Social Determinants of Health among Adults with Diagnosed HIV Infection in the United States and Puerto Rico, 2021: Tables

All Tables
Table 1. Diagnoses of HIV infection among adults aged ≥18 years, by age at diagnosis, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
18–24 years 25–34 years 35–44 years
No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 785 3,845,493 20.4 1,610 6,032,986 26.7 846 6,734,392 12.6
6.00–9.99 876 3,233,952 27.1 1,882 5,508,690 34.2 975 5,144,427 19.0
10.00–16.99 1,440 3,791,488 38.0 2,833 6,166,669 45.9 1,457 5,319,911 27.4
≥17 2,279 4,657,916 48.9 3,742 5,363,698 69.8 1,840 4,250,791 43.3
Less than high school diploma (%)
<5 865 4,561,209 19.0 1,788 5,757,323 31.1 909 5,575,880 16.3
5.00–8.99 953 3,486,411 27.3 1,788 5,469,622 32.7 921 5,228,532 17.6
9.00–15.99 1,399 3,678,221 38.0 2,702 5,888,810 45.9 1,315 5,332,674 24.7
≥16 2,164 3,934,261 55.0 3,791 6,047,551 62.7 1,975 5,383,574 36.7
Median household income (U.S. $)
<49,000 2,241 4,326,296 51.8 3,701 5,194,613 71.2 1,792 4,214,202 42.5
49,000–65,999 1,352 3,791,448 35.7 2,667 5,882,466 45.3 1,299 5,045,529 25.7
66,000–89,999 1,060 3,656,422 29.0 2,144 6,139,556 34.9 1,152 5,635,355 20.4
≥90,000 693 3,561,991 19.5 1,513 5,771,175 26.2 854 6,482,523 13.2
Without health insurance (%)
<4 602 3,623,030 16.6 1,183 4,971,242 23.8 682 5,218,724 13.1
4.00–7.99 1,021 4,160,260 24.5 2,015 6,102,217 33.0 1,056 5,720,586 18.5
8.00–13.99 1,433 3,833,569 37.4 2,800 5,918,620 47.3 1,313 5,218,861 25.2
≥14 2,325 3,982,959 58.4 4,069 6,081,398 66.9 2,067 5,291,528 39.1
Gini index (%)
<37 1,129 3,646,162 31.0 2,050 5,699,655 36.0 998 5,642,200 17.7
37.00–40.99 1,145 3,664,538 31.2 2,259 5,804,523 38.9 1,162 5,490,195 21.2
41.00–45.99 1,460 4,103,239 35.6 2,772 6,267,616 44.2 1,369 5,742,778 23.8
≥46 1,644 4,068,637 40.4 2,983 5,277,796 56.5 1,586 4,554,336 34.8
Subtotala 5,585 15,660,102 35.7 10,452 23,163,306 45.1 5,335 21,520,660 24.8
Female
Below federal poverty level (%)
<6 83 3,522,464 2.4 209 5,971,810 3.5 191 6,804,216 2.8
6.00–9.99 121 3,025,001 4.0 266 5,393,072 4.9 235 5,041,263 4.7
10.00–16.99 169 3,636,875 4.6 407 5,971,358 6.8 428 5,202,293 8.2
≥17 327 4,717,907 6.9 723 5,274,543 13.7 649 4,273,089 15.2
Less than high school diploma (%)
<5 84 4,512,193 1.9 185 5,732,610 3.2 156 5,661,750 2.8
5.00–8.99 113 3,343,801 3.4 314 5,446,838 5.8 234 5,248,213 4.5
9.00–15.99 191 3,516,937 5.4 437 5,805,511 7.5 432 5,318,638 8.1
≥16 312 3,620,941 8.6 669 5,631,889 11.9 681 5,096,180 13.4
Median household income (U.S. $)
<49,000 323 4,305,272 7.5 734 5,171,876 14.2 694 4,306,539 16.1
49,000–65,999 167 3,592,414 4.6 424 5,660,151 7.5 354 4,914,054 7.2
66,000–89,999 129 3,464,300 3.7 258 5,968,494 4.3 257 5,495,597 4.7
≥90,000 79 3,356,316 2.4 186 5,759,025 3.2 193 6,560,399 2.9
Without health insurance (%)
<4 75 3,452,690 2.2 161 4,945,655 3.3 143 5,282,989 2.7
4.00–7.99 139 4,010,496 3.5 302 6,024,972 5.0 287 5,735,806 5.0
8.00–13.99 172 3,719,862 4.6 396 5,790,714 6.8 398 5,180,922 7.7
≥14 314 3,801,886 8.3 746 5,850,390 12.8 675 5,121,198 13.2
Gini index (%)
<37 128 3,305,384 3.9 298 5,552,920 5.4 278 5,559,369 5.0
37.00–40.99 158 3,489,368 4.5 375 5,659,662 6.6 335 5,435,672 6.2
41.00–45.99 197 3,923,369 5.0 449 6,137,331 7.3 421 5,726,950 7.4
≥46 217 4,144,117 5.2 483 5,257,973 9.2 469 4,596,676 10.2
Subtotala 717 14,993,872 4.8 1,662 22,616,848 7.3 1,562 21,324,781 7.3
Totalb 6,302 30,653,974 20.6 12,114 45,780,154 26.5 6,897 42,845,441 16.1
Table 1. Diagnoses of HIV infection among adults aged ≥18 years, by age at diagnosis, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
45–54 years ≥55 years Total
No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 503 7,019,310 7.2 476 14,819,733 3.2 4,220 38,451,914 11.0
6.00–9.99 576 4,976,659 11.6 464 11,222,759 4.1 4,773 30,086,487 15.9
10.00–16.99 772 5,019,253 15.4 668 11,003,070 6.1 7,170 31,300,391 22.9
≥17 1,003 3,885,765 25.8 834 8,107,685 10.3 9,698 26,265,855 36.9
Less than high school diploma (%)
<5 482 5,563,846 8.7 472 12,327,051 3.8 4,516 33,785,309 13.4
5.00–8.99 538 5,183,243 10.4 451 11,783,264 3.8 4,651 31,151,072 14.9
9.00–15.99 742 5,220,236 14.2 596 11,636,996 5.1 6,754 31,756,937 21.3
≥16 1,093 4,981,478 21.9 923 9,442,217 9.8 9,946 29,789,081 33.4
Median household income (U.S. $)
<49,000 990 3,978,999 24.9 846 8,959,231 9.4 9,570 26,673,341 35.9
49,000–65,999 700 4,806,471 14.6 588 10,968,497 5.4 6,606 30,494,411 21.7
66,000–89,999 650 5,379,035 12.1 524 11,922,304 4.4 5,530 32,732,672 16.9
≥90,000 507 6,673,471 7.6 475 13,197,955 3.6 4,042 35,687,115 11.3
Without health insurance (%)
<4 400 5,462,667 7.3 381 12,604,189 3.0 3,248 31,879,852 10.2
4.00–7.99 634 5,655,683 11.2 538 12,816,594 4.2 5,264 34,455,340 15.3
8.00–13.99 734 4,989,336 14.7 619 10,744,017 5.8 6,899 30,704,403 22.5
≥14 1,086 4,793,402 22.7 904 8,988,923 10.1 10,451 29,138,210 35.9
Gini index (%)
<37 575 5,310,038 10.8 465 10,020,132 4.6 5,217 30,318,187 17.2
37.00–40.99 614 5,389,862 11.4 525 11,556,842 4.5 5,705 31,905,960 17.9
41.00–45.99 764 5,691,614 13.4 675 12,894,781 5.2 7,040 34,700,028 20.3
≥46 901 4,494,292 20.0 777 10,666,059 7.3 7,891 29,061,120 27.2
Subtotala 2,955 20,948,803 14.1 2,532 45,189,528 5.6 26,859 126,482,399 21.2
Female
Below federal poverty level (%)
<6 164 7,079,357 2.3 129 16,414,858 0.8 776 39,792,705 2.0
6.00–9.99 179 5,006,142 3.6 155 12,770,728 1.2 956 31,236,206 3.1
10.00–16.99 305 5,034,986 6.1 265 12,767,033 2.1 1,574 32,612,545 4.8
≥17 440 3,990,905 11.0 388 9,720,128 4.0 2,527 27,976,572 9.0
Less than high school diploma (%)
<5 126 5,673,366 2.2 114 13,907,888 0.8 665 35,487,807 1.9
5.00–8.99 179 5,275,750 3.4 152 13,484,661 1.1 992 32,799,263 3.0
9.00–15.99 331 5,322,720 6.2 277 13,486,514 2.1 1,668 33,450,320 5.0
≥16 452 4,841,470 9.3 394 10,795,134 3.6 2,508 29,985,614 8.4
Median household income (U.S. $)
<49,000 461 4,140,558 11.1 406 10,863,329 3.7 2,618 28,787,574 9.1
49,000–65,999 268 4,824,196 5.6 243 12,723,684 1.9 1,456 31,714,499 4.6
66,000–89,999 211 5,402,560 3.9 161 13,519,217 1.2 1,016 33,850,168 3.0
≥90,000 142 6,699,664 2.1 121 14,468,421 0.8 721 36,843,825 2.0
Without health insurance (%)
<4 129 5,521,958 2.3 93 14,278,624 0.7 601 33,481,916 1.8
4.00–7.99 207 5,761,130 3.6 180 14,648,134 1.2 1,115 36,180,538 3.1
8.00–13.99 277 5,052,262 5.5 266 12,403,634 2.1 1,509 32,147,394 4.7
≥14 475 4,776,107 9.9 398 10,342,564 3.8 2,608 29,892,145 8.7
Gini index (%)
<37 200 5,314,971 3.8 171 11,114,831 1.5 1,075 30,847,475 3.5
37.00–40.99 275 5,417,750 5.1 192 13,137,409 1.5 1,335 33,139,861 4.0
41.00–45.99 293 5,769,954 5.1 288 14,836,509 1.9 1,648 36,394,113 4.5
≥46 320 4,607,131 6.9 286 12,581,778 2.3 1,775 31,187,675 5.7
Subtotala 1,139 21,113,306 5.4 968 51,674,197 1.9 6,048 131,723,004 4.6
Totalb 4,094 42,062,109 9.7 3,500 96,863,725 3.6 32,907 258,205,403 12.7

Abbreviations: Pop., population; SDOH, 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 SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

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 SDOH subpopulations.
b Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.

Table 2. Diagnoses of HIV infection among adults aged ≥18 years, by race/ethnicity, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
American Indian/Alaska Native Asian Black/African American Hispanic/Latinoa
No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 17 141,230 12.0 160 2,753,261 5.8 1,212 2,612,289 46.4 1,156 4,123,111 28.0
6.00–9.99 25 172,813 14.5 137 1,707,016 8.0 1,454 2,612,861 55.6 1,493 4,504,114 33.1
10.00–16.99 34 276,987 12.3 140 1,500,211 9.3 2,512 3,807,909 66.0 2,490 6,302,436 39.5
≥17 49 401,114 12.2 146 1,089,642 13.4 4,477 5,679,159 78.8 3,103 7,392,595 42.0
Less than high school diploma (%)
<5 24 118,527 20.2 155 2,452,518 6.3 1,367 2,174,785 62.9 1,017 2,638,128 38.6
5.00–8.99 24 174,083 13.8 112 1,642,525 6.8 1,700 2,870,977 59.2 1,101 3,183,762 34.6
9.00–15.99 38 294,479 12.9 145 1,484,758 9.8 2,857 4,460,046 64.1 1,765 5,004,092 35.3
≥16 39 411,526 9.5 171 1,486,333 11.5 3,736 5,322,212 70.2 4,360 11,589,516 37.6
Median household income (U.S. $)
<49,000 47 384,907 12.2 108 758,214 14.2 4,596 5,863,040 78.4 2,908 6,884,065 42.2
49,000–65,999 35 270,983 12.9 114 1,053,038 10.8 2,314 3,535,387 65.5 2,221 5,700,914 39.0
66,000–89,999 26 197,754 13.1 146 1,684,139 8.7 1,657 2,880,028 57.5 1,899 5,423,478 35.0
≥90,000 17 132,563 12.8 210 3,520,487 6.0 1,033 2,313,477 44.7 1,181 4,204,082 28.1
Without health insurance (%)
<4 9 93,663 9.6 143 2,435,694 5.9 961 1,994,045 48.2 724 2,626,838 27.6
4.00–7.99 26 175,975 14.8 165 2,070,600 8.0 1,800 3,364,025 53.5 1,386 4,400,878 31.5
8.00–13.99 36 253,251 14.2 154 1,511,146 10.2 2,625 4,211,823 62.3 2,067 5,556,909 37.2
≥14 54 469,520 11.5 121 1,042,742 11.6 4,270 5,150,632 82.9 4,065 9,746,421 41.7
Gini index (%)
<37 25 167,913 14.9 137 1,818,151 7.5 1,882 3,269,618 57.6 1,677 5,460,653 30.7
37.00–40.99 26 220,563 11.8 114 1,707,449 6.7 2,022 3,195,496 63.3 1,910 5,477,473 34.9
41.00–45.99 38 317,330 12.0 161 1,873,003 8.6 2,521 3,915,046 64.4 2,289 5,988,523 38.2
≥46 36 284,998 12.6 170 1,645,565 10.3 3,229 4,297,696 75.1 2,363 5,370,122 44.0
Subtotalb 137 998,615 13.7 610 7,066,134 8.6 10,059 14,828,020 67.8 8,491 22,415,498 37.9
Female
Below federal poverty level (%)
<6 2 140,167 1.4 21 3,131,813 0.7 368 2,733,731 13.5 126 4,114,793 3.1
6.00–9.99 6 174,285 3.4 22 1,950,162 1.1 461 2,838,811 16.2 174 4,420,644 3.9
10.00–16.99 12 273,324 4.4 25 1,690,787 1.5 844 4,283,573 19.7 292 6,151,820 4.7
≥17 12 416,953 2.9 15 1,165,982 1.3 1,506 6,745,520 22.3 513 7,526,578 6.8
Less than high school diploma (%)
<5 7 124,558 5.6 18 2,751,486 0.7 326 2,410,138 13.5 89 2,779,129 3.2
5.00–8.99 13 181,344 7.2 14 1,896,430 0.7 535 3,263,683 16.4 127 3,253,609 3.9
9.00–15.99 5 303,725 1.6 17 1,677,503 1.0 961 5,176,395 18.6 244 5,011,040 4.9
≥16 7 396,125 1.8 34 1,623,658 2.1 1,357 5,768,214 23.5 645 11,187,192 5.8
Median household income (U.S. $)
<49,000 13 401,521 3.2 13 812,612 1.6 1,549 7,033,489 22.0 498 7,041,242 7.1
49,000–65,999 9 272,184 3.3 20 1,185,888 1.7 761 3,945,136 19.3 273 5,520,917 4.9
66,000–89,999 5 196,510 2.5 26 1,904,670 1.4 513 3,126,704 16.4 199 5,329,900 3.7
≥90,000 5 130,239 3.8 24 3,999,687 0.6 341 2,404,422 14.2 131 4,236,156 3.1
Without health insurance (%)
<4 0 92,534 0.0 15 2,777,100 0.5 305 2,098,708 14.5 83 2,725,498 3.0
4.00–7.99 10 179,597 5.6 29 2,345,892 1.2 533 3,768,925 14.1 177 4,568,578 3.9
8.00–13.99 10 259,464 3.9 15 1,676,491 0.9 833 4,844,674 17.2 260 5,589,264 4.7
≥14 12 473,507 2.5 24 1,148,780 2.1 1,508 5,900,818 25.6 585 9,343,288 6.3
Gini index (%)
<37 5 166,107 3.0 17 2,031,717 0.8 572 3,465,632 16.5 219 5,275,480 4.2
37.00–40.99 4 218,513 1.8 23 1,915,759 1.2 703 3,561,681 19.7 243 5,393,660 4.5
41.00–45.99 11 323,650 3.4 18 2,109,566 0.9 877 4,463,946 19.6 313 5,959,331 5.3
≥46 12 296,019 4.1 25 1,875,742 1.3 1,027 5,103,080 20.1 330 5,577,040 5.9
Subtotalb 35 1,005,752 3.5 86 7,949,077 1.1 3,288 16,618,430 19.8 1,136 22,230,970 5.1
Totalc 172 2,004,367 8.6 696 15,015,211 4.6 13,347 31,446,450 42.4 9,627 44,646,468 21.6
Table 2. Diagnoses of HIV infection among adults aged ≥18 years, by race/ethnicity, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
Native Hawaiian/other Pacific Islander White Multiracial
No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 16 61,882 25.9 1,522 27,880,809 5.5 137 1,841,049 7.4
6.00–9.99 10 58,517 17.1 1,502 20,370,655 7.4 152 1,647,544 9.2
10.00–16.99 15 63,225 23.7 1,814 18,714,315 9.7 165 1,971,877 8.4
≥17 16 47,103 34.0 1,650 11,350,212 14.5 257 1,933,844 13.3
Less than high school diploma (%)
<5 9 51,035 17.6 1,784 25,500,039 7.0 160 1,504,116 10.6
5.00–8.99 15 55,587 27.0 1,560 22,478,604 6.9 139 1,488,155 9.3
9.00–15.99 18 66,404 27.1 1,739 19,789,121 8.8 192 1,794,961 10.7
≥16 15 58,771 25.5 1,405 10,686,413 13.1 220 2,632,761 8.4
Median household income (U.S. $)
<49,000 15 37,182 40.3 1,654 12,442,496 13.3 242 1,838,585 13.2
