1,396,991	34.4	1,076,294	26.5
Hawaii	231,850	41.5	161,683	28.9	138,839	24.8	26,726	4.8
Idaho	186,897	29.8	196,513	31.3	177,606	28.3	66,296	10.6
Illinois	1,670,038	32.8	1,302,437	25.6	1,236,973	24.3	882,768	17.3
Indiana	526,655	20.3	708,947	27.3	940,397	36.2	421,719	16.2
Iowa	497,296	40.7	422,301	34.6	207,833	17.0	93,250	7.6
Kansas	431,963	38.9	315,298	28.4	237,577	21.4	125,036	11.3
Kentucky	314,440	17.9	295,337	16.8	621,229	35.3	529,681	30.1
Louisiana	245,382	13.3	311,347	16.9	636,594	34.6	646,708	35.1
Maine	198,956	35.7	198,358	35.6	150,912	27.1	8,321	1.5
Maryland	838,008	34.4	703,550	28.9	585,742	24.1	307,498	12.6
Massachusetts	1,228,868	43.3	654,588	23.0	550,257	19.4	407,492	14.3
Michigan	1,246,099	31.3	1,197,494	30.0	1,126,436	28.3	415,854	10.4
Minnesota	984,771	45.9	697,668	32.5	343,963	16.0	118,348	5.5
Mississippi	103,336	8.7	178,727	15.1	464,500	39.2	439,366	37.0
Missouri	663,037	27.3	592,650	24.4	855,382	35.3	314,631	13.0
Montana	162,579	40.0	150,763	37.0	82,689	20.3	10,910	2.7
Nebraska	295,249	40.7	226,740	31.3	130,115	17.9	72,849	10.0
Nevada	221,989	19.7	306,633	27.2	319,649	28.4	277,561	24.7
New Hampshire	232,369	42.2	208,521	37.9	90,414	16.4	18,849	3.4
New Jersey	1,324,404	37.0	931,326	26.0	782,462	21.9	541,407	15.1
New Mexico	173,692	21.3	135,033	16.6	227,983	28.0	277,678	34.1
New York	2,171,992	26.9	1,740,723	21.6	2,081,524	25.8	2,079,513	25.8
North Carolina	942,366	23.0	755,808	18.5	1,403,006	34.3	987,614	24.2
North Dakota	98,604	35.0	121,458	43.1	56,336	20.0	5,208	1.8
Ohio	1,433,496	30.8	1,307,764	28.1	1,334,810	28.7	582,826	12.5
Oklahoma	297,819	19.7	369,429	24.5	555,782	36.8	285,636	18.9
Oregon	469,350	28.7	432,926	26.5	573,839	35.1	159,690	9.8
Pennsylvania	1,616,744	31.0	1,598,382	30.6	1,444,766	27.7	562,451	10.8
Puerto Rico	40,266	2.8	75,260	5.2	378,180	26.3	943,810	65.7
Rhode Island	115,273	26.1	134,269	30.4	112,519	25.5	79,393	18.0
South Carolina	457,140	22.7	388,902	19.3	640,655	31.8	525,713	26.1
South Dakota	104,588	32.2	123,454	38.0	70,587	21.7	26,356	8.1
Tennessee	561,793	21.0	493,697	18.5	986,312	36.9	630,812	23.6
Texas	2,291,981	21.9	1,804,286	17.2	2,652,304	25.4	3,714,104	35.5
Utah	459,703	43.1	274,358	25.7	233,816	21.9	97,783	9.2
Vermont	97,681	37.6	103,075	39.7	56,750	21.9	2,168	0.8
Virginia	1,059,151	31.5	762,843	22.7	1,041,782	31.0	498,083	14.8
Washington	1,047,995	36.8	791,702	27.8	755,964	26.5	255,877	9.0
West Virginia	95,289	12.8	136,099	18.3	372,391	50.1	139,109	18.7
Wisconsin	912,874	40.1	756,137	33.2	463,956	20.4	143,692	6.3
Wyoming	77,234	35.4	86,596	39.7	49,991	22.9	4,381	2.0
Total	36,180,417	28.0	29,727,618	23.0	35,412,254	27.4	28,068,400	21.7

Table S2. Adults with less than high school diploma, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Less than high school diploma (%)
	Total
	<6			6.00–9.99			10.00–17.99			≥18
Area of residence	No.	%^c	%^d	No.	%^c	%^d	No.	%^c	%^d	No.	%^c	%^d
Alabama	638,548	17.0	0.9	624,667	16.6	1.1	1,287,944	34.2	1.9	1,214,728	32.3	2.2
Alaska	206,178	37.3	0.3	183,137	33.2	0.3	136,726	24.8	0.2	26,337	4.8	0.0
Arizona	1,646,294	31.0	2.3	1,038,154	19.5	1.8	1,265,741	23.8	1.8	1,362,713	25.6	2.4
Arkansas	341,125	14.9	0.5	385,257	16.9	0.7	1,012,703	44.3	1.5	545,643	23.9	1.0
California	7,542,761	25.1	10.7	5,081,805	16.9	8.8	6,658,421	22.1	9.7	10,792,118	35.9	19.4
Colorado	2,025,885	47.4	2.9	882,483	20.7	1.5	847,072	19.8	1.2	515,882	12.1	0.9
Connecticut	1,147,188	40.6	1.6	719,862	25.4	1.3	609,733	21.6	0.9	352,096	12.4	0.6
Delaware	194,458	26.1	0.3	215,256	28.9	0.4	243,044	32.6	0.4	93,311	12.5	0.2
District of Columbia	236,583	42.0	0.3	72,850	12.9	0.1	174,636	31.0	0.3	78,692	14.0	0.1
Florida	4,084,606	24.8	5.8	3,862,871	23.5	6.7	4,934,385	30.0	7.2	3,567,725	21.7	6.4
Georgia	1,474,332	18.9	2.1	1,564,724	20.1	2.7	2,642,604	33.9	3.9	2,114,529	27.1	3.8
Hawaii	469,302	42.1	0.7	317,200	28.4	0.6	274,750	24.6	0.4	54,276	4.9	0.1
Idaho	369,098	29.6	0.5	388,127	31.1	0.7	356,804	28.6	0.5	134,604	10.8	0.2
Illinois	3,241,951	32.8	4.6	2,506,886	25.3	4.4	2,374,033	24.0	3.5	1,772,066	17.9	3.2
Indiana	1,024,925	20.2	1.5	1,378,635	27.2	2.4	1,829,467	36.1	2.7	830,106	16.4	1.5
Iowa	974,075	40.5	1.4	831,373	34.6	1.4	411,562	17.1	0.6	185,457	7.7	0.3
Kansas	848,598	38.7	1.2	622,393	28.4	1.1	467,028	21.3	0.7	255,212	11.6	0.5
Kentucky	608,072	17.7	0.9	570,427	16.6	1.0	1,213,403	35.4	1.8	1,036,283	30.2	1.9
Louisiana	472,549	13.3	0.7	595,969	16.8	1.0	1,218,427	34.3	1.8	1,268,197	35.7	2.3
Maine	380,193	35.3	0.5	385,393	35.7	0.7	295,316	27.4	0.4	17,250	1.6	0.0
Maryland	1,593,418	34.2	2.3	1,337,866	28.7	2.3	1,111,996	23.9	1.6	615,978	13.2	1.1
Massachusetts	2,344,043	43.0	3.3	1,255,446	23.0	2.2	1,063,974	19.5	1.6	786,833	14.4	1.4
Michigan	2,426,418	31.3	3.5	2,322,368	29.9	4.0	2,195,022	28.3	3.2	817,582	10.5	1.5
Minnesota	1,927,883	45.5	2.7	1,388,086	32.8	2.4	681,596	16.1	1.0	238,186	5.6	0.4
Mississippi	198,129	8.7	0.3	335,384	14.8	0.6	886,154	39.1	1.3	848,787	37.4	1.5
Missouri	1,284,626	27.3	1.8	1,139,928	24.2	2.0	1,654,545	35.2	2.4	625,900	13.3	1.1
Montana	325,372	40.0	0.5	299,879	36.8	0.5	166,862	20.5	0.2	22,027	2.7	0.0
Nebraska	577,564	40.3	0.8	444,548	31.0	0.8	260,428	18.2	0.4	149,702	10.5	0.3
Nevada	433,603	19.3	0.6	597,767	26.6	1.0	636,637	28.3	0.9	580,366	25.8	1.0
New Hampshire	456,004	42.2	0.6	408,921	37.8	0.7	178,407	16.5	0.3	37,727	3.5	0.1
New Jersey	2,546,602	36.9	3.6	1,787,146	25.9	3.1	1,505,508	21.8	2.2	1,069,187	15.5	1.9
New Mexico	336,163	21.0	0.5	259,059	16.2	0.5	447,219	28.0	0.7	555,829	34.8	1.0
New York	4,160,654	26.9	5.9	3,350,427	21.6	5.8	3,990,359	25.8	5.8	3,975,380	25.7	7.1
North Carolina	1,820,751	23.2	2.6	1,445,862	18.4	2.5	2,687,891	34.2	3.9	1,908,504	24.3	3.4
North Dakota	199,695	34.5	0.3	252,819	43.7	0.4	115,375	19.9	0.2	10,594	1.8	0.0
Ohio	2,774,413	30.7	3.9	2,516,533	27.9	4.4	2,571,791	28.5	3.7	1,160,974	12.9	2.1
Oklahoma	579,879	19.6	0.8	712,030	24.1	1.2	1,087,280	36.7	1.6	580,242	19.6	1.0
Oregon	915,178	28.5	1.3	843,732	26.3	1.5	1,133,385	35.3	1.7	321,470	10.0	0.6
Pennsylvania	3,105,802	30.7	4.4	3,093,286	30.6	5.4	2,807,882	27.8	4.1	1,108,881	11.0	2.0
Puerto Rico	73,848	2.7	0.1	136,306	5.1	0.2	692,047	25.6	1.0	1,796,795	66.6	3.2
Rhode Island	222,719	26.3	0.3	254,902	30.1	0.4	215,276	25.4	0.3	154,845	18.3	0.3
South Carolina	881,785	22.8	1.3	742,639	19.2	1.3	1,215,670	31.5	1.8	1,019,580	26.4	1.8
South Dakota	209,016	32.1	0.3	243,908	37.5	0.4	144,405	22.2	0.2	53,894	8.3	0.1
Tennessee	1,071,321	20.8	1.5	944,892	18.3	1.6	1,899,797	36.9	2.8	1,233,685	24.0	2.2
Texas	4,468,158	21.7	6.4	3,498,753	17.0	6.1	5,143,710	25.0	7.5	7,481,888	36.3	13.4
Utah	915,973	43.1	1.3	542,502	25.5	0.9	466,486	21.9	0.7	201,340	9.5	0.4
Vermont	189,482	37.4	0.3	202,165	39.9	0.4	110,512	21.8	0.2	4,472	0.9	0.0
Virginia	2,070,769	31.6	2.9	1,477,038	22.6	2.6	2,009,183	30.7	2.9	989,357	15.1	1.8
Washington	2,073,697	36.6	3.0	1,560,436	27.6	2.7	1,506,376	26.6	2.2	520,952	9.2	0.9
West Virginia	187,660	12.9	0.3	265,675	18.3	0.5	727,420	50.0	1.1	274,926	18.9	0.5
Wisconsin	1,787,799	39.8	2.5	1,491,109	33.2	2.6	926,525	20.6	1.4	284,018	6.3	0.5
Wyoming	156,022	35.1	0.2	176,331	39.7	0.3	102,691	23.1	0.1	9,073	2.0	0.0
Total	70,241,167	27.9	100	57,555,212	22.8	100	68,596,208	27.2	100	55,656,199	22.1	100

Abbreviations: ACS, American Community Survey; SDH, social determinants of health [footnotes only].
Note. Proportion of residents in the census tract with less than a high school diploma at the time of the survey response (individuals aged 18 years and older).
^a Percentage of male residents of area.
^b Percentage of female residents of area.
^c Percentage of residents of area.
^d Percentage of SDH subpopulation total.