49,000–65,999 13 48,229 27.0 1,731 19,305,032 9.0 178 1,772,205 10.0
66,000–89,999 14 68,324 20.5 1,631 21,784,462 7.5 157 1,864,849 8.4
≥90,000 15 75,248 19.9 1,455 24,549,460 5.9 131 1,880,893 7.0
Without health insurance (%)
<4 9 54,472 16.5 1,288 23,943,792 5.4 114 1,359,320 8.4
4.00–7.99 13 70,528 18.4 1,713 23,624,755 7.3 161 1,757,672 9.2
8.00–13.99 18 57,678 31.2 1,812 18,520,759 9.8 187 1,823,485 10.3
≥14 17 48,065 35.4 1,675 12,270,571 13.7 249 2,457,676 10.1
Gini index (%)
<37 15 68,566 21.9 1,318 18,876,470 7.0 163 1,862,232 8.8
37.00–40.99 12 59,753 20.1 1,486 20,589,914 7.2 135 1,835,195 7.4
41.00–45.99 13 57,183 22.7 1,833 21,873,918 8.4 185 1,985,680 9.3
≥46 17 44,956 37.8 1,849 16,926,177 10.9 227 1,702,521 13.3
Subtotalb 61 231,797 26.3 6,763 78,454,177 8.6 738 7,419,993 9.9
Female
Below federal poverty level (%)
<6 1 59,005 1.7 233 28,700,736 0.8 25 1,875,288 1.3
6.00–9.99 3 61,210 4.9 257 21,079,389 1.2 33 1,668,387 2.0
10.00–16.99 3 61,656 4.9 353 19,443,558 1.8 45 2,003,597 2.2
≥17 2 48,049 4.2 403 11,707,488 3.4 76 2,028,201 3.7
Less than high school diploma (%)
<5 2 47,471 4.2 193 26,478,457 0.7 30 1,584,940 1.9
5.00–8.99 1 56,876 1.8 271 23,349,000 1.2 31 1,575,309 2.0
9.00–15.99 4 65,375 6.1 389 20,491,305 1.9 48 1,855,658 2.6
≥16 2 60,385 3.3 393 10,669,467 3.7 70 2,566,267 2.7
Median household income (U.S. $)
<49,000 2 37,291 5.4 454 13,095,283 3.5 89 1,946,444 4.6
49,000–65,999 2 51,402 3.9 353 20,090,728 1.8 38 1,786,014 2.1
66,000–89,999 3 67,572 4.4 246 22,479,430 1.1 24 1,895,132 1.3
≥90,000 2 72,172 2.8 190 25,071,815 0.8 28 1,917,446 1.5
Without health insurance (%)
<4 2 54,058 3.7 170 24,962,837 0.7 26 1,414,688 1.8
4.00–7.99 3 69,699 4.3 331 24,444,930 1.4 32 1,858,461 1.7
8.00–13.99 1 59,049 1.7 354 19,069,103 1.9 36 1,885,839 1.9
≥14 3 47,185 6.4 391 12,501,974 3.1 85 2,421,940 3.5
Gini index (%)
<37 2 68,840 2.9 238 19,149,567 1.2 22 1,844,451 1.2
37.00–40.99 4 57,626 6.9 318 21,278,089 1.5 40 1,867,457 2.1
41.00–45.99 1 58,801 1.7 362 22,738,425 1.6 66 2,042,848 3.2
≥46 2 44,588 4.5 328 17,739,626 1.8 51 1,817,309 2.8
Subtotalb 9 230,107 3.9 1,304 80,988,229 1.6 190 7,582,174 2.5
Totalc 70 461,904 15.2 8,067 159,442,406 5.1 928 15,002,167 6.2

Abbreviations: Pop., population; SDOH, social determinants of health [footnotes only]; ACS, American Community Survey [footnotes only].

Note. Numbers less than 12, and rates based on these numbers, should be interpreted with caution. 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 SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Hispanic/Latino persons can be of any race.
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 SDOH subpopulations.
c Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.

Table 3. Diagnoses of HIV infection among adults aged ≥18 years, by transmission category, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
Male-to-male sexual contacta Injection drug useb Male-to-male sexual contacta
and injection drug useb
Heterosexual contactc
No. % No. % No. % No. %
Male
Below federal poverty level (%)
<6 3,553 16.5 159 15.2 198 17.8 306 14.0
6.00–9.99 4,004 18.6 170 16.4 240 21.6 356 16.2
10.00–16.99 5,999 27.9 281 27.0 296 26.6 589 26.9
≥17 7,941 36.9 432 41.4 377 33.9 941 42.9
Less than high school diploma (%)
<5 3,917 18.2 125 12.0 220 19.8 251 11.4
5.00–8.99 3,872 18.0 181 17.4 225 20.3 369 16.8
9.00–15.99 5,553 25.8 293 28.1 293 26.4 610 27.8
≥16 8,158 37.9 444 42.6 372 33.5 964 44.0
Median household income (U.S. $)
<49,000 7,766 36.3 446 42.9 370 33.4 980 44.9
49,000–65,999 5,519 25.8 234 22.6 314 28.4 536 24.5
66,000–89,999 4,675 21.8 210 20.3 239 21.6 402 18.4
≥90,000 3,443 16.1 148 14.2 183 16.5 266 12.2
Without health insurance (%)
<4 2,695 12.5 141 13.5 171 15.4 238 10.9
4.00–7.99 4,368 20.3 270 25.9 251 22.6 369 16.9
8.00–13.99 5,764 26.8 279 26.8 300 27.0 553 25.2
≥14 8,671 40.3 352 33.8 389 35.0 1,031 47.0
Gini index (%)
<37 4,396 20.5 175 16.8 209 18.8 433 19.8
37.00–40.99 4,728 22.0 213 20.5 265 23.9 494 22.5
41.00–45.99 5,822 27.1 318 30.5 302 27.2 590 26.9
≥46 6,544 30.5 336 32.2 334 30.0 674 30.8
Subtotald 22,301 100 1,088 100 1,167 100 2,283 100
Female
Below federal poverty level (%)
<6 110 13.0 660 13.4
6.00–9.99 142 16.7 807 16.3
10.00–16.99 215 25.2 1,348 27.3
≥17 384 45.1 2,126 43.0
Less than high school diploma (%)
<5 99 11.6 561 11.4
5.00–8.99 137 16.1 847 17.1
9.00–15.99 250 29.4 1,407 28.5
≥16 366 42.9 2,126 43.0
Median household income (U.S. $)
<49,000 394 46.3 2,209 44.9
49,000–65,999 221 26.0 1,226 24.9
66,000–89,999 129 15.2 878 17.8
≥90,000 107 12.5 608 12.4
Without health insurance (%)
<4 106 12.5 488 9.9
4.00–7.99 193 22.6 913 18.5
8.00–13.99 224 26.4 1,274 25.8
≥14 328 38.5 2,266 45.9
Gini index (%)
<37 152 17.8 916 18.5
37.00–40.99 169 19.8 1,154 23.4
41.00–45.99 252 29.6 1,386 28.1
≥46 279 32.8 1,485 30.0
Subtotald 889 100 5,118 100
Totale 22,301 100 1,977 100 1,167 100 7,400 100

Abbreviation: SDOH, social determinants of health [footnotes only].

Note. Transmission category is classified based on a hierarchy of the risk factors most likely responsible for HIV transmission; classification is determined based on the person’s assigned sex at birth. Data have been statistically adjusted to account for missing transmission category; therefore, values may not sum to column subtotals and total. 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 SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Includes individuals assigned male sex at birth, regardless of current gender identity, who have had sexual contact with other males, and individuals assigned male sex at birth who have had sexual contact with both males and females (i.e., bisexual contact).
b Includes persons who injected nonprescription drugs or who injected prescription drugs for nonmedical purposes. Also includes injection of drugs prescribed to persons if there is evidence that injection equipment was shared (e.g., syringes, needles, cookers).
c Heterosexual contact with a person known to have, or with a risk factor for, HIV infection.
d 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 SDOH subpopulations.
e Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.

Table 4. Diagnoses of HIV infection among adults aged ≥18 years, by percentage living below federal poverty level, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Below federal poverty level (%)
Male
<6 6.00–9.99 10.00–16.99 ≥17
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 52 14.8 9 60 15.2 16 126 22.9 13 188 33.7 17
Alaska 6 6.7 5 5.4 10 12.0 1 4.1
Arizona 99 12.9 13 98 16.0 14 155 23.6 12 197 30.1 25
Arkansas 25 15.1 8 37 15.6 15 55 15.2 24 110 31.0 20
California 558 13.3 12 732 18.5 10 1,113 27.2 11 998 36.2 14
Colorado 73 8.1 25 94 16.7 12 89 17.9 20 55 20.0 35
Connecticut 38 5.5 34 27 10.3 28 42 19.1 19 64 30.3 24
Delaware 9 7.4 13 13.2 21 15 14.9 27 20 39.2 13
District of Columbia 21 33.1 1 22 40.4 1 36 64.1 1 45 51.1 5
Florida 360 17.7 6 557 26.6 4 911 37.5 4 1,141 65.7 1
Georgia 268 24.6 2 323 38.8 2 507 49.2 2 596 63.0 2
Hawaii 13 5.4 35 13 9.0 32 14 10.9 38 5 8.7
Idaho 7 4.3 16 7.1 38 10 5.0 8 9.1
Illinois 168 10.2 18 162 13.0 22 253 22.3 14 374 45.3 7
Indiana 58 7.3 26 59 9.2 31 105 17.0 21 165 34.7 16
Iowa 12 3.4 39 13 3.4 41 20 6.6 43 19 11.2 42
Kansas 34 9.6 21 24 8.0 35 22 8.7 41 40 20.3 34
Kentucky 34 10.4 17 46 14.8 18 73 15.9 22 118 19.8 36
Louisiana 58 23.9 3 64 21.6 7 136 28.7 9 345 48.8 6
Maine 6 4.3 4 2.5 10 5.8 3 4.4
Maryland 145 13.7 11 143 24.8 6 157 37.9 3 101 43.8 9
Massachusetts 71 6.1 30 50 7.6 36 69 13.9 29 79 20.6 33
Michigan 63 5.3 36 94 9.8 30 101 11.3 36 203 25.3 29
Minnesota 54 5.7 32 48 8.1 34 61 15.4 23 52 23.3 30
Mississippi 21 13.7 10 19 12.6 23 47 15.1 25 145 30.9 22
Missouri 42 6.3 28 61 11.3 26 79 12.6 33 136 28.3 27
Montana 1 1.1 6 4.9 7 5.1 3 3.8
Nebraska 17 7.0 27 15 7.5 37 26 15.0 26 21 19.0 37
Nevada 60 18.8 5 86 28.9 3 100 32.2 6 136 52.6 4
New Hampshire 9 3.1 7 5.0 6 6.1 1 4.0
New Jersey 155 9.2 22 110 14.2 20 179 33.0 5 267 56.3 3
New Mexico 10 9.3 16 11.2 27 20 9.7 39 40 11.7 41
New York 198 8.6 23 263 14.4 19 390 21.3 16 720 43.6 10
North Carolina 161 15.8 7 176 20.9 8 318 28.2 10 386 42.9 11
North Dakota 2 2.3 4 4.7 8 9.1 2 4.5
Ohio 80 5.7 33 92 8.8 33 153 14.9 28 316 32.7 19
Oklahoma 35 11.9 15 43 16.2 13 64 12.7 32 116 28.5 26
Oregon 21 5.8 31 41 9.9 29 54 9.2 40 41 14.4 38
Pennsylvania 86 4.7 37 86 6.9 39 139 13.0 30 257 30.9 21
Puerto Rico 0 0.0 4 22.9 14 32.1 8 279 23.2 31
Rhode Island 15 10.0 20 6 5.7 12 12.0 35 23 32.9 18
South Carolina 45 10.1 19 76 18.6 9 122 21.8 15 170 35.0 15
South Dakota 7 7.2 2 2.1 5 5.9 7 12.5
Tennessee 70 12.3 14 87 14.8 17 158 20.1 17 265 42.0 12
Texas 649 20.6 4 552 24.9 5 855 32.1 7 1,110 43.8 8
Utah 34 6.2 29 32 12.1 24 26 13.0 31 17 13.2 40
Vermont 1 1.8 1 1.0 3 4.2 3 9.5
Virginia 144 10.4 16 136 16.9 11 132 20.0 18 128 30.8 23
Washington 91 8.5 24 99 11.6 25 87 12.5 34 74 21.0 32
West Virginia 3 3.8 8 6.0 21 8.7 42 34 13.4 39
Wisconsin 30 3.5 38 39 5.8 40 53 11.1 37 74 26.6 28
Wyoming 1 1.5 2 3.1 2 3.0 0 0.0
Region of residence
Northeast 579 7.0 554 10.5 850 18.5 1,417 37.8
Midwest 567 6.6 613 9.1 886 14.6 1,409 30.4
South 2,100 16.7 2,362 22.9 3,733 29.3 5,018 44.2
West 974 10.9 1,240 16.0 1,687 21.5 1,575 29.6
Totalb 4,220 11.0 4,773 15.9 7,170 22.9 9,698 36.9
Table 4. Diagnoses of HIV infection among adults aged ≥18 years, by percentage living below federal poverty level, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Below federal poverty level (%)
Female
<6 6.00–9.99 10.00–16.99 ≥17
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 11 3.0 17 4.1 9 28 4.7 16 56 8.9 15
Alaska 0 0.0 1 1.2 4 5.4 0 0.0
Arizona 15 1.9 10 15 2.3 16 17 2.6 29 28 4.3 32
Arkansas 7 4.1 6 2.4 15 3.9 18 27 7.1 25
California 87 2.0 8 89 2.2 18 121 2.9 27 187 6.6 26
Colorado 6 0.7 17 3.0 14 14 2.8 28 8 3.0
Connecticut 5 0.7 6 2.1 12 5.0 13 25 10.7 7
Delaware 3 2.4 1 0.9 6 5.4 6 10.5
District of Columbia 4 6.0 6 9.7 7 11.2 21 20.1 1
Florida 73 3.4 6 107 4.9 6 251 9.7 4 325 17.9 2
Georgia 60 5.2 1 60 6.8 1 136 12.1 1 171 16.6 4
Hawaii 4 1.7 4 2.8 1 0.7 1 1.7
Idaho 1 0.6 2 0.9 1 0.5 3 3.5
Illinois 13 0.8 18 28 2.2 20 45 3.8 19 92 10.3 8
Indiana 13 1.6 11 10 1.5 20 3.1 24 52 10.3 9