Table S3. Median household income among adults, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Median household income (U.S. $)
	Male
	<42,000		42,000–56,999		57,000–77,999		≥78,000
Area of residence	No.	%^a	No.	%^a	No.	%^a	No.	%^a
Alabama	642,323	35.8	578,511	32.2	356,883	19.9	216,389	12.1
Alaska	16,516	5.7	39,536	13.8	87,352	30.4	144,110	50.1
Arizona	697,807	26.8	685,695	26.3	633,841	24.3	589,846	22.6
Arkansas	434,763	39.4	400,954	36.3	209,185	18.9	59,797	5.4
California	1,929,210	13.1	2,808,400	19.1	3,629,094	24.6	6,360,752	43.2
Colorado	229,279	10.8	454,368	21.4	611,524	28.8	825,086	38.9
Connecticut	156,051	11.5	155,966	11.5	316,031	23.3	727,022	53.7
Delaware	22,400	6.3	98,158	27.5	134,207	37.7	101,650	28.5
District of Columbia	40,751	15.6	24,871	9.5	31,685	12.1	164,309	62.8
Florida	2,103,201	26.5	2,467,886	31.1	1,996,019	25.2	1,365,239	17.2
Georgia	971,201	26.0	975,281	26.1	926,651	24.8	857,217	23.0
Hawaii	30,489	5.5	63,330	11.4	157,561	28.4	303,399	54.7
Idaho	117,509	18.9	262,215	42.2	187,934	30.2	53,663	8.6
Illinois	763,742	15.9	1,119,551	23.3	1,360,761	28.3	1,556,081	32.4
Indiana	553,366	22.5	739,020	30.1	752,857	30.7	410,358	16.7
Iowa	142,823	12.1	412,672	35.0	453,566	38.5	169,617	14.4
Kansas	210,538	19.5	354,081	32.7	268,335	24.8	248,256	23.0
Kentucky	640,744	38.6	452,756	27.3	374,204	22.6	190,827	11.5
Louisiana	614,564	35.9	473,083	27.6	421,824	24.6	202,376	11.8
Maine	107,544	20.6	144,622	27.7	203,500	39.0	65,939	12.6
Maryland	148,863	6.7	282,988	12.8	511,809	23.2	1,261,974	57.2
Massachusetts	243,233	9.3	344,430	13.2	601,549	23.1	1,415,115	54.3
Michigan	876,121	23.4	1,066,447	28.4	1,063,997	28.4	744,103	19.8
Minnesota	186,253	8.9	440,748	21.1	745,572	35.7	716,285	34.3
Mississippi	513,025	47.4	312,092	28.8	190,911	17.6	66,374	6.1
Missouri	581,953	25.5	729,281	32.0	574,966	25.2	392,196	17.2
Montana	90,871	22.3	146,857	36.1	148,831	36.6	20,066	4.9
Nebraska	79,873	11.4	254,302	36.2	228,052	32.4	140,859	20.0
Nevada	255,464	22.8	242,586	21.6	382,546	34.1	241,932	21.6
New Hampshire	28,249	5.3	84,519	15.9	179,489	33.8	238,649	45.0
New Jersey	320,147	9.7	399,866	12.1	780,611	23.5	1,815,236	54.7
New Mexico	299,612	39.0	214,118	27.9	174,629	22.7	79,986	10.4
New York	1,171,801	15.9	1,502,387	20.4	1,896,118	25.8	2,780,236	37.8
North Carolina	1,082,025	28.8	1,262,636	33.7	821,086	21.9	586,113	15.6
North Dakota	36,809	12.4	68,050	22.9	113,160	38.1	78,858	26.6
Ohio	1,019,950	23.5	1,177,344	27.1	1,326,089	30.5	818,587	18.9
Oklahoma	424,469	29.3	512,270	35.4	323,621	22.3	188,261	13.0
Oregon	252,523	16.0	458,991	29.1	549,244	34.8	317,202	20.1
Pennsylvania	823,900	16.9	1,319,738	27.1	1,524,411	31.3	1,194,935	24.6
Puerto Rico	1,188,401	94.4	57,849	4.6	9,966	0.8	3,135	0.2
Rhode Island	67,054	16.5	82,011	20.2	117,627	29.0	139,596	34.4
South Carolina	586,867	32.1	526,208	28.8	468,254	25.6	248,293	13.6
South Dakota	57,416	17.6	109,811	33.7	115,632	35.4	43,379	13.3
Tennessee	795,291	32.2	784,763	31.8	543,065	22.0	344,185	13.9
Texas	2,283,760	22.7	2,520,292	25.0	2,552,942	25.3	2,720,063	27.0
Utah	95,835	9.1	218,743	20.7	353,470	33.4	390,414	36.9
Vermont	20,696	8.4	80,376	32.5	115,234	46.7	30,651	12.4
Virginia	417,112	13.2	684,021	21.6	684,915	21.6	1,383,202	43.6
Washington	235,320	8.4	589,413	21.0	845,922	30.2	1,130,510	40.4
West Virginia	298,295	41.9	271,484	38.1	113,864	16.0	28,679	4.0
Wisconsin	297,198	13.4	679,477	30.7	772,101	34.9	462,911	20.9
Wyoming	15,531	6.9	70,898	31.4	88,830	39.3	50,656	22.4
Total	25,218,738	20.6	30,205,952	24.7	32,031,527	26.2	34,684,574	28.4

Table S3. Median household income among adults, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Median household income (U.S. $)
	Female
	<42,000		42,000–56,999		57,000–77,999		≥78,000
Area of residence	No.	%^b	No.	%^b	No.	%^b	No.	%^b
Alabama	724,612	36.8	626,501	31.8	385,596	19.6	231,757	11.8
Alaska	13,700	5.2	33,887	12.9	78,535	30.0	135,885	51.9
Arizona	697,280	25.9	697,313	25.9	669,249	24.9	625,404	23.3
Arkansas	470,513	40.0	421,791	35.8	221,535	18.8	62,882	5.3
California	1,998,557	13.1	2,872,183	18.8	3,763,245	24.7	6,609,650	43.4
Colorado	229,386	10.8	451,373	21.2	613,499	28.8	837,748	39.3
Connecticut	174,510	11.9	175,044	11.9	341,595	23.3	774,406	52.8
Delaware	25,984	6.7	110,666	28.4	146,708	37.7	106,296	27.3
District of Columbia	54,674	18.4	30,065	10.1	35,755	12.0	176,848	59.5
Florida	2,239,790	26.4	2,656,286	31.3	2,141,014	25.2	1,445,687	17.0
Georgia	1,078,838	26.6	1,064,573	26.2	1,000,895	24.7	913,347	22.5
Hawaii	30,690	5.5	61,972	11.1	156,097	27.9	310,134	55.5
Idaho	117,268	18.7	266,977	42.6	187,115	29.8	55,952	8.9
Illinois	849,905	16.7	1,173,836	23.1	1,432,633	28.1	1,635,773	32.1
Indiana	612,176	23.6	772,926	29.8	778,491	30.0	428,348	16.5
Iowa	142,943	11.7	430,699	35.3	468,179	38.4	176,635	14.5
Kansas	211,137	19.1	362,720	32.7	276,390	25.0	257,492	23.2
Kentucky	690,570	39.3	474,286	27.0	392,235	22.3	197,908	11.3
Louisiana	688,345	37.4	492,942	26.8	440,550	24.0	217,029	11.8
Maine	113,239	20.3	154,698	27.8	216,758	38.9	71,852	12.9
Maryland	178,970	7.4	325,917	13.4	567,883	23.3	1,360,682	55.9
Massachusetts	279,914	9.9	374,237	13.2	654,716	23.1	1,529,362	53.9
Michigan	961,625	24.2	1,125,019	28.3	1,120,147	28.2	769,059	19.3
Minnesota	193,518	9.0	454,333	21.2	756,858	35.3	738,928	34.5
Mississippi	575,481	48.5	332,617	28.0	204,883	17.3	72,913	6.1
Missouri	643,998	26.6	758,260	31.3	610,014	25.2	411,983	17.0
Montana	89,805	22.1	147,248	36.2	150,532	37.0	19,353	4.8
Nebraska	82,757	11.5	261,150	36.2	229,797	31.8	147,933	20.5
Nevada	238,728	21.2	246,799	21.9	388,689	34.5	251,616	22.3
New Hampshire	27,765	5.0	88,849	16.1	184,682	33.6	248,857	45.2
New Jersey	364,111	10.2	435,641	12.2	829,548	23.2	1,949,157	54.5
New Mexico	308,274	38.6	225,428	28.2	181,545	22.7	83,812	10.5
New York	1,393,371	17.3	1,617,006	20.1	2,017,103	25.1	3,015,136	37.5
North Carolina	1,207,807	29.6	1,347,833	33.0	893,947	21.9	634,179	15.5
North Dakota	32,919	11.7	67,172	23.9	107,309	38.1	74,206	26.4
Ohio	1,142,214	24.6	1,258,844	27.1	1,391,167	29.9	858,532	18.5
Oklahoma	440,164	29.2	531,382	35.2	338,729	22.5	197,788	13.1
Oregon	258,626	15.8	477,188	29.2	570,686	34.9	329,305	20.1
Pennsylvania	934,612	17.9	1,397,743	26.8	1,603,349	30.8	1,275,706	24.5
Puerto Rico	1,354,602	94.2	67,657	4.7	11,080	0.8	4,050	0.3
Rhode Island	71,902	16.3	91,797	20.8	130,277	29.5	147,478	33.4
South Carolina	664,878	33.2	564,732	28.2	505,925	25.3	267,614	13.4
South Dakota	57,887	17.8	108,094	33.3	112,904	34.7	46,100	14.2
Tennessee	875,750	32.8	833,384	31.2	583,285	21.9	374,749	14.1
Texas	2,387,448	22.9	2,571,406	24.6	2,637,951	25.3	2,850,158	27.3
Utah	93,690	8.8	216,057	20.3	363,739	34.1	392,043	36.8
Vermont	21,605	8.3	85,110	32.8	121,340	46.7	31,619	12.2
Virginia	460,342	13.7	719,923	21.4	728,433	21.7	1,447,608	43.1
Washington	241,281	8.5	595,146	20.9	860,163	30.2	1,151,730	40.4
West Virginia	312,841	42.1	283,324	38.2	116,982	15.8	29,286	3.9
Wisconsin	322,208	14.2	696,982	30.6	785,001	34.5	472,468	20.8
Wyoming	15,211	7.0	69,179	31.7	85,927	39.4	47,885	21.9
Total	27,398,421	21.2	31,706,195	24.5	33,590,665	26.0	36,502,328	28.3