Iowa 1 0.3 6 1.6 1 0.3 4 2.3
Kansas 4 1.1 5 1.7 8 3.1 7 3.5
Kentucky 8 2.4 6 1.9 15 3.1 23 31 4.9 31
Louisiana 12 4.7 2 17 5.3 3 33 6.7 6 133 17.3 3
Maine 0 0.0 0 0.0 1 0.5 2 2.9
Maryland 50 4.4 3 38 6.0 2 48 10.5 2 39 14.7 6
Massachusetts 20 1.6 12 27 3.8 10 28 5.3 10 37 8.9 16
Michigan 5 0.4 9 0.9 16 1.7 31 62 7.1 24
Minnesota 8 0.8 13 2.2 19 19 4.7 17 19 8.4 19
Mississippi 8 5.0 11 6.8 26 7.8 5 42 8.1 23
Missouri 5 0.7 6 1.1 12 1.8 30 19 3.6 33
Montana 0 0.0 0 0.0 1 0.7 1 1.3
Nebraska 3 1.2 1 0.5 4 2.3 9 8.0
Nevada 7 2.1 10 3.4 16 5.2 11 21 8.4 20
New Hampshire 1 0.3 3 2.0 1 1.0 0 0.0
New Jersey 28 1.6 13 41 5.0 5 57 10.0 3 85 16.5 5
New Mexico 0 0.0 2 1.3 2 0.9 8 2.3
New York 38 1.5 14 66 3.4 13 97 5.0 14 168 9.0 13
North Carolina 24 2.2 7 31 3.5 12 78 6.5 8 98 9.8 10
North Dakota 4 5.1 4 4.8 4 4.8 1 2.5
Ohio 18 1.2 15 33 3.0 15 38 3.5 21 89 8.6 18
Oklahoma 5 1.6 5 1.8 15 2.9 26 35 8.4 21
Oregon 2 0.5 7 1.6 7 1.2 5 1.7
Pennsylvania 20 1.0 17 16 1.2 21 33 2.9 25 84 9.0 14
Puerto Rico 0 0.0 0 0.0 4 7.4 70 5.1 29
Rhode Island 1 0.7 4 3.5 3 2.7 2 2.7
South Carolina 19 4.0 4 23 5.3 4 36 5.9 9 44 8.2 22
South Dakota 0 0.0 0 0.0 2 2.4 2 3.6
Tennessee 11 1.8 23 3.7 11 30 3.6 20 66 9.6 11
Texas 122 3.8 5 109 4.8 7 181 6.6 7 249 9.6 12
Utah 3 0.5 1 0.4 2 1.0 3 2.4
Vermont 0 0.0 0 0.0 0 0.0 0 0.0
Virginia 28 2.0 9 36 4.2 8 33 4.8 15 39 8.7 17
Washington 13 1.2 16 19 2.2 17 24 3.5 22 17 5.0 30
West Virginia 2 2.4 4 3.0 13 5.2 12 17 6.5 27
Wisconsin 4 0.5 11 1.7 7 1.5 17 5.7 28
Wyoming 0 0.0 0 0.0 1 1.6 0 0.0
Region of residence
Northeast 113 1.3 163 2.9 232 4.8 403 9.6
Midwest 78 0.9 126 1.8 176 2.8 373 7.6
South 447 3.4 500 4.6 951 7.1 1,399 11.5
West 138 1.5 167 2.1 211 2.7 282 5.3
Totalb 776 2.0 956 3.1 1,574 4.8 2,527 9.0
Table 4. Diagnoses of HIV infection among adults aged ≥18 years, by percentage living below federal poverty level, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Below federal poverty level (%)
Total
<6 6.00–9.99 10.00–16.99 ≥17
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 63 8.7 11 77 9.5 14 154 13.4 13 244 20.6 17
Alaska 6 3.5 6 3.3 14 8.9 29 1 2.2
Arizona 114 7.3 13 113 9.0 17 172 13.0 14 225 17.2 26
Arkansas 32 9.5 7 43 8.8 18 70 9.4 26 137 18.7 23
California 645 7.6 12 821 10.3 11 1,234 15.0 11 1,185 21.3 15
Colorado 79 4.4 27 111 9.9 12 103 10.4 21 63 11.7 37
Connecticut 43 3.1 36 33 6.0 28 54 11.7 18 89 20.1 19
Delaware 12 4.8 24 14 6.8 24 21 9.9 23 26 24.0 13
District of Columbia 25 19.1 1 28 24.1 1 43 36.3 1 66 34.3 4
Florida 433 10.3 6 664 15.5 4 1,162 23.2 4 1,466 41.2 1
Georgia 328 14.6 2 383 22.3 2 643 29.8 2 767 38.8 2
Hawaii 17 3.6 30 17 5.9 29 15 5.7 42 6 5.2
Idaho 8 2.5 18 4.0 40 11 2.7 11 6.3
Illinois 181 5.4 19 190 7.5 22 298 12.9 15 466 27.1 8
Indiana 71 4.4 26 69 5.3 33 125 9.8 24 217 22.1 14
Iowa 13 1.8 40 19 2.5 42 21 3.4 45 23 6.7 42
Kansas 38 5.3 20 29 4.8 36 30 5.9 41 47 11.9 36
Kentucky 42 6.3 17 52 8.2 21 88 9.3 27 149 12.2 35
Louisiana 70 14.0 3 81 13.2 7 169 17.5 9 478 32.4 5
Maine 6 2.1 4 1.2 11 3.1 5 3.6
Maryland 195 8.9 9 181 15.0 5 205 23.5 3 140 28.2 7
Massachusetts 91 3.8 29 77 5.6 32 97 9.4 25 116 14.5 31
Michigan 68 2.8 37 103 5.3 34 117 6.4 39 265 15.9 27
Minnesota 62 3.3 34 61 5.1 35 80 9.9 22 71 15.8 28
Mississippi 29 9.3 8 30 9.6 13 73 11.3 20 187 18.9 22
Missouri 47 3.4 31 67 6.1 27 91 7.1 34 155 15.5 30
Montana 1 0.6 6 2.5 8 3.0 4 2.5
Nebraska 20 4.1 28 16 4.0 39 30 8.6 30 30 13.4 33
Nevada 67 10.4 5 96 16.2 3 116 18.8 7 157 30.8 6
New Hampshire 10 1.7 10 3.5 7 3.6 1 1.9
New Jersey 183 5.3 22 151 9.5 15 236 21.2 5 352 35.6 3
New Mexico 10 4.6 18 6.2 26 22 5.3 43 48 6.9 41
New York 236 5.0 23 329 8.8 20 487 12.9 16 888 25.2 11
North Carolina 185 8.8 10 207 11.9 8 396 17.0 10 484 25.5 10
North Dakota 6 3.7 8 4.8 12 7.0 36 3 3.5
Ohio 98 3.4 32 125 5.8 30 191 9.0 28 405 20.2 18
Oklahoma 40 6.7 16 48 8.8 19 79 7.8 33 151 18.3 24
Oregon 23 3.1 35 48 5.7 31 61 5.1 44 46 8.0 39
Pennsylvania 106 2.8 38 102 4.0 38 172 7.9 32 341 19.3 21
Puerto Rico 0 0.0 4 10.7 18 18.5 8 349 13.6 32
Rhode Island 16 5.3 21 10 4.5 15 7.1 35 25 17.4 25
South Carolina 64 6.9 14 99 11.7 9 158 13.5 12 214 21.0 16
South Dakota 7 3.6 2 1.1 7 4.1 9 8.1
Tennessee 81 6.9 15 110 9.1 16 188 11.6 19 331 25.1 12
Texas 771 12.1 4 661 14.7 6 1,036 19.2 6 1,359 26.5 9
Utah 37 3.4 33 33 6.3 25 28 7.0 37 20 7.8 40
Vermont 1 0.9 1 0.5 3 2.1 3 4.5
Virginia 172 6.1 18 172 10.4 10 165 12.3 17 167 19.3 20
Washington 104 4.8 25 118 6.9 23 111 8.0 31 91 13.1 34
West Virginia 5 3.1 12 4.5 37 34 6.9 38 51 9.9 38
Wisconsin 34 2.0 39 50 3.8 41 60 6.2 40 91 15.8 29
Wyoming 1 0.8 2 1.6 3 2.3 0 0.0
Region of residence
Northeast 692 4.1 717 6.6 1,082 11.4 1,820 23.0
Midwest 645 3.7 739 5.4 1,062 8.6 1,782 18.7
South 2,547 9.9 2,862 13.5 4,684 17.9 6,417 27.3
West 1,112 6.2 1,407 9.0 1,898 12.0 1,857 17.4
Totalb 4,996 6.4 5,729 9.3 8,744 13.7 12,225 22.5

Abbreviation: SDOH, 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. Numbers less than 12, and rates based on these numbers, should be interpreted with caution. For the definitions of SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Based on rate. Ranks were not assigned to areas with rates that were based on reported numbers less than 12.
b Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.