Table S3. Median household income among adults, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Median household income (U.S. $)
	Total
	<42,000			42,000–56,999			57,000–77,999			≥78,000
Area of residence	No.	%^c	%^d	No.	%^c	%^d	No.	%^c	%^d	No.	%^c	%^d
Alabama	1,366,935	36.3	2.6	1,205,012	32.0	1.9	742,479	19.7	1.1	448,146	11.9	0.6
Alaska	30,216	5.5	0.1	73,423	13.4	0.1	165,887	30.2	0.3	279,995	51.0	0.4
Arizona	1,395,087	26.3	2.7	1,383,008	26.1	2.2	1,303,090	24.6	2.0	1,215,250	22.9	1.7
Arkansas	905,276	39.7	1.7	822,745	36.1	1.3	430,720	18.9	0.7	122,679	5.4	0.2
California	3,927,767	13.1	7.5	5,680,583	19.0	9.2	7,392,339	24.7	11.3	12,970,402	43.3	18.2
Colorado	458,665	10.8	0.9	905,741	21.3	1.5	1,225,023	28.8	1.9	1,662,834	39.1	2.3
Connecticut	330,561	11.7	0.6	331,010	11.7	0.5	657,626	23.3	1.0	1,501,428	53.2	2.1
Delaware	48,384	6.5	0.1	208,824	28.0	0.3	280,915	37.7	0.4	207,946	27.9	0.3
District of Columbia	95,425	17.1	0.2	54,936	9.8	0.1	67,440	12.1	0.1	341,157	61.0	0.5
Florida	4,342,991	26.5	8.3	5,124,172	31.2	8.3	4,137,033	25.2	6.3	2,810,926	17.1	3.9
Georgia	2,050,039	26.3	3.9	2,039,854	26.2	3.3	1,927,546	24.8	2.9	1,770,564	22.7	2.5
Hawaii	61,179	5.5	0.1	125,302	11.3	0.2	313,658	28.2	0.5	613,533	55.1	0.9
Idaho	234,777	18.8	0.4	529,192	42.4	0.9	375,049	30.0	0.6	109,615	8.8	0.2
Illinois	1,613,647	16.3	3.1	2,293,387	23.2	3.7	2,793,394	28.2	4.3	3,191,854	32.3	4.5
Indiana	1,165,542	23.1	2.2	1,511,946	30.0	2.4	1,531,348	30.3	2.3	838,706	16.6	1.2
Iowa	285,766	11.9	0.5	843,371	35.2	1.4	921,745	38.5	1.4	346,252	14.4	0.5
Kansas	421,675	19.3	0.8	716,801	32.7	1.2	544,725	24.9	0.8	505,748	23.1	0.7
Kentucky	1,331,314	39.0	2.5	927,042	27.2	1.5	766,439	22.5	1.2	388,735	11.4	0.5
Louisiana	1,302,909	36.7	2.5	966,025	27.2	1.6	862,374	24.3	1.3	419,405	11.8	0.6
Maine	220,783	20.5	0.4	299,320	27.8	0.5	420,258	39.0	0.6	137,791	12.8	0.2
Maryland	327,833	7.1	0.6	608,905	13.1	1.0	1,079,692	23.3	1.6	2,622,656	56.5	3.7
Massachusetts	523,147	9.6	1.0	718,667	13.2	1.2	1,256,265	23.1	1.9	2,944,477	54.1	4.1
Michigan	1,837,746	23.8	3.5	2,191,466	28.4	3.5	2,184,144	28.3	3.3	1,513,162	19.6	2.1
Minnesota	379,771	9.0	0.7	895,081	21.1	1.4	1,502,430	35.5	2.3	1,455,213	34.4	2.0
Mississippi	1,088,506	48.0	2.1	644,709	28.4	1.0	395,794	17.4	0.6	139,287	6.1	0.2
Missouri	1,225,951	26.1	2.3	1,487,541	31.6	2.4	1,184,980	25.2	1.8	804,179	17.1	1.1
Montana	180,676	22.2	0.3	294,105	36.2	0.5	299,363	36.8	0.5	39,419	4.8	0.1
Nebraska	162,630	11.4	0.3	515,452	36.2	0.8	457,849	32.1	0.7	288,792	20.3	0.4
Nevada	494,192	22.0	0.9	489,385	21.8	0.8	771,235	34.3	1.2	493,548	22.0	0.7
New Hampshire	56,014	5.2	0.1	173,368	16.0	0.3	364,171	33.7	0.6	487,506	45.1	0.7
New Jersey	684,258	9.9	1.3	835,507	12.1	1.3	1,610,159	23.4	2.5	3,764,393	54.6	5.3
New Mexico	607,886	38.8	1.2	439,546	28.0	0.7	356,174	22.7	0.5	163,798	10.5	0.2
New York	2,565,172	16.7	4.9	3,119,393	20.3	5.0	3,913,221	25.4	6.0	5,795,372	37.6	8.1
North Carolina	2,289,832	29.2	4.4	2,610,469	33.3	4.2	1,715,033	21.9	2.6	1,220,292	15.6	1.7
North Dakota	69,728	12.1	0.1	135,222	23.4	0.2	220,469	38.1	0.3	153,064	26.5	0.2
Ohio	2,162,164	24.0	4.1	2,436,188	27.1	3.9	2,717,256	30.2	4.1	1,677,119	18.6	2.4
Oklahoma	864,633	29.2	1.6	1,043,652	35.3	1.7	662,350	22.4	1.0	386,049	13.1	0.5
Oregon	511,149	15.9	1.0	936,179	29.1	1.5	1,119,930	34.8	1.7	646,507	20.1	0.9
Pennsylvania	1,758,512	17.5	3.3	2,717,481	27.0	4.4	3,127,760	31.0	4.8	2,470,641	24.5	3.5
Puerto Rico	2,543,003	94.3	4.8	125,506	4.7	0.2	21,046	0.8	0.0	7,185	0.3	0.0
Rhode Island	138,956	16.4	0.3	173,808	20.5	0.3	247,904	29.2	0.4	287,074	33.9	0.4
South Carolina	1,251,745	32.7	2.4	1,090,940	28.5	1.8	974,179	25.4	1.5	515,907	13.5	0.7
South Dakota	115,303	17.7	0.2	217,905	33.5	0.4	228,536	35.1	0.3	89,479	13.7	0.1
Tennessee	1,671,041	32.5	3.2	1,618,147	31.5	2.6	1,126,350	21.9	1.7	718,934	14.0	1.0
Texas	4,671,208	22.8	8.9	5,091,698	24.8	8.2	5,190,893	25.3	7.9	5,570,221	27.1	7.8
Utah	189,525	8.9	0.4	434,800	20.5	0.7	717,209	33.8	1.1	782,457	36.8	1.1
Vermont	42,301	8.3	0.1	165,486	32.7	0.3	236,574	46.7	0.4	62,270	12.3	0.1
Virginia	877,454	13.4	1.7	1,403,944	21.5	2.3	1,413,348	21.7	2.2	2,830,810	43.4	4.0
Washington	476,601	8.4	0.9	1,184,559	21.0	1.9	1,706,085	30.2	2.6	2,282,240	40.4	3.2
West Virginia	611,136	42.0	1.2	554,808	38.1	0.9	230,846	15.9	0.4	57,965	4.0	0.1
Wisconsin	619,406	13.8	1.2	1,376,459	30.7	2.2	1,557,102	34.7	2.4	935,379	20.8	1.3
Wyoming	30,742	6.9	0.1	140,077	31.5	0.2	174,757	39.3	0.3	98,541	22.2	0.1
Total	52,617,159	20.9	100	61,912,147	24.6	100	65,622,192	26.1	100	71,186,902	28.3	100

Abbreviations: ACS, American Community Survey; SDH, social determinants of health [footnotes only].
Note. Median household income (all age groups) in the census tract during the 12 months before the survey response.
^a Percentage of male residents of area.
^b Percentage of female residents of area.
^c Percentage of residents of area.
^d Percentage of SDH subpopulation total.

Table S4. Adults without health insurance, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Without health insurance (%)
	Male
	<5		5.00–8.99		9.00–14.99		≥15
Area of residence	No.	%^a	No.	%^a	No.	%^a	No.	%^a
Alabama	208,392	11.6	402,276	22.4	674,642	37.6	509,981	28.4
Alaska	23,068	8.0	27,446	9.5	90,189	31.1	149,184	51.5
Arizona	567,938	21.7	630,247	24.1	668,412	25.6	747,064	28.6
Arkansas	120,866	10.9	391,598	35.4	415,109	37.5	179,556	16.2
California	4,075,459	27.6	3,990,369	27.1	3,546,791	24.1	3,129,997	21.2
Colorado	648,935	30.5	609,283	28.7	501,393	23.6	366,373	17.2
Connecticut	808,175	59.4	265,218	19.5	167,071	12.3	119,864	8.8
Delaware	143,931	40.4	133,576	37.5	62,729	17.6	16,179	4.5
District of Columbia	175,213	66.5	56,433	21.4	29,114	11.1	2,645	1.0
Florida	700,866	8.8	1,306,294	16.4	2,411,392	30.4	3,524,190	44.4
Georgia	278,561	7.5	523,429	14.0	1,130,683	30.3	1,801,900	48.2
Hawaii	342,615	61.7	164,781	29.7	47,873	8.6	284	0.1
Idaho	59,493	9.6	119,325	19.2	249,369	40.1	193,134	31.1
Illinois	1,808,042	37.6	1,307,811	27.2	920,713	19.2	765,771	15.9
Indiana	502,751	20.4	844,166	34.2	709,300	28.8	409,198	16.6
Iowa	651,865	55.2	362,688	30.7	128,267	10.9	38,967	3.3
Kansas	266,707	24.6	313,071	28.9	290,274	26.8	213,290	19.7
Kentucky	614,796	37.0	675,321	40.6	311,892	18.8	60,347	3.6
Louisiana	145,050	8.5	308,282	18.0	651,680	38.1	607,669	35.5
Maine	89,663	17.2	185,727	35.6	202,379	38.8	43,836	8.4
Maryland	1,027,274	46.5	592,192	26.8	370,668	16.8	219,416	9.9
Massachusetts	2,103,204	80.6	408,189	15.6	88,768	3.4	8,724	0.3
Michigan	1,385,363	36.8	1,448,467	38.5	749,441	19.9	177,472	4.7
Minnesota	1,254,605	60.0	589,979	28.2	186,176	8.9	58,787	2.8
Mississippi	47,600	4.4	120,339	11.1	351,849	32.5	562,644	52.0
Missouri	446,217	19.6	555,228	24.4	724,699	31.8	553,155	24.3
Montana	36,301	8.9	138,869	34.2	164,376	40.4	67,079	16.5
Nebraska	202,332	28.7	214,474	30.4	165,296	23.4	123,801	17.5
Nevada	143,681	12.8	255,098	22.7	352,745	31.4	371,004	33.1
New Hampshire	162,775	30.7	201,972	38.0	139,274	26.2	26,885	5.1
New Jersey	1,251,792	37.7	766,163	23.1	616,777	18.6	681,822	20.6
New Mexico	127,538	16.3	183,070	23.4	245,442	31.3	226,957	29.0
New York	3,086,679	41.8	2,069,542	28.0	1,405,858	19.0	823,744	11.2
North Carolina	389,163	10.3	819,092	21.8	1,313,271	34.9	1,243,947	33.0
North Dakota	100,687	33.9	116,205	39.1	66,683	22.5	13,302	4.5
Ohio	1,652,860	37.9	1,573,386	36.1	856,047	19.6	278,728	6.4
Oklahoma	77,582	5.3	204,317	14.1	412,442	28.4	756,424	52.1
Oregon	361,475	22.9	646,663	41.0	441,655	28.0	128,167	8.1
Pennsylvania	2,181,767	44.6	1,584,613	32.4	756,018	15.5	365,576	7.5
Puerto Rico	378,108	30.0	588,419	46.7	252,141	20.0	40,771	3.2
Rhode Island	232,297	57.2	93,638	23.0	50,653	12.5	29,700	7.3
South Carolina	176,525	9.6	344,972	18.8	731,853	39.8	583,931	31.8
South Dakota	58,599	18.0	127,996	39.2	80,792	24.8	58,851	18.0
Tennessee	293,086	11.9	590,451	23.9	970,639	39.3	617,903	25.0
Texas	650,293	6.4	1,309,511	13.0	2,116,427	20.9	6,029,522	59.7
Utah	193,980	18.3	314,646	29.7	287,870	27.2	261,966	24.7
Vermont	149,353	60.5	89,841	36.4	7,763	3.1	0	0.0
Virginia	719,127	22.6	820,573	25.8	1,010,082	31.8	626,217	19.7
Washington	915,504	32.6	1,020,178	36.3	635,254	22.6	238,987	8.5
West Virginia	154,166	21.6	351,852	49.4	195,806	27.5	10,969	1.5
Wisconsin	1,044,375	47.2	766,853	34.7	298,025	13.5	102,434	4.6
Wyoming	16,515	7.3	46,525	20.6	87,696	38.8	75,179	33.3
Total^c	33,253,209	27.2	31,570,654	25.8	29,341,758	24.0	28,243,493	23.1

Table S4. Adults without health insurance, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Without health insurance (%)
	Female
	<5		5.00–8.99		9.00–14.99		≥15
Area of residence	No.	%^b	No.	%^b	No.	%^b	No.	%^b
Alabama	229,643	11.7	437,996	22.2	731,334	37.1	571,623	29.0
Alaska	19,072	7.3	25,362	9.7	85,117	32.4	132,940	50.6
Arizona	606,709	22.6	662,124	24.6	671,898	25.0	748,664	27.8
Arkansas	128,962	11.0	419,342	35.6	439,417	37.3	189,878	16.1
California	4,293,625	28.1	4,155,193	27.2	3,654,541	24.0	3,152,462	20.7
Colorado	665,681	31.2	623,493	29.2	492,969	23.1	353,049	16.5
Connecticut	867,687	59.2	290,016	19.8	184,827	12.6	124,180	8.5
Delaware	159,141	40.8	146,547	37.6	65,766	16.9	18,200	4.7
District of Columbia	202,216	67.6	65,050	21.7	29,513	9.9	2,577	0.9
Florida	775,894	9.1	1,433,498	16.9	2,603,661	30.6	3,682,541	43.3
Georgia	282,155	7.0	559,983	13.8	1,231,613	30.3	1,984,714	48.9
Hawaii	342,996	61.4	168,255	30.1	47,364	8.5	289	0.1
Idaho	61,535	9.8	122,675	19.6	249,194	39.7	193,908	30.9
Illinois	1,922,570	37.8	1,391,667	27.3	1,001,445	19.7	776,477	15.2
Indiana	524,454	20.2	886,330	34.1	747,230	28.8	439,704	16.9
Iowa	680,289	55.7	371,315	30.4	131,419	10.8	37,657	3.1
Kansas	274,993	24.8	320,670	28.9	298,061	26.9	216,150	19.5
Kentucky	643,301	36.5	721,193	41.0	333,202	18.9	62,767	3.6
Louisiana	153,792	8.4	339,739	18.5	688,219	37.4	658,220	35.8
Maine	101,687	18.3	197,427	35.5	211,231	38.0	46,202	8.3
Maryland	1,116,261	45.9	670,767	27.6	421,867	17.3	224,589	9.2
Massachusetts	2,306,117	81.2	437,303	15.4	90,851	3.2	6,925	0.2
Michigan	1,470,090	36.9	1,544,061	38.7	785,348	19.7	186,372	4.7
Minnesota	1,299,408	60.6	598,991	27.9	188,540	8.8	57,811	2.7
Mississippi	48,334	4.1	134,676	11.4	382,240	32.2	620,679	52.3
Missouri	478,812	19.7	586,298	24.2	769,659	31.7	590,931	24.4
Montana	36,614	9.0	137,998	33.9	163,900	40.3	68,426	16.8
Nebraska	214,543	29.6	218,238	30.1	168,535	23.2	123,610	17.1
Nevada	151,431	13.5	265,654	23.6	357,618	31.8	351,129	31.2
New Hampshire	170,040	30.9	211,668	38.5	141,465	25.7	26,980	4.9
New Jersey	1,362,825	38.1	839,073	23.4	671,830	18.8	705,701	19.7
New Mexico	132,631	16.3	192,272	23.6	259,801	31.9	229,682	28.2
New York	3,363,497	41.7	2,273,068	28.2	1,580,286	19.6	856,035	10.6
North Carolina	399,569	9.8	898,324	22.0	1,427,356	34.9	1,362,857	33.3
North Dakota	97,100	34.5	110,766	39.3	61,210	21.7	12,530	4.4
Ohio	1,764,182	37.9	1,687,967	36.2	915,616	19.7	291,131	6.2
Oklahoma	78,478	5.2	219,711	14.6	429,923	28.5	780,554	51.7
Oregon	384,191	23.5	668,320	40.9	449,571	27.5	133,723	8.2
Pennsylvania	2,319,681	44.4	1,686,996	32.3	832,646	15.9	383,020	7.3
Puerto Rico	433,029	30.1	665,984	46.3	295,801	20.6	42,698	3.0
Rhode Island	256,363	58.1	100,061	22.7	56,046	12.7	28,984	6.6
South Carolina	189,436	9.4	373,645	18.6	804,331	40.0	641,105	31.9
South Dakota	61,243	18.8	125,143	38.5	81,990	25.2	56,609	17.4
Tennessee	320,846	12.0	637,806	23.9	1,037,403	38.8	676,104	25.3
Texas	679,360	6.5	1,366,873	13.1	2,220,537	21.2	6,195,211	59.2
Utah	197,489	18.5	319,267	30.0	292,303	27.4	256,470	24.1
Vermont	159,133	61.3	92,575	35.7	7,966	3.1	0	0.0
Virginia	761,144	22.6	854,167	25.4	1,094,173	32.6	651,892	19.4
Washington	941,340	33.0	1,041,517	36.5	641,987	22.5	226,694	7.9
West Virginia	162,545	21.9	364,405	49.1	204,556	27.5	11,382	1.5
Wisconsin	1,080,341	47.5	781,749	34.3	309,481	13.6	105,088	4.6
Wyoming	15,915	7.3	46,428	21.3	81,812	37.5	74,047	33.9
Total^c	35,388,390	27.4	33,489,646	25.9	31,124,669	24.1	29,371,171	22.7

Table S4. Adults without health insurance, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Without health insurance (%)
	Total
	<5			5.00–8.99			9.00–14.99			≥15
Area of residence	No.	%^c	%^d	No.	%^c	%^d	No.	%^c	%^d	No.	%^c	%^d
Alabama	438,035	11.6	0.6	840,272	22.3	1.3	1,405,976	37.3	2.3	1,081,604	28.7	1.9
Alaska	42,140	7.6	0.1	52,808	9.6	0.1	175,306	31.7	0.3	282,124	51.1	0.5
Arizona	1,174,647	22.2	1.7	1,292,371	24.4	2.0	1,340,310	25.3	2.2	1,495,728	28.2	2.6
Arkansas	249,828	10.9	0.4	810,940	35.5	1.2	854,526	37.4	1.4	369,434	16.2	0.6
California	8,369,084	27.9	12.2	8,145,562	27.2	12.5	7,201,332	24.0	11.9	6,282,459	20.9	10.9
Colorado	1,314,616	30.9	1.9	1,232,776	28.9	1.9	994,362	23.3	1.6	719,422	16.9	1.2
Connecticut	1,675,862	59.3	2.4	555,234	19.6	0.9	351,898	12.4	0.6	244,044	8.6	0.4
Delaware	303,072	40.6	0.4	280,123	37.5	0.4	128,495	17.2	0.2	34,379	4.6	0.1
District of Columbia	377,429	67.1	0.5	121,483	21.6	0.2	58,627	10.4	0.1	5,222	0.9	0.0
Florida	1,476,760	9.0	2.2	2,739,792	16.7	4.2	5,015,053	30.5	8.3	7,206,731	43.8	12.5
Georgia	560,716	7.2	0.8	1,083,412	13.9	1.7	2,362,296	30.3	3.9	3,786,614	48.6	6.6
Hawaii	685,611	61.5	1.0	333,036	29.9	0.5	95,237	8.5	0.2	573	0.1	0.0
Idaho	121,028	9.7	0.2	242,000	19.4	0.4	498,563	39.9	0.8	387,042	31.0	0.7
Illinois	3,730,612	37.7	5.4	2,699,478	27.3	4.1	1,922,158	19.4	3.2	1,542,248	15.6	2.7
Indiana	1,027,205	20.3	1.5	1,730,496	34.2	2.7	1,456,530	28.8	2.4	848,902	16.8	1.5
Iowa	1,332,154	55.4	1.9	734,003	30.6	1.1	259,686	10.8	0.4	76,624	3.2	0.1
Kansas	541,700	24.7	0.8	633,741	28.9	1.0	588,335	26.8	1.0	429,440	19.6	0.7
Kentucky	1,258,097	36.8	1.8	1,396,514	40.8	2.1	645,094	18.8	1.1	123,114	3.6	0.2
Louisiana	298,842	8.4	0.4	648,021	18.2	1.0	1,339,899	37.7	2.2	1,265,889	35.6	2.2
Maine	191,350	17.7	0.3	383,154	35.5	0.6	413,610	38.4	0.7	90,038	8.4	0.2
Maryland	2,143,535	46.2	3.1	1,262,959	27.2	1.9	792,535	17.1	1.3	444,005	9.6	0.8
Massachusetts	4,409,321	80.9	6.4	845,492	15.5	1.3	179,619	3.3	0.3	15,649	0.3	0.0
Michigan	2,855,453	36.9	4.2	2,992,528	38.6	4.6	1,534,789	19.8	2.5	363,844	4.7	0.6
Minnesota	2,554,013	60.3	3.7	1,188,970	28.1	1.8	374,716	8.8	0.6	116,598	2.8	0.2
Mississippi	95,934	4.2	0.1	255,015	11.2	0.4	734,089	32.4	1.2	1,183,323	52.2	2.1
Missouri	925,029	19.7	1.3	1,141,526	24.3	1.8	1,494,358	31.8	2.5	1,144,086	24.3	2.0
Montana	72,915	9.0	0.1	276,867	34.0	0.4	328,276	40.4	0.5	135,505	16.7	0.2
Nebraska	416,875	29.1	0.6	432,712	30.2	0.7	333,831	23.3	0.6	247,411	17.3	0.4
Nevada	295,112	13.1	0.4	520,752	23.2	0.8	710,363	31.6	1.2	722,133	32.1	1.3
New Hampshire	332,815	30.8	0.5	413,640	38.3	0.6	280,739	26.0	0.5	53,865	5.0	0.1
New Jersey	2,614,617	37.9	3.8	1,605,236	23.3	2.5	1,288,607	18.7	2.1	1,387,523	20.1	2.4
New Mexico	260,169	16.3	0.4	375,342	23.5	0.6	505,243	31.6	0.8	456,639	28.6	0.8
New York	6,450,176	41.7	9.4	4,342,610	28.1	6.7	2,986,144	19.3	4.9	1,679,779	10.9	2.9
North Carolina	788,732	10.0	1.1	1,717,416	21.9	2.6	2,740,627	34.9	4.5	2,606,804	33.2	4.5
North Dakota	197,787	34.2	0.3	226,971	39.2	0.3	127,893	22.1	0.2	25,832	4.5	0.0
Ohio	3,417,042	37.9	5.0	3,261,353	36.2	5.0	1,771,663	19.6	2.9	569,859	6.3	1.0
Oklahoma	156,060	5.3	0.2	424,028	14.3	0.7	842,365	28.5	1.4	1,536,978	51.9	2.7
Oregon	745,666	23.2	1.1	1,314,983	40.9	2.0	891,226	27.7	1.5	261,890	8.1	0.5
Pennsylvania	4,501,448	44.5	6.6	3,271,609	32.4	5.0	1,588,664	15.7	2.6	748,596	7.4	1.3
Puerto Rico	811,137	30.1	1.2	1,254,403	46.5	1.9	547,942	20.3	0.9	83,469	3.1	0.1
Rhode Island	488,660	57.6	0.7	193,699	22.8	0.3	106,699	12.6	0.2	58,684	6.9	0.1
South Carolina	365,961	9.5	0.5	718,617	18.7	1.1	1,536,184	39.9	2.5	1,225,036	31.9	2.1
South Dakota	119,842	18.4	0.2	253,139	38.9	0.4	162,782	25.0	0.3	115,460	17.7	0.2
Tennessee	613,932	11.9	0.9	1,228,257	23.9	1.9	2,008,042	39.0	3.3	1,294,007	25.2	2.2
Texas	1,329,653	6.5	1.9	2,676,384	13.0	4.1	4,336,964	21.1	7.2	12,224,733	59.4	21.2
Utah	391,469	18.4	0.6	633,913	29.8	1.0	580,173	27.3	1.0	518,436	24.4	0.9
Vermont	308,486	60.9	0.4	182,416	36.0	0.3	15,729	3.1	0.0	0	0.0	0.0
Virginia	1,480,271	22.6	2.2	1,674,740	25.6	2.6	2,104,255	32.2	3.5	1,278,109	19.6	2.2
Washington	1,856,844	32.8	2.7	2,061,695	36.4	3.2	1,277,241	22.6	2.1	465,681	8.2	0.8
West Virginia	316,711	21.8	0.5	716,257	49.2	1.1	400,362	27.5	0.7	22,351	1.5	0.0
Wisconsin	2,124,716	47.3	3.1	1,548,602	34.5	2.4	607,506	13.5	1.0	207,522	4.6	0.4
Wyoming	32,430	7.3	0.0	92,953	20.9	0.1	169,508	38.2	0.3	149,226	33.6	0.3
Total^c	68,641,599	27.3	100	65,060,300	25.8	100	60,466,427	24.0	100	57,614,664	22.9	100