Table 5. Diagnoses of HIV infection among adults aged ≥18 years, by percentage with less than high school diploma, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Less than high school diploma (%)
Male
<5 5.00–8.99 9.00–15.99 ≥16
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 65 19.3 11 92 26.4 6 127 22.5 13 142 23.4 26
Alaska 8 9.0 7 5.8 7 11.0 0 0.0
Arizona 121 16.0 14 92 14.3 19 127 22.8 12 210 27.9 18
Arkansas 38 24.0 6 43 17.8 14 77 17.4 23 69 24.8 25
California 467 13.4 18 435 15.8 16 681 22.2 15 1,818 31.3 13
Colorado 101 10.1 25 57 11.4 23 87 20.2 19 66 20.9 32
Connecticut 38 7.7 32 32 7.7 39 37 13.9 30 64 30.3 14
Delaware 12 10.7 23 12 12.4 23 20.2 18 10 20.4
District of Columbia 37 31.3 3 31 71.9 1 27 41.7 2 29 80.6 1
Florida 425 20.7 8 549 27.6 3 819 35.8 3 1,177 59.5 2
Georgia 359 41.7 1 333 41.1 2 486 43.6 1 516 46.4 5
Hawaii 13 5.6 38 20 11.3 24 8 6.5 4 9.9
Idaho 13 7.3 33 10 4.7 9 4.6 9 9.8
Illinois 198 13.3 19 176 14.2 20 265 22.2 14 318 34.1 11
Indiana 65 11.9 21 76 11.0 25 127 15.0 28 119 26.5 21
Iowa 14 3.3 40 22 5.0 42 11 4.6 17 16.6 37
Kansas 43 10.1 26 17 6.1 40 23 9.8 38 37 22.6 27
Kentucky 52 16.4 13 50 15.4 18 91 16.2 25 78 15.7 38
Louisiana 81 31.0 4 77 26.5 5 177 33.6 4 268 41.7 6
Maine 11 5.7 7 3.2 5 4.3 0 0.0
Maryland 101 15.0 16 129 18.5 13 174 30.0 6 142 41.3 7
Massachusetts 59 5.6 39 57 8.1 37 65 12.9 32 88 20.3 33
Michigan 80 7.0 35 117 9.5 31 144 13.8 31 120 27.5 19
Minnesota 63 7.2 34 67 9.1 34 44 10.8 37 41 29.3 16
Mississippi 18 15.3 15 29 17.0 15 78 21.2 16 107 25.0 24
Missouri 63 9.9 27 68 10.4 28 112 16.2 26 75 22.3 28
Montana 8 4.3 7 4.7 1 1.2 1 10.4
Nebraska 11 4.2 23 10.3 30 27 18.3 22 18 18.4 34
Nevada 47 19.9 10 63 22.8 8 97 31.1 5 175 48.3 4
New Hampshire 10 4.1 8 4.1 4 4.5 1 3.9
New Jersey 100 8.6 30 112 10.9 26 173 25.1 10 326 53.0 3
New Mexico 10 6.4 19 12.7 21 34 15.0 29 23 8.6 41
New York 170 9.3 28 211 11.4 22 375 20.1 20 817 38.4 8
North Carolina 196 20.8 7 202 24.2 7 328 27.6 8 316 34.2 10
North Dakota 7 6.6 3 2.7 4 5.3 2 25.0
Ohio 118 9.2 29 148 10.8 27 197 17.1 24 178 27.9 17
Oklahoma 46 20.1 9 70 19.5 11 66 12.4 34 76 21.5 29
Oregon 48 10.2 24 46 9.5 32 38 7.7 41 25 12.3 39
Pennsylvania 94 6.2 37 134 8.6 36 167 12.9 33 173 26.9 20
Puerto Rico 15 32.7 2 20 26.8 4 87 28.0 7 175 20.9 31
Rhode Island 5 4.5 13 10.3 29 16 15.6 27 22 25.3 23
South Carolina 66 14.4 17 90 22.6 10 132 23.7 11 125 25.4 22
South Dakota 4 3.9 8 7.3 6 7.0 3 8.6
Tennessee 82 16.5 12 108 18.7 12 189 21.2 17 202 33.0 12
Texas 593 25.2 5 442 22.8 9 619 26.3 9 1,512 38.3 9
Utah 38 8.3 31 30 8.6 35 20 8.9 40 21 18.1 35
Vermont 2 2.0 1 1.0 4 6.7 1 80.3
Virginia 119 11.9 22 138 15.7 17 172 19.7 21 111 21.2 30
Washington 120 12.0 20 85 9.3 33 89 12.2 35 57 17.4 36
West Virginia 7 6.9 12 7.8 38 32 11.3 36 15 8.8 40
Wisconsin 54 6.5 36 49 6.0 41 46 9.7 39 47 30.2 15
Wyoming 1 1.3 4 4.8 0 0.0 0 0.0
Region of residence
Northeast 489 7.3 575 9.3 846 17.0 1,492 35.9
Midwest 720 8.9 774 9.8 1,006 15.3 975 27.9
South 2,297 21.7 2,407 23.7 3,617 27.2 4,895 37.7
West 995 12.0 875 12.8 1,198 18.2 2,409 29.0
Totalb 4,516 13.4 4,651 14.9 6,754 21.3 9,946 33.4
Table 5. Diagnoses of HIV infection among adults aged ≥18 years, by percentage with less than high school diploma, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Less than high school diploma (%)
Female
<5 5.00–8.99 9.00–15.99 ≥16
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 15 4.0 2 13 3.4 12 36 5.8 11 48 7.5 19
Alaska 1 1.3 4 3.5 0 0.0 0 0.0
Arizona 14 1.8 10 18 2.7 16 14 2.5 30 29 4.0 31
Arkansas 5 2.9 14 5.4 5 24 5.1 15 12 4.3 30
California 57 1.6 12 57 2.0 21 109 3.4 27 261 4.6 29
Colorado 12 1.2 16 7 1.4 9 2.1 17 5.9 25
Connecticut 4 0.8 14 3.1 14 9 3.1 21 9.6 9
Delaware 3 2.4 4 3.7 4 3.2 5 10.7
District of Columbia 7 5.3 4 7.4 17 24.7 1 10 23.8
Florida 63 2.8 8 109 5.1 6 234 9.5 4 350 17.9 1
Georgia 48 5.3 1 94 10.3 1 137 11.1 2 148 13.0 5
Hawaii 5 2.2 2 1.1 2 1.6 1 2.5
Idaho 1 0.6 4 1.9 2 1.1 0 0.0
Illinois 20 1.3 15 26 2.0 22 67 5.2 14 65 7.1 22
Indiana 9 1.6 9 1.3 35 4.0 23 42 9.1 11
Iowa 5 1.1 2 0.4 1 0.4 4 3.9
Kansas 7 1.6 3 1.1 8 3.4 6 3.8
Kentucky 8 2.4 7 2.0 21 3.6 25 24 4.7 27
Louisiana 10 3.5 27 8.5 3 56 9.8 3 102 15.5 3
Maine 0 0.0 2 0.9 0 0.0 1 9.1
Maryland 25 3.4 5 47 6.2 4 47 7.4 6 56 16.1 2
Massachusetts 20 1.7 11 14 1.9 23 37 7.0 8 41 8.9 14
Michigan 9 0.8 20 1.6 25 29 2.7 29 34 7.7 18
Minnesota 13 1.4 14 12 1.6 24 19 4.6 17 15 11.0 6
Mississippi 3 2.3 17 9.0 2 27 6.7 9 40 8.8 15
Missouri 7 1.0 7 1.0 12 1.7 31 16 4.7 28
Montana 0 0.0 1 0.7 0 0.0 1 10.2
Nebraska 1 0.4 3 1.3 6 4.1 7 7.4
Nevada 2 0.8 5 1.7 22 7.3 7 25 7.2 21
New Hampshire 1 0.4 2 1.0 2 2.4 0 0.0