Abbreviations: ACS, American Community Survey; SDH, social determinants of health [footnotes only].
Note. Proportion of residents in the census tract without health insurance or health coverage plan at the time of the survey response (individuals aged 18 years and older).
^a Percentage of male residents of area.
^b Percentage of female residents of area.
^c Percentage of residents of area.
^d Percentage of SDH subpopulation total.

Table S5. GINI index among adults, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Gini index (%)
	Male
	<38		38.00–41.99		42.00–45.99		≥46
Area of residence	No.	%^a	No.	%^a	No.	%^a	No.	%^a
Alabama	284,104	15.8	435,038	24.2	464,066	25.9	611,870	34.1
Alaska	103,988	36.2	97,139	33.8	56,754	19.7	29,633	10.3
Arizona	820,334	31.4	688,725	26.4	564,770	21.6	539,808	20.7
Arkansas	132,504	12.0	313,475	28.4	310,858	28.1	348,635	31.5
California	3,678,385	25.0	4,039,884	27.4	3,566,184	24.2	3,445,884	23.4
Colorado	740,911	34.9	544,547	25.7	421,636	19.9	413,163	19.5
Connecticut	279,256	20.6	413,824	30.5	306,802	22.6	355,188	26.2
Delaware	85,654	24.0	133,465	37.4	67,183	18.8	70,113	19.7
District of Columbia	18,842	7.2	25,096	9.6	64,305	24.6	153,373	58.6
Florida	1,591,657	20.1	2,291,228	28.9	1,905,851	24.0	2,147,579	27.1
Georgia	848,703	22.7	1,002,177	26.8	925,189	24.8	956,620	25.6
Hawaii	195,694	35.3	131,665	23.7	122,280	22.0	105,140	19.0
Idaho	148,413	23.9	183,863	29.6	148,059	23.8	140,986	22.7
Illinois	1,178,791	24.6	1,410,961	29.4	1,104,415	23.0	1,105,968	23.0
Indiana	786,925	32.0	818,328	33.2	483,952	19.7	372,791	15.1
Iowa	286,096	24.2	452,538	38.3	261,357	22.1	181,796	15.4
Kansas	378,433	34.9	304,685	28.1	203,355	18.8	196,869	18.2
Kentucky	319,252	19.2	390,338	23.5	428,141	25.8	524,424	31.6
Louisiana	160,077	9.3	381,997	22.3	466,559	27.2	704,021	41.1
Maine	112,261	21.5	147,359	28.3	140,226	26.9	121,759	23.3
Maryland	961,028	43.5	589,232	26.7	333,827	15.1	325,463	14.7
Massachusetts	423,703	16.3	799,928	30.7	707,320	27.1	674,479	25.9
Michigan	997,698	26.6	1,202,885	32.1	808,128	21.5	743,426	19.8
Minnesota	624,721	29.9	684,053	32.7	450,146	21.5	329,938	15.8
Mississippi	159,975	14.8	217,016	20.0	273,636	25.3	431,805	39.9
Missouri	652,296	28.6	654,123	28.7	515,179	22.6	457,688	20.1
Montana	51,867	12.8	109,119	26.8	124,999	30.7	120,640	29.7
Nebraska	233,000	33.1	233,367	33.2	135,690	19.3	101,029	14.4
Nevada	413,340	36.8	295,382	26.3	218,285	19.4	195,521	17.4
New Hampshire	160,757	30.3	196,883	37.1	93,621	17.6	79,645	15.0
New Jersey	774,405	23.4	970,260	29.3	815,601	24.6	756,217	22.8
New Mexico	122,976	16.0	191,463	24.9	189,980	24.7	263,926	34.3
New York	1,271,143	17.3	1,826,811	24.8	1,755,170	23.8	2,513,430	34.1
North Carolina	809,034	21.6	1,019,237	27.2	921,041	24.5	1,004,032	26.8
North Dakota	47,568	16.0	70,582	23.8	94,574	31.9	84,153	28.3
Ohio	1,305,883	30.0	1,274,857	29.3	900,683	20.7	868,905	20.0
Oklahoma	302,942	20.9	408,349	28.1	362,346	25.0	377,124	26.0
Oregon	360,723	22.9	492,114	31.2	401,659	25.5	323,464	20.5
Pennsylvania	1,077,158	22.1	1,649,048	33.9	1,136,205	23.3	1,006,037	20.7
Puerto Rico	30,411	2.4	101,536	8.1	245,798	19.5	881,688	70.0
Rhode Island	77,378	19.0	86,528	21.3	108,947	26.8	133,435	32.8
South Carolina	353,983	19.3	475,592	26.0	485,424	26.5	516,881	28.2
South Dakota	88,353	27.1	91,769	28.1	68,248	20.9	77,868	23.9
Tennessee	518,524	21.0	619,520	25.1	605,106	24.5	727,117	29.4
Texas	3,020,524	29.9	2,561,265	25.4	2,216,668	22.0	2,289,048	22.7
Utah	567,073	53.6	214,058	20.2	151,069	14.3	126,262	11.9
Vermont	41,879	17.0	71,706	29.0	84,128	34.1	49,244	19.9
Virginia	1,252,454	39.5	790,427	24.9	589,555	18.6	538,591	17.0
Washington	886,783	31.6	831,530	29.6	612,504	21.8	476,395	17.0
West Virginia	86,063	12.1	199,655	28.0	217,714	30.5	209,361	29.4
Wisconsin	652,619	29.5	755,601	34.2	464,544	21.0	338,923	15.3
Wyoming	68,830	30.5	65,056	28.8	50,438	22.3	41,591	18.4
Total^c	30,545,371	25.0	33,955,284	27.8	28,150,175	23.0	29,588,946	24.2

Table S5. GINI index among adults, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Gini index (%)
	Female
	<38		38.00–41.99		42.00–45.99		≥46
Area of residence	No.	%^b	No.	%^b	No.	%^b	No.	%^b
Alabama	305,386	15.5	467,912	23.8	508,179	25.8	688,455	34.9
Alaska	95,758	36.5	87,893	33.5	51,192	19.5	27,164	10.4
Arizona	849,027	31.6	714,860	26.6	579,922	21.6	545,571	20.3
Arkansas	140,645	11.9	330,716	28.1	324,415	27.6	381,754	32.4
California	3,738,015	24.5	4,204,152	27.6	3,716,900	24.4	3,585,582	23.5
Colorado	746,797	35.0	552,111	25.9	421,004	19.7	412,094	19.3
Connecticut	290,410	19.8	444,093	30.3	340,101	23.2	390,951	26.7
Delaware	88,980	22.8	146,327	37.6	75,873	19.5	78,474	20.1
District of Columbia	17,900	6.0	26,691	9.0	70,365	23.7	182,386	61.3
Florida	1,694,988	20.0	2,461,293	29.0	2,035,097	24.0	2,295,205	27.0
Georgia	907,287	22.4	1,084,565	26.7	1,004,946	24.8	1,061,402	26.2
Hawaii	185,771	33.2	136,575	24.4	124,904	22.3	111,643	20.0
Idaho	150,630	24.0	185,984	29.6	147,401	23.5	143,297	22.8
Illinois	1,221,148	24.0	1,464,147	28.8	1,175,266	23.1	1,231,586	24.2
Indiana	807,233	31.1	861,756	33.2	520,888	20.1	405,254	15.6
Iowa	284,871	23.3	475,476	39.0	271,509	22.2	188,824	15.5
Kansas	382,703	34.5	315,285	28.4	210,727	19.0	201,159	18.1
Kentucky	334,586	19.0	412,487	23.4	452,004	25.7	561,305	31.9
Louisiana	162,816	8.8	406,451	22.1	507,846	27.6	762,857	41.5
Maine	114,796	20.6	156,904	28.2	150,615	27.1	134,232	24.1
Maryland	1,037,001	42.6	645,180	26.5	378,895	15.6	372,408	15.3
Massachusetts	440,668	15.5	863,429	30.4	770,793	27.1	764,597	26.9
Michigan	1,027,677	25.8	1,272,904	32.0	865,777	21.8	809,656	20.4
Minnesota	630,214	29.4	698,338	32.6	469,027	21.9	346,058	16.1
Mississippi	172,469	14.5	233,547	19.7	298,264	25.2	481,649	40.6
Missouri	679,654	28.0	689,933	28.4	556,026	22.9	500,077	20.6
Montana	52,179	12.8	107,532	26.4	125,141	30.8	122,086	30.0
Nebraska	234,742	32.5	239,998	33.3	139,581	19.3	107,316	14.9
Nevada	419,502	37.3	296,583	26.3	219,729	19.5	190,018	16.9
New Hampshire	161,834	29.4	203,966	37.1	100,096	18.2	84,257	15.3
New Jersey	817,424	22.8	1,043,963	29.2	877,930	24.5	839,934	23.5
New Mexico	128,716	16.1	200,980	25.2	197,184	24.7	272,179	34.1
New York	1,331,565	16.5	1,953,404	24.2	1,904,973	23.6	2,866,650	35.6
North Carolina	857,343	21.0	1,108,946	27.1	999,470	24.5	1,119,680	27.4
North Dakota	44,042	15.6	67,749	24.1	90,720	32.2	79,095	28.1
Ohio	1,364,854	29.3	1,369,974	29.4	973,565	20.9	950,472	20.4
Oklahoma	314,730	20.9	421,182	27.9	376,707	25.0	396,047	26.3
Oregon	367,969	22.5	513,909	31.4	414,009	25.3	339,918	20.8
Pennsylvania	1,118,403	21.4	1,733,917	33.2	1,234,924	23.7	1,128,281	21.6
Puerto Rico	37,943	2.6	114,499	8.0	276,336	19.2	1,008,728	70.2
Rhode Island	79,299	18.0	93,021	21.1	120,910	27.4	148,224	33.6
South Carolina	381,153	19.0	516,874	25.8	528,698	26.4	579,323	28.9
South Dakota	87,599	27.0	90,278	27.8	67,988	20.9	79,120	24.3
Tennessee	553,832	20.7	666,789	25.0	639,061	23.9	810,443	30.4
Texas	3,102,292	29.7	2,647,326	25.3	2,318,493	22.2	2,379,372	22.8
Utah	571,464	53.6	219,646	20.6	151,785	14.2	122,634	11.5
Vermont	42,088	16.2	74,943	28.9	90,207	34.7	52,436	20.2
Virginia	1,291,977	38.5	843,167	25.1	635,496	18.9	585,775	17.5
Washington	892,331	31.3	848,135	29.7	625,305	21.9	485,751	17.0
West Virginia	88,581	11.9	206,038	27.7	228,393	30.7	219,876	29.6
Wisconsin	662,808	29.1	770,690	33.9	484,630	21.3	358,531	15.7
Wyoming	65,925	30.2	63,258	29.0	48,054	22.0	40,965	18.8
Total^c	31,578,025	24.4	35,755,776	27.7	29,897,321	23.1	32,030,751	24.8

Table S5. GINI index among adults, by sex at birth and area of residence, 2014–2018 5-year ACS estimates—census tract level, United States and Puerto Rico
	Gini index (%)
	Total
	<38			38.00–41.99			42.00–45.99			≥46
Area of residence	No.	%^c	%^d	No.	%^c	%^d	No.	%^c	%^d	No.	%^c	%^d
Alabama	589,490	15.7	0.9	902,950	24.0	1.3	972,245	25.8	1.7	1,300,325	34.5	2.1
Alaska	199,746	36.3	0.3	185,032	33.7	0.3	107,946	19.6	0.2	56,797	10.3	0.1
Arizona	1,669,361	31.5	2.7	1,403,585	26.5	2.0	1,144,692	21.6	2.0	1,085,379	20.5	1.8
Arkansas	273,149	12.0	0.4	644,191	28.2	0.9	635,273	27.8	1.1	730,389	32.0	1.2
California	7,416,400	24.7	11.9	8,244,036	27.5	11.8	7,283,084	24.3	12.5	7,031,466	23.5	11.4
Colorado	1,487,708	35.0	2.4	1,096,658	25.8	1.6	842,640	19.8	1.5	825,257	19.4	1.3
Connecticut	569,666	20.2	0.9	857,917	30.4	1.2	646,903	22.9	1.1	746,139	26.5	1.2
Delaware	174,634	23.4	0.3	279,792	37.5	0.4	143,056	19.2	0.2	148,587	19.9	0.2
District of Columbia	36,742	6.6	0.1	51,787	9.3	0.1	134,670	24.1	0.2	335,759	60.1	0.5
Florida	3,286,645	20.0	5.3	4,752,521	28.9	6.8	3,940,948	24.0	6.8	4,442,784	27.1	7.2
Georgia	1,755,990	22.5	2.8	2,086,742	26.8	3.0	1,930,135	24.8	3.3	2,018,022	25.9	3.3
Hawaii	381,465	34.3	0.6	268,240	24.1	0.4	247,184	22.2	0.4	216,783	19.5	0.4
Idaho	299,043	23.9	0.5	369,847	29.6	0.5	295,460	23.7	0.5	284,283	22.8	0.5
Illinois	2,399,939	24.3	3.9	2,875,108	29.1	4.1	2,279,681	23.0	3.9	2,337,554	23.6	3.8
Indiana	1,594,158	31.5	2.6	1,680,084	33.2	2.4	1,004,840	19.9	1.7	778,045	15.4	1.3
Iowa	570,967	23.8	0.9	928,014	38.6	1.3	532,866	22.2	0.9	370,620	15.4	0.6
Kansas	761,136	34.7	1.2	619,970	28.3	0.9	414,082	18.9	0.7	398,028	18.1	0.6
Kentucky	653,838	19.1	1.1	802,825	23.5	1.2	880,145	25.7	1.5	1,085,729	31.7	1.8
Louisiana	322,893	9.1	0.5	788,448	22.2	1.1	974,405	27.4	1.7	1,466,878	41.3	2.4
Maine	227,057	21.1	0.4	304,263	28.2	0.4	290,841	27.0	0.5	255,991	23.7	0.4
Maryland	1,998,029	43.0	3.2	1,234,412	26.6	1.8	712,722	15.4	1.2	697,871	15.0	1.1
Massachusetts	864,371	15.9	1.4	1,663,357	30.5	2.4	1,478,113	27.1	2.5	1,439,076	26.4	2.3
Michigan	2,025,375	26.2	3.3	2,475,789	32.0	3.6	1,673,905	21.7	2.9	1,553,082	20.1	2.5
Minnesota	1,254,935	29.7	2.0	1,382,391	32.7	2.0	919,173	21.7	1.6	675,996	16.0	1.1
Mississippi	332,444	14.7	0.5	450,563	19.9	0.6	571,900	25.2	1.0	913,454	40.3	1.5
Missouri	1,331,950	28.3	2.1	1,344,056	28.6	1.9	1,071,205	22.8	1.8	957,765	20.4	1.6
Montana	104,046	12.8	0.2	216,651	26.6	0.3	250,140	30.7	0.4	242,726	29.8	0.4
Nebraska	467,742	32.8	0.8	473,365	33.2	0.7	275,271	19.3	0.5	208,345	14.6	0.3
Nevada	832,842	37.0	1.3	591,965	26.3	0.8	438,014	19.5	0.8	385,539	17.1	0.6
New Hampshire	322,591	29.8	0.5	400,849	37.1	0.6	193,717	17.9	0.3	163,902	15.2	0.3
New Jersey	1,591,829	23.1	2.6	2,014,223	29.2	2.9	1,693,531	24.6	2.9	1,596,151	23.1	2.6
New Mexico	251,692	16.1	0.4	392,443	25.0	0.6	387,164	24.7	0.7	536,105	34.2	0.9
New York	2,602,708	16.9	4.2	3,780,215	24.5	5.4	3,660,143	23.7	6.3	5,380,080	34.9	8.7
North Carolina	1,666,377	21.3	2.7	2,128,183	27.1	3.1	1,920,511	24.5	3.3	2,123,712	27.1	3.4
North Dakota	91,610	15.8	0.1	138,331	23.9	0.2	185,294	32.0	0.3	163,248	28.2	0.3
Ohio	2,670,737	29.6	4.3	2,644,831	29.4	3.8	1,874,248	20.8	3.2	1,819,377	20.2	3.0
Oklahoma	617,672	20.9	1.0	829,531	28.0	1.2	739,053	25.0	1.3	773,171	26.1	1.3
Oregon	728,692	22.7	1.2	1,006,023	31.3	1.4	815,668	25.4	1.4	663,382	20.6	1.1
Pennsylvania	2,195,561	21.8	3.5	3,382,965	33.5	4.9	2,371,129	23.5	4.1	2,134,318	21.2	3.5
Puerto Rico	68,354	2.5	0.1	216,035	8.0	0.3	522,134	19.4	0.9	1,890,416	70.1	3.1
Rhode Island	156,677	18.5	0.3	179,549	21.2	0.3	229,857	27.1	0.4	281,659	33.2	0.5
South Carolina	735,136	19.2	1.2	992,466	25.9	1.4	1,014,122	26.4	1.7	1,096,204	28.6	1.8
South Dakota	175,952	27.0	0.3	182,047	28.0	0.3	136,236	20.9	0.2	156,988	24.1	0.3
Tennessee	1,072,356	20.9	1.7	1,286,309	25.0	1.8	1,244,167	24.2	2.1	1,537,560	29.9	2.5
Texas	6,122,816	29.8	9.9	5,208,591	25.4	7.5	4,535,161	22.1	7.8	4,668,420	22.7	7.6
Utah	1,138,537	53.6	1.8	433,704	20.4	0.6	302,854	14.3	0.5	248,896	11.7	0.4
Vermont	83,967	16.6	0.1	146,649	28.9	0.2	174,335	34.4	0.3	101,680	20.1	0.2
Virginia	2,544,431	39.0	4.1	1,633,594	25.0	2.3	1,225,051	18.8	2.1	1,124,366	17.2	1.8
Washington	1,779,114	31.4	2.9	1,679,665	29.7	2.4	1,237,809	21.9	2.1	962,146	17.0	1.6
West Virginia	174,644	12.0	0.3	405,693	27.9	0.6	446,107	30.6	0.8	429,237	29.5	0.7
Wisconsin	1,315,427	29.3	2.1	1,526,291	34.0	2.2	949,174	21.1	1.6	697,454	15.5	1.1
Wyoming	134,755	30.3	0.2	128,314	28.9	0.2	98,492	22.2	0.2	82,556	18.6	0.1
Total^c	62,123,396	24.7	100	69,711,060	27.7	100	58,047,496	23.1	100	61,619,697	24.5	100

Abbreviations: ACS, American Community Survey; SDH, social determinants of health [footnotes only].
Note. proportion of household income distribution within the census tract during the 12 months before the survey response.
^a Percentage of male residents of area.
^b Percentage of female residents of area.
^c Percentage of residents of area.
^d Percentage of SDH subpopulation total.

Table A1. Diagnoses of HIV infection among black/African American adults, by transmission category, sex at birth, and selected social determinants of health, 2018—census tract level, United States and Puerto Rico
	Male-to-male sexual contact		Injection drug use		Male-to-male sexual contact and injection drug use		Heterosexual contact^a
	No.	%	No.	%	No.	%	No.	%
Male
Below federal poverty level (%)
<6	696	8.7	28	8.5	10	4.7	139	9.3
6.00–10.99	1,334	16.7	43	13.3	37	17.6	252	16.9
11.00–17.99	2,029	25.4	82	25.0	45	21.5	357	23.9
≥18	3,929	49.2	174	53.2	118	56.3	746	49.9
Less than high school diploma (%)
<6	1,066	13.3	33	10.2	19	9.0	157	10.5
6.00–9.99	1,298	16.2	42	12.9	31	15.0	193	12.9
10.00–17.99	2,611	32.7	106	32.5	72	34.5	498	33.3
≥18	3,015	37.7	145	44.5	87	41.5	648	43.3
Median household income (U.S. $)
<42,000	3,817	47.8	165	50.7	104	49.9	726	48.7
42,000–56,999	1,916	24.0	77	23.6	47	22.3	370	24.8
57,000–77,999	1,367	17.1	46	14.2	36	17.0	239	16.0
≥78,000	880	11.0	38	11.5	22	10.7	158	10.6
Without health insurance (%)
<5	729	9.1	39	12.1	23	11.2	150	10.1
5.00–8.99	1,336	16.7	61	18.7	38	17.9	219	14.6
9.00–14.99	2,206	27.6	99	30.2	60	28.6	354	23.7
≥15	3,719	46.5	128	39.1	88	42.3	771	51.6
Gini index (%)
<38	1,469	18.4	39	11.8	36	17.3	255	17.1
38.00–41.99	1,786	22.4	81	24.9	33	15.6	333	22.3
42.00–45.99	1,843	23.1	73	22.4	44	21.1	367	24.6
≥46	2,887	36.2	134	40.9	96	46.0	537	36.0
Subtotal^b	8,140	100	335	100	215	100	1,510	100
Female
Below federal poverty level (%)
<6	—	—	20	7.6	—	—	281	8.6
6.00–10.99	—	—	36	13.9	—	—	519	15.9
11.00–17.99	—	—	58	22.1	—	—	834	25.6
≥18	—	—	147	56.4	—	—	1,620	49.8
Less than high school diploma (%)
<6	—	—	19	7.4	—	—	314	9.6
6.00–9.99	—	—	39	14.8	—	—	461	14.2
10.00–17.99	—	—	91	34.9	—	—	1,093	33.6
≥18	—	—	112	42.8	—	—	1,387	42.6
Median household income (U.S. $)
<42,000	—	—	138	53.1	—	—	1,610	49.5
42,000–56,999	—	—	64	24.5	—	—	755	23.2
57,000–77,999	—	—	35	13.5	—	—	530	16.3
≥78,000	—	—	23	8.9	—	—	356	11.0
Without health insurance (%)
<5	—	—	24	9.4	—	—	311	9.6
5.00–8.99	—	—	45	17.3	—	—	480	14.7
9.00–14.99	—	—	77	29.7	—	—	828	25.4
≥15	—	—	114	43.7	—	—	1,635	50.2
Gini index (%)
<38	—	—	30	11.6	—	—	568	17.4
38.00–41.99	—	—	45	17.4	—	—	784	24.1
42.00–45.99	—	—	65	24.7	—	—	757	23.3
≥46	—	—	121	46.2	—	—	1,145	35.2
Subtotal^b	—	—	264	100	—	—	3,315	100
Total^c	8,140	100	598	100	215	100	4,825	100