New Jersey 14 1.1 17 41 3.7 10 63 8.6 5 93 14.9 4
New Mexico 2 1.2 1 0.6 2 0.8 7 2.6
New York 20 1.0 18 47 2.4 18 88 4.4 19 214 9.4 10
North Carolina 31 3.1 7 40 4.4 8 73 5.7 12 87 8.9 13
North Dakota 6 6.0 7 6.6 0 0.0 0 0.0
Ohio 21 1.5 13 37 2.5 17 56 4.6 18 64 10.0 8
Oklahoma 6 2.5 14 3.7 11 17 3.1 28 23 6.8 23
Oregon 2 0.4 5 1.0 7 1.4 7 3.6
Pennsylvania 16 1.0 19 36 2.2 19 55 4.0 22 46 7.3 20
Puerto Rico 2 3.6 7 7.6 14 3.7 24 51 5.5 26
Rhode Island 0 0.0 3 2.2 4 3.7 3 3.3
South Carolina 19 3.9 3 19 4.3 9 30 4.9 16 54 10.4 7
South Dakota 1 1.0 1 0.9 2 2.4 0 0.0
Tennessee 18 3.3 6 17 2.7 15 41 4.3 20 54 8.5 17
Texas 87 3.6 4 100 4.9 7 137 5.6 13 337 8.7 16
Utah 4 0.9 1 0.3 1 0.5 3 2.7
Vermont 0 0.0 0 0.0 0 0.0 0 0.0
Virginia 21 2.0 9 31 3.3 13 38 4.1 21 46 8.9 12
Washington 9 0.9 19 2.1 20 25 3.5 26 20 6.5 24
West Virginia 2 1.9 9 5.7 17 5.9 10 8 4.7
Wisconsin 9 1.1 9 1.1 11 2.4 10 6.3
Wyoming 0 0.0 0 0.0 1 1.9 0 0.0
Region of residence
Northeast 75 1.0 159 2.4 258 4.9 419 9.6
Midwest 108 1.3 136 1.7 246 3.6 263 7.5
South 371 3.3 566 5.2 956 6.7 1,404 10.7
West 109 1.3 124 1.8 194 2.9 371 4.6
Totalb 665 1.9 992 3.0 1,668 5.0 2,508 8.4
Table 5. Diagnoses of HIV infection among adults aged ≥18 years, by percentage with less than high school diploma, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Less than high school diploma (%)
Total
<5 5.00–8.99 9.00–15.99 ≥16
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 80 11.3 9 105 14.3 6 163 13.7 12 190 15.3 25
Alaska 9 5.4 11 4.7 7 5.9 0 0.0
Arizona 135 8.8 16 110 8.3 19 141 12.5 17 239 16.2 23
Arkansas 43 13.0 6 57 11.4 13 101 11.1 23 81 14.5 27
California 524 7.4 18 492 8.8 17 790 12.6 15 2,079 18.0 17
Colorado 113 5.7 26 64 6.4 27 96 11.2 22 83 13.8 31
Connecticut 42 4.1 34 46 5.3 36 46 8.3 32 85 19.8 14
Delaware 15 6.4 23 16 7.8 21 27 11.3 21 15 15.6 24
District of Columbia 44 17.6 2 35 36.1 1 44 32.9 1 39 50.0 1
Florida 488 11.4 8 658 16.0 5 1,053 22.2 3 1,527 38.8 2
Georgia 407 23.1 1 427 24.8 2 623 26.5 2 664 29.5 4
Hawaii 18 3.9 35 22 6.2 28 10 4.0 5 6.2
Idaho 14 3.9 36 14 3.3 43 11 2.9 9 4.9
Illinois 218 7.1 19 202 7.9 20 332 13.4 14 383 20.8 11
Indiana 74 6.6 21 85 6.0 30 162 9.4 28 161 17.6 19
Iowa 19 2.2 43 24 2.7 44 12 2.5 42 21 10.3 38
Kansas 50 5.7 25 20 3.6 41 31 6.6 38 43 13.4 33
Kentucky 60 9.2 13 57 8.5 18 112 9.8 26 102 10.2 39
Louisiana 91 16.6 4 104 17.1 3 233 21.2 4 370 28.4 6
Maine 11 2.7 9 2.0 5 2.1 1 4.6
Maryland 126 9.0 15 176 12.1 12 221 18.1 6 198 28.6 5
Massachusetts 79 3.6 40 71 4.9 39 102 9.9 25 129 14.4 28
Michigan 89 3.8 37 137 5.5 34 173 8.1 33 154 17.5 20
Minnesota 76 4.3 33 79 5.4 35 63 7.7 36 56 20.3 13
Mississippi 21 8.4 17 46 12.8 10 105 13.6 13 147 16.7 22
Missouri 70 5.3 27 75 5.6 33 124 8.8 29 91 13.4 32
Montana 8 2.2 8 2.7 1 0.6 2 10.3
Nebraska 12 2.3 42 26 5.7 31 33 11.3 20 25 13.0 34
Nevada 49 10.2 11 68 12.1 11 119 19.5 5 200 28.1 7
New Hampshire 11 2.3 10 2.5 6 3.5 1 1.9
New Jersey 114 4.8 31 153 7.2 22 236 16.6 7 419 33.8 3
New Mexico 12 3.8 38 20 6.5 26 36 7.8 35 30 5.6 42
New York 190 5.0 30 258 6.8 24 463 11.9 18 1,031 23.4 9
North Carolina 227 11.6 7 242 13.9 7 401 16.2 8 403 21.2 10
North Dakota 13 6.3 24 10 4.6 4 2.7 2 12.4
Ohio 139 5.2 29 185 6.5 25 253 10.7 24 242 19.0 15
Oklahoma 52 11.0 10 84 11.3 14 83 7.7 37 99 14.3 29
Oregon 50 5.2 28 51 5.2 38 45 4.5 41 32 8.1 40
Pennsylvania 110 3.5 41 170 5.3 37 222 8.3 31 219 17.2 21
Puerto Rico 17 16.8 3 27 16.2 4 101 14.8 10 226 12.8 35
Rhode Island 5 2.2 16 6.1 29 20 9.5 27 25 14.1 30
South Carolina 85 9.0 14 109 13.0 9 162 13.8 11 179 17.7 18
South Dakota 5 2.4 9 4.1 8 4.8 3 4.4
Tennessee 100 9.6 12 125 10.4 15 230 12.5 16 256 20.6 12
Texas 680 14.2 5 542 13.6 8 756 15.7 9 1,849 23.6 8
Utah 42 4.6 32 31 4.4 40 21 4.7 40 24 10.5 37
Vermont 2 1.0 1 0.5 4 3.3 1 37.6
Virginia 140 6.8 20 169 9.4 16 210 11.7 19 157 15.1 26
Washington 129 6.4 22 104 5.7 32 114 7.8 34 77 12.1 36
West Virginia 9 4.3 21 6.8 23 49 8.5 30 23 6.7 41
Wisconsin 63 3.7 39 58 3.5 42 57 6.0 39 57 18.2 16
Wyoming 1 0.6 4 2.4 1 0.9 0 0.0
Region of residence
Northeast 564 4.1 734 5.7 1,104 10.7 1,911 22.5
Midwest 828 5.0 910 5.6 1,252 9.3 1,238 17.7
South 2,668 12.2 2,973 14.1 4,573 16.6 6,299 24.1
West 1,104 6.6 999 7.2 1,392 10.5 2,780 16.9
Totalb 5,181 7.5 5,643 8.8 8,422 12.9 12,454 20.8

Abbreviation: SDOH, 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. Numbers less than 12, and rates based on these numbers, should be interpreted with caution. For the definitions of SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Based on rate. Ranks were not assigned to areas with rates that were based on reported numbers less than 12.
b Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.