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Row entries indicate categories based on census tracts; data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Data have been statistically adjusted to account for missing transmission category.
For the definitions of SDH indicator variables used in this report, see https://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
^b Because column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.
^c Totals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

Table A2. Diagnoses of HIV infection among Hispanic/Latino adults, by transmission category, sex at birth, and selected social determinants of health, 2018—census tract level, United States and Puerto Rico
	Male-to-male sexual contact		Injection drug use		Male-to-male sexual contact and injection drug use		Heterosexual contact^a
	No.	%	No.	%	No.	%	No.	%
Male
Below federal poverty level (%)
<6	629	9.2	21	8.1	29	10.3	47	8.4
6.00–10.99	1,427	21.0	52	19.8	57	19.9	92	16.6
11.00–17.99	1,890	27.8	56	21.4	77	27.2	120	21.5
≥18	2,860	42.0	132	50.7	121	42.5	297	53.4
Less than high school diploma (%)
<6	843	12.4	27	10.2	37	13.1	45	8.1
6.00–9.99	837	12.3	23	8.6	36	12.5	70	12.5
10.00–17.99	1,598	23.5	57	21.8	63	22.1	134	24.1
≥18	3,533	51.9	155	59.4	149	52.2	308	55.3
Median household income (U.S. $)
<42,000	2,409	35.4	111	42.6	103	36.0	262	47.2
42,000–56,999	1,865	27.4	71	27.4	75	26.2	143	25.7
57,000–77,999	1,503	22.1	44	16.9	55	19.4	85	15.3
≥78,000	1,025	15.1	34	13.1	52	18.4	66	11.8
Without health insurance (%)
<5	599	8.8	28	10.6	36	12.8	44	7.9
5.00–8.99	1,021	15.0	55	21.0	56	19.6	86	15.5
9.00–14.99	1,579	23.2	63	24.4	72	25.4	126	22.7
≥15	3,608	53.0	115	44.1	120	42.2	299	53.9
Gini index (%)
<38	1,366	20.1	45	17.2	64	22.5	95	17.1
38.00–41.99	1,736	25.5	75	28.9	73	25.6	131	23.5
42.00–45.99	1,665	24.5	68	26.2	64	22.6	135	24.3
≥46	2,038	29.9	72	27.7	83	29.3	195	35.1
Subtotal^b	6,892	100	264	100	288	100	561	100
Female
Below federal poverty level (%)
<6	—	—	8	6.1	—	—	77	7.8
6.00–10.99	—	—	22	16.2	—	—	150	15.2
11.00–17.99	—	—	31	23.0	—	—	255	25.8
≥18	—	—	73	54.7	—	—	506	51.2
Less than high school diploma (%)
<6	—	—	10	7.6	—	—	76	7.7
6.00–9.99	—	—	12	9.0	—	—	95	9.6
10.00–17.99	—	—	30	22.3	—	—	227	23.0
≥18	—	—	81	61.1	—	—	590	59.7
Median household income (U.S. $)
<42,000	—	—	63	47.4	—	—	460	46.5
42,000–56,999	—	—	38	28.9	—	—	257	26.0
57,000–77,999	—	—	19	14.4	—	—	162	16.4
≥78,000	—	—	12	9.3	—	—	110	11.1
Without health insurance (%)
<5	—	—	14	10.2	—	—	83	8.3
5.00–8.99	—	—	25	18.6	—	—	142	14.4
9.00–14.99	—	—	30	22.2	—	—	230	23.3
≥15	—	—	65	49.1	—	—	533	54.0
Gini index (%)
<38	—	—	17	12.7	—	—	168	17.0
38.00–41.99	—	—	37	27.5	—	—	247	25.0
42.00–45.99	—	—	29	21.9	—	—	236	23.8
≥46	—	—	50	37.9	—	—	337	34.1
Subtotal^b	—	—	135	100	—	—	1,002	100
Total^c	6,892	100	399	100	288	100	1,563	100

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Row entries indicate categories based on census tracts; data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Data have been statistically adjusted to account for missing transmission category.
Hispanics/Latinos can be of any race.
For the definitions of SDH indicator variables used in this report, see https://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
^b Because column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.
^c Totals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

Table A3. Diagnoses of HIV infection among white adults, by transmission category, sex at birth, and selected social determinants of health, 2018—census tract level, United States and Puerto Rico
	Male-to-male sexual contact		Injection drug use		Male-to-male sexual contact and injection drug use		Heterosexual contact^a
	No.	%	No.	%	No.	%	No.	%
Male
Below federal poverty level (%)
<6	1,173	20.9	59	14.1	99	18.4	97	25.6
6.00–10.99	1,609	28.6	83	19.8	136	25.3	108	28.3
11.00–17.99	1,430	25.5	112	26.6	148	27.6	83	21.8
≥18	1,405	25.0	166	39.5	154	28.7	93	24.4
Less than high school diploma (%)
<6	1,722	30.6	67	16.1	160	29.9	78	20.5
6.00–9.99	1,264	22.5	82	19.7	106	19.6	100	26.3
10.00–17.99	1,519	27.0	119	28.3	162	30.1	123	32.4
≥18	1,113	19.8	151	36.0	110	20.4	79	20.8
Median household income (U.S. $)
<42,000	1,250	22.3	160	38.3	143	26.6	82	21.6
42,000–56,999	1,393	24.8	90	21.6	156	29.1	99	25.9
57,000–77,999	1,532	27.3	100	23.9	122	22.8	115	30.3
≥78,000	1,441	25.7	68	16.2	116	21.5	84	22.2
Without health insurance (%)
<5	1,276	22.7	74	17.6	117	21.7	68	17.7
5.00–8.99	1,389	24.7	113	26.8	143	26.7	92	24.1
9.00–14.99	1,484	26.4	109	26.0	130	24.1	105	27.6
≥15	1,467	26.1	124	29.6	147	27.4	116	30.5
Gini index (%)
<38	1,236	22.0	96	22.9	104	19.3	92	24.2
38.00–41.99	1,389	24.7	92	22.0	142	26.4	93	24.5
42.00–45.99	1,358	24.2	100	23.9	110	20.4	95	25.1
≥46	1,633	29.1	130	31.2	182	33.9	100	26.3
Subtotal^b	5,724	100	428	100	547	100	383	100
Female
Below federal poverty level (%)
<6	—	—	45	11.5	—	—	132	16.3
6.00–10.99	—	—	101	25.5	—	—	186	23.0
11.00–17.99	—	—	82	20.8	—	—	233	28.9
≥18	—	—	167	42.3	—	—	257	31.8
Less than high school diploma (%)
<6	—	—	60	15.3	—	—	147	18.2
6.00–9.99	—	—	68	17.2	—	—	167	20.7
10.00–17.99	—	—	127	32.1	—	—	257	31.8
≥18	—	—	140	35.5	—	—	237	29.3
Median household income (U.S. $)
<42,000	—	—	150	38.1	—	—	247	30.6
42,000–56,999	—	—	106	26.9	—	—	251	31.1
57,000–77,999	—	—	81	20.5	—	—	169	20.9
≥78,000	—	—	57	14.5	—	—	141	17.5
Without health insurance (%)
<5	—	—	81	20.4	—	—	131	16.2
5.00–8.99	—	—	78	19.8	—	—	181	22.4
9.00–14.99	—	—	110	27.8	—	—	212	26.3
≥15	—	—	126	32.0	—	—	284	35.1
Gini index (%)
<38	—	—	85	21.6	—	—	173	21.3
38.00–41.99	—	—	95	24.1	—	—	224	27.7
42.00–45.99	—	—	108	27.4	—	—	184	22.8
≥46	—	—	106	27.0	—	—	228	28.2
Subtotal^b	—	—	406	100	—	—	830	100
Total^c	5,724	100	833	100	547	100	1,212	100

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Row entries indicate categories based on census tracts; data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Data have been statistically adjusted to account for missing transmission category.
For the definitions of SDH indicator variables used in this report, see https://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
^b Because column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.
^c Totals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

Table B1. Diagnoses of HIV infection among black/African American adults, by age at diagnosis, sex at birth, and selected social determinants of health, 2018—census tract level, United States and Puerto Rico
	18–24 years		25–34 years		35–44 years		45–54 years		≥55 years
	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate
Male
Below federal poverty level (%)
<6	248	88.8	343	95.4	124	33.3	81	21.2	77	15.1
6.00–10.99	444	101.5	667	107.9	259	47.5	176	33.1	121	15.6
11.00–17.99	738	130.8	974	123.9	399	62.4	215	34.4	187	18.6
≥18	1,448	136.3	1,948	158.9	687	72.8	514	53.1	375	21.7
Less than high school diploma (%)
<6	363	88.8	529	126.4	190	52.3	110	31.5	85	17.5
6.00–9.99	472	116.5	627	121.3	211	46.5	143	31.7	111	16.9
10.00–17.99	961	129.8	1,287	131.5	496	60.1	296	35.6	249	18.2
≥18	1,084	133.7	1,490	135.1	572	65.0	439	49.3	315	20.7
Median household income (U.S. $)
<42,000	1,447	142.7	1,902	158.9	631	68.2	490	51.6	347	19.9
42,000–56,999	694	120.1	908	116.2	394	62.9	209	35.0	206	22.2
57,000–77,999	449	105.7	700	118.4	270	52.2	158	31.8	111	15.3
≥78,000	284	91.6	416	102.8	174	41.3	129	28.5	95	15.4
Without health insurance (%)
<5	241	75.1	353	99.1	154	46.5	103	29.9	92	17.4
5.00–8.99	490	100.8	636	105.9	232	44.7	168	32.0	129	15.3
9.00–14.99	786	117.1	1,080	124.1	403	55.1	256	35.2	196	16.5
≥15	1,363	156.7	1,864	160.4	680	74.1	459	50.6	343	23.5
Gini index (%)
<38	541	111.7	724	110.7	257	42.6	161	27.6	117	15.3
38.00–41.99	636	118.8	877	122.0	338	56.9	212	35.5	171	18.9
42.00–45.99	643	121.0	938	137.3	343	60.2	221	38.8	183	19.1
≥46	1,057	134.9	1,390	150.4	531	73.1	392	52.2	288	20.8
Subtotal^a	2,950	124.7	3,985	132.1	1,495	59.3	1,010	40.1	769	19.1
Female
Below federal poverty level (%)
<6	26	11.2	64	18.7	79	20.2	72	17.6	62	10.2
6.00–10.99	78	19.8	119	19.5	129	21.6	113	19.2	119	11.8
11.00–17.99	125	23.2	224	27.5	227	32.1	167	23.5	150	11.3
≥18	242	21.7	519	37.2	417	37.2	325	28.4	277	11.8
Less than high school diploma (%)
<6	35	8.6	87	20.2	75	18.9	72	18.6	69	11.3
6.00–9.99	60	15.1	124	22.6	120	22.8	103	20.1	93	10.8
10.00–17.99	161	21.8	305	28.3	291	30.1	235	23.9	200	10.9
≥18	215	28.8	410	37.0	366	39.5	267	27.6	246	12.4
Median household income (U.S. $)
<42,000	240	22.5	512	37.0	425	38.1	325	28.5	258	10.8
42,000–56,999	118	22.1	210	26.4	189	27.7	148	21.8	158	12.7
57,000–77,999	73	18.8	124	21.1	150	26.3	114	20.5	106	11.3
≥78,000	40	14.3	80	20.2	87	19.5	90	18.9	86	11.7
Without health insurance (%)
<5	36	12.4	69	20.8	82	24.3	76	21.1	77	11.7
5.00–8.99	67	14.7	127	20.4	135	23.4	97	16.5	103	9.5
9.00–14.99	115	17.4	249	26.8	223	26.6	178	21.0	143	9.0
≥15	253	28.7	481	37.6	412	38.7	326	30.9	285	14.5
Gini index (%)
<38	71	16.4	126	19.2	164	24.8	135	21.0	105	11.0
38.00–41.99	112	22.6	237	32.3	184	27.4	169	25.0	132	11.1
42.00–45.99	112	21.8	237	32.6	175	27.6	144	22.2	156	12.3
≥46	176	21.2	326	31.2	329	38.7	229	26.0	215	11.4
Subtotal^a	478	20.9	946	29.9	866	30.7	689	24.2	620	11.7
Total^b	3,428	73.7	4,931	79.8	2,361	44.2	1,699	31.6	1,389	14.9

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Row entries indicate categories based on census tracts; data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Reported numbers less than 12, and rates based on these numbers, should be interpreted with caution. Rates are per 100,000 population.
For the definitions of SDH indicator variables used in this report, see https://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Because column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.
^b Totals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

Table B2. Diagnoses of HIV infection among Hispanic/Latino adults, by age at diagnosis, sex at birth, and selected social determinants of health, 2018—census tract level, United States and Puerto Rico
	18–24 years		25–34 years		35–44 years		45–54 years		≥55 years
	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate
Male
Below federal poverty level (%)
<6	141	32.0	302	50.8	144	23.7	96	18.4	43	7.6
6.00–10.99	327	41.9	669	58.6	353	34.0	190	23.2	90	9.6
11.00–17.99	403	42.3	907	65.6	431	35.4	280	29.7	122	11.2
≥18	723	50.3	1,306	71.3	697	44.6	464	36.8	221	12.7
Less than high school diploma (%)
<6	187	37.5	406	73.2	187	37.6	118	28.5	54	11.4
6.00–9.99	197	44.0	403	62.5	207	35.4	102	22.5	56	10.4
10.00–17.99	348	41.6	768	64.3	379	35.0	247	29.1	112	10.8
≥18	862	46.6	1,609	62.3	856	37.5	564	30.7	255	11.1
Median household income (U.S. $)
<42,000	618	51.3	1,097	70.7	574	43.3	414	38.6	182	11.6
42,000–56,999	421	41.9	888	64.1	443	36.9	263	28.2	140	13.1
57,000–77,999	330	40.8	719	61.1	346	32.7	202	24.4	92	10.0
≥78,000	225	38.6	478	57.7	261	31.2	151	21.3	62	8.0
Without health insurance (%)
<5	144	31.9	295	56.6	136	27.6	84	19.2	48	8.0
5.00–8.99	250	39.1	475	56.0	241	31.3	166	26.1	85	9.8
9.00–14.99	367	43.1	768	64.1	379	36.0	219	26.2	108	10.5
≥15	833	49.6	1,647	69.1	869	41.2	561	34.2	235	12.8
Gini index (%)
<38	323	35.4	655	52.4	326	27.9	191	21.0	75	8.0
38.00–41.99	415	42.9	829	61.7	401	32.9	255	26.3	116	10.4
42.00–45.99	396	49.2	742	64.8	405	40.3	269	33.6	122	12.1
≥46	460	50.0	957	79.2	493	48.0	315	36.6	163	12.9
Subtotal^a	1,616	44.5	3,222	64.8	1,646	37.0	1,043	29.3	482	11.1
Female
Below federal poverty level (%)
<6	13	3.3	27	4.8	23	3.7	12	2.2	10	1.5
6.00–10.99	19	2.6	37	3.5	48	4.8	38	4.7	30	2.7
11.00–17.99	30	3.4	69	5.6	70	6.2	64	7.1	53	4.2
≥18	67	4.9	151	8.9	125	8.3	142	11.2	95	4.6
Less than high school diploma (%)
<6	13	2.7	18	3.3	24	4.6	18	4.0	13	2.2
6.00–9.99	15	3.4	33	5.4	24	4.1	20	4.3	15	2.2
10.00–17.99	25	3.2	58	5.2	57	5.5	72	8.5	45	3.7
≥18	76	4.5	175	7.7	161	7.6	146	8.2	115	4.4
Median household income (U.S. $)
<42,000	62	5.4	136	9.5	119	9.2	121	11.0	86	4.6
42,000–56,999	33	3.6	71	5.7	70	6.2	70	7.7	52	4.2
57,000–77,999	17	2.2	48	4.4	50	5.0	40	5.0	26	2.4
≥78,000	17	3.1	29	3.7	27	3.2	25	3.4	24	2.6
Without health insurance (%)
<5	12	2.8	26	5.1	20	3.9	19	4.1	19	2.6
5.00–8.99	18	2.9	32	3.9	45	5.8	43	6.6	29	2.7
9.00–14.99	27	3.3	65	5.9	58	5.7	58	6.8	52	4.2
≥15	72	4.6	161	7.6	143	7.3	136	8.7	88	4.2
Gini index (%)
<38	24	2.9	53	4.6	48	4.3	40	4.5	20	1.9
38.00–41.99	33	3.6	62	5.0	70	6.0	66	6.9	53	4.1
42.00–45.99	30	4.0	68	6.5	69	7.2	61	7.6	38	3.2
≥46	42	4.7	101	9.1	79	7.8	89	10.0	77	4.9
Subtotal^a	134	3.9	289	6.3	269	6.3	259	7.3	189	3.7
Total^b	1,750	24.9	3,511	36.9	1,915	22.0	1,302	18.4	671	7.1

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Row entries indicate categories based on census tracts; data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Reported numbers less than 12, and rates based on these numbers, should be interpreted with caution. Rates are per 100,000 population.
Hispanics/Latinos can be of any race.
For the definitions of SDH indicator variables used in this report, see https://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Because column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.
^b Totals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

Table B3. Diagnoses of HIV infection among white adults, by age at diagnosis, sex at birth, and selected social determinants of health, 2018—census tract level, United States and Puerto Rico
	18–24 years		25–34 years		35–44 years		45–54 years		≥55 years
	No.	Rate	No.	Rate	No.	Rate	No.	Rate	No.	Rate
Male
Below federal poverty level (%)
<6	227	10.4	451	13.6	253	6.7	277	6.0	222	2.2
6.00–10.99	282	12.1	623	15.4	372	9.9	352	8.2	308	3.0
11.00–17.99	227	12.1	643	20.3	386	14.4	286	9.5	231	3.2
≥18	253	11.8	677	32.0	385	25.0	295	17.6	209	5.3
Less than high school diploma (%)
<6	295	8.9	674	16.4	401	10.1	359	7.7	300	2.9
6.00–9.99	225	10.6	525	15.7	295	9.5	269	7.5	239	2.8
10.00–17.99	289	13.5	641	18.4	400	12.6	343	9.3	251	2.9
≥18	180	18.3	555	32.5	300	20.2	239	14.0	180	4.6
Median household income (U.S. $)
<42,000	232	12.5	592	30.3	341	22.4	279	16.1	192	4.4
42,000–56,999	234	10.9	641	19.6	344	12.3	284	8.9	236	2.9
57,000–77,999	274	12.5	636	17.0	380	11.2	309	8.0	272	3.0
≥78,000	249	11.0	524	14.3	330	8.2	337	7.0	270	2.7
Without health insurance (%)
<5	229	8.2	469	12.6	306	7.9	292	6.2	240	2.2
5.00–8.99	258	10.3	603	16.5	349	10.3	289	7.4	239	2.7
9.00–14.99	238	11.9	662	21.0	353	12.8	337	10.9	239	3.3
≥15	264	20.9	660	31.2	388	22.5	292	15.2	252	5.6
Gini index (%)
<38	254	12.1	517	15.4	290	8.9	251	6.8	216	2.9
38.00–41.99	268	11.9	584	16.4	324	9.5	316	7.9	225	2.4
42.00–45.99	215	11.7	569	19.9	341	12.9	305	9.8	235	3.1
≥46	252	10.8	723	25.5	440	18.3	337	12.1	294	4.1
Subtotal^a	1,012	11.8	2,439	19.3	1,418	12.1	1,232	9.0	986	3.1
Female
Below federal poverty level (%)
<6	18	0.9	50	1.5	46	1.2	32	0.7	32	0.3
6.00–10.99	37	1.7	96	2.4	62	1.7	52	1.2	41	0.3
11.00–17.99	29	1.6	89	2.9	88	3.4	76	2.5	34	0.4
≥18	51	2.4	128	6.5	118	8.0	77	4.7	51	1.1
Less than high school diploma (%)
<6	21	0.7	66	1.6	53	1.3	30	0.6	39	0.3
6.00–9.99	29	1.4	70	2.1	53	1.7	50	1.4	34	0.3
10.00–17.99	50	2.5	119	3.5	87	2.8	87	2.4	42	0.4
≥18	35	3.9	109	6.9	121	8.7	70	4.3	43	1.0
Median household income (U.S. $)
<42,000	43	2.3	119	6.5	117	7.9	78	4.5	41	0.8
42,000–56,999	41	2.1	113	3.6	87	3.2	69	2.2	48	0.5
57,000–77,999	30	1.4	69	1.9	63	1.9	53	1.4	36	0.3
≥78,000	21	1.0	62	1.7	46	1.1	37	0.8	33	0.3
Without health insurance (%)
<5	21	0.8	62	1.7	61	1.6	35	0.7	34	0.3
5.00–8.99	23	1.0	85	2.4	59	1.8	56	1.4	37	0.4
9.00–14.99	48	2.5	86	2.8	84	3.1	67	2.2	38	0.5
≥15	43	3.6	130	6.5	110	6.7	79	4.2	49	1.0
Gini index (%)
<38	30	1.6	81	2.5	65	2.0	49	1.3	33	0.4
38.00–41.99	37	1.7	87	2.5	88	2.6	65	1.6	43	0.4
42.00–45.99	33	1.9	88	3.2	80	3.0	53	1.7	39	0.4
≥46	35	1.5	107	3.9	80	3.4	70	2.5	43	0.5
Subtotal^a	139	1.7	375	3.0	320	2.8	246	1.8	160	0.4
Total^b	1,151	6.9	2,814	11.3	1,738	7.5	1,478	5.4	1,146	1.7

Abbreviation: SDH, social determinants of health [footnotes only].
Note. Row entries indicate categories based on census tracts; data reflect the census tract of the person’s residential address at the time they received an HIV diagnosis. Reported numbers less than 12, and rates based on these numbers, should be interpreted with caution. Rates are per 100,000 population.
For the definitions of SDH indicator variables used in this report, see https://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2018_ACSSubjectDefinitions.pdfpdf iconexternal icon.
^a Because column subtotals were calculated independently of the values for the subpopulations, the values in each column may not sum to the column subtotals. See Technical Notes for criteria used to define SDH subpopulations.
^b Totals do not represent all adults whose HIV infection was diagnosed during 2018 in these areas. See Technical Notes for exclusion criteria.

Social Determinants of Health among Adults with Diagnosed HIV Infection, 2018: Tables

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