Table 6. Diagnoses of HIV infection among adults aged ≥18 years, by median household income, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Median household income (U.S. $)
Male
<49,000 49,000–65,999 66,000–89,999 ≥90,000
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 229 31.7 18 100 18.7 19 73 18.9 10 22 10.7 14
Alaska 1 6.1 7 12.4 8 7.0 6 5.9
Arizona 192 28.9 24 159 23.6 11 119 17.6 13 77 11.5 13
Arkansas 122 24.9 27 59 15.8 22 32 18.0 11 14 18.3 4
California 670 39.6 13 851 32.1 8 924 23.2 7 946 14.3 8
Colorado 52 21.7 32 86 18.4 20 100 15.3 18 73 8.4 22
Connecticut 55 33.5 15 40 21.3 14 37 10.9 24 39 5.7 29
Delaware 15 40.1 12 19 19.1 18 18 13.3 20 5 5.1
District of Columbia 22 59.3 4 21 103.7 1 25 57.9 1 55 34.9 1
Florida 1,276 59.4 3 852 34.9 5 592 27.6 4 232 15.2 7
Georgia 658 64.1 2 452 45.5 2 356 37.9 2 218 23.8 2
Hawaii 2 6.2 5 7.4 18 10.5 27 19 6.4 26
Idaho 17 12.1 39 8 3.3 10 4.8 6 6.8
Illinois 330 40.8 10 249 22.2 12 216 15.6 17 157 10.3 16
Indiana 194 31.6 19 91 12.3 28 75 9.4 30 25 6.8 24
Iowa 20 11.2 43 21 4.7 40 18 4.3 41 5 3.0
Kansas 43 17.3 37 33 9.1 37 19 7.6 37 25 10.4 15
Kentucky 124 19.2 34 96 18.3 21 37 11.6 22 12 6.1 27
Louisiana 352 51.1 6 145 31.0 9 58 16.5 15 44 23.2 3
Maine 3 2.9 9 4.9 9 4.8 2 3.2
Maryland 71 42.5 9 139 43.2 3 160 30.9 3 176 13.8 9
Massachusetts 59 23.0 31 40 12.1 30 71 10.9 25 98 6.8 25
Michigan 222 24.4 29 113 10.0 34 84 8.1 36 36 4.8 31
Minnesota 38 19.1 35 70 14.0 26 66 9.0 33 40 5.5 30
Mississippi 156 29.5 23 47 14.8 24 17 10.7 26 9 13.3
Missouri 156 24.6 28 87 12.2 29 57 9.9 28 18 4.6 33
Montana 5 4.9 8 5.0 3 2.2 1 3.3
Nebraska 22 20.2 33 34 12.7 27 15 7.5 38 8 5.3
Nevada 136 52.0 5 108 36.8 4 93 24.9 6 45 17.5 6
New Hampshire 1 2.6 7 7.5 6 3.2 8 3.5
New Jersey 235 65.1 1 149 34.4 6 172 20.8 9 153 8.3 23
New Mexico 41 11.7 41 24 12.1 32 14 8.6 34 7 8.7
New York 547 45.2 7 294 19.8 15 358 17.8 12 350 12.3 12
North Carolina 456 40.2 11 310 25.4 10 186 22.1 8 88 13.3 11
North Dakota 4 9.7 8 9.7 3 2.4 1 1.9
Ohio 350 30.3 21 150 12.1 31 100 8.1 35 38 4.7 32
Oklahoma 135 25.7 25 53 11.8 33 46 14.3 19 23 13.4 10
Oregon 26 11.4 42 44 9.3 36 52 9.2 32 34 9.0 20
Pennsylvania 261 29.5 22 142 10.0 35 107 7.5 39 55 4.5 34
Puerto Rico 286 23.6 30 8 22.1 2 17.6 0 0.0
Rhode Island 23 33.5 16 11 15.4 13 9.3 31 9 6.2
South Carolina 203 33.3 17 131 21.4 13 55 12.9 21 22 9.2 19
South Dakota 8 11.2 7 6.3 5 4.2 1 3.2
Tennessee 304 35.9 14 149 19.2 17 91 16.5 16 35 8.9 21
Texas 1,119 44.0 8 841 33.5 7 703 26.7 5 499 17.7 5
Utah 12 12.1 40 36 15.1 23 36 9.4 29 25 5.8 28
Vermont 2 5.4 4 5.7 1 0.9 1 2.3
Virginia 147 31.4 20 135 19.5 16 121 17.0 14 134 9.7 18
Washington 49 18.6 36 79 14.4 25 97 11.1 23 125 9.8 17
West Virginia 40 12.4 38 18 8.0 38 6 4.6 2 7.9
Wisconsin 79 25.3 26 55 7.5 39 43 5.4 40 19 4.4 35
Wyoming 0 0.0 2 2.6 3 3.5 0 0.0
Region of residence
Northeast 1,186 37.9 696 16.3 774 13.1 715 8.4
Midwest 1,466 27.8 918 12.3 701 9.2 373 6.6
South 5,429 42.0 3,567 28.4 2,576 23.9 1,590 15.3
West 1,203 29.2 1,417 23.1 1,477 17.6 1,364 12.3
Totalb 9,570 35.9 6,606 21.7 5,530 16.9 4,042 11.3
Table 6. Diagnoses of HIV infection among adults aged ≥18 years, by median household income, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Median household income (U.S. $)
Female
<49,000 49,000–65,999 66,000–89,999 ≥90,000
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 68 8.4 18 29 5.0 12 9 2.2 6 2.8
Alaska 0 0.0 3 6.6 1 1.0 1 1.0
Arizona 27 3.9 34 18 2.7 26 20 2.9 14 10 1.5
Arkansas 32 6.1 27 13 3.4 24 8 4.4 2 2.4
California 123 7.0 24 110 4.1 19 124 3.0 12 124 1.8 10
Colorado 12 5.1 32 16 3.5 21 11 1.7 6 0.7
Connecticut 18 9.9 10 16 7.6 6 5 1.4 9 1.3
Delaware 6 13.9 5 4.4 3 2.1 2 1.9
District of Columbia 16 32.0 1 8 32.1 4 9.0 10 5.8
Florida 384 16.7 4 226 8.8 5 94 4.2 8 47 3.0 4
Georgia 202 17.8 3 107 9.9 3 74 7.4 2 41 4.3 2
Hawaii 1 3.4 1 1.5 0 0.0 6 2.0
Idaho 4 2.8 0 0.0 2 0.9 1 1.2
Illinois 87 9.9 9 49 4.2 18 25 1.7 19 17 1.1 12
Indiana 61 9.2 15 20 2.6 27 9 1.1 5 1.3
Iowa 3 1.6 5 1.1 4 1.0 0 0.0
Kansas 13 5.3 29 6 1.6 3 1.2 2 0.8
Kentucky 35 5.1 31 15 2.7 25 6 1.8 4 2.0
Louisiana 124 16.3 5 43 8.9 4 20 5.3 3 7 3.5
Maine 2 1.8 1 0.5 0 0.0 0 0.0
Maryland 23 11.7 6 39 10.7 2 48 8.4 1 64 4.7 1
Massachusetts 31 10.7 7 18 5.1 11 24 3.5 11 39 2.5 5
Michigan 62 6.3 25 20 1.7 30 7 0.7 2 0.3
Minnesota 17 8.2 21 19 3.7 20 17 2.3 16 5 0.7
Mississippi 55 9.3 14 22 6.5 7 7 4.3 2 2.7
Missouri 25 3.6 35 10 1.3 4 0.7 3 0.7
Montana 1 1.0 1 0.6 0 0.0 0 0.0
Nebraska 8 7.1 4 1.5 3 1.5 2 1.3
Nevada 24 9.4 13 13 4.5 15 14 3.7 10 3 1.1
New Hampshire 0 0.0 0 0.0 3 1.6 2 0.8
New Jersey 78 19.1 2 50 10.8 1 44 5.0 4 37 1.9 9
New Mexico 8 2.2 3 1.4 1 0.6 0 0.0
New York 139 9.9 11 74 4.7 14 95 4.4 6 60 2.0 8
North Carolina 120 9.6 12 69 5.3 9 27 3.0 13 15 2.1 6
North Dakota 0 0.0 6 7.5 5 4.3 2 4.0
Ohio 100 7.9 22 45 3.4 22 24 1.9 18 9 1.1
Oklahoma 33 6.2 26 20 4.3 17 2 0.6 5 2.8
Oregon 2 0.8 8 1.7 7 1.2 4 1.0
Pennsylvania 82 8.2 20 38 2.6 28 22 1.5 20 11 0.9
Puerto Rico 72 5.2 30 1 2.3 1 8.2 0 0.0
Rhode Island 2 2.6 2 2.6 5 3.4 1 0.7
South Carolina 58 8.6 17 34 5.1 10 20 4.4 7 10 3.9
South Dakota 2 2.9 1 0.9 1 0.8 0 0.0
Tennessee 80 8.7 16 28 3.4 23 16 2.7 15 5 1.2
Texas 281 10.6 8 157 6.1 8 132 4.9 5 91 3.2 3
Utah 1 1.0 2 0.9 3 0.8 3 0.7
Vermont 0 0.0 0 0.0 0 0.0 0 0.0
Virginia 42 8.3 19 34 4.7 13 31 4.1 9 29 2.0 7
Washington 14 5.4 28 24 4.4 16 20 2.3 17 15 1.2 11
West Virginia 26 7.8 23 8 3.5 2 1.5 0 0.0
Wisconsin 14 4.1 33 15 2.0 29 8 1.0 2 0.5
Wyoming 0 0.0 0 0.0 1 1.3 0 0.0
Region of residence
Northeast 352 9.9 199 4.4 198 3.2 159 1.8
Midwest 392 6.9 200 2.6 110 1.4 49 0.9
South 1,585 11.3 857 6.5 503 4.5 340 3.1
West 217 5.2 199 3.2 204 2.4 173 1.5
Totalb 2,618 9.1 1,456 4.6 1,016 3.0 721 2.0
Table 6. Diagnoses of HIV infection among adults aged ≥18 years, by median household income, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Median household income (U.S. $)
Total
<49,000 49,000–65,999 66,000–89,999 ≥90,000
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 297 19.4 18 129 11.6 17 82 10.3 14 28 6.7 13
Alaska 1 3.2 10 9.8 9 4.1 7 3.5
Arizona 219 16.2 25 177 13.1 12 139 10.2 15 87 6.4 15
Arkansas 154 15.2 27 72 9.5 23 40 11.1 10 16 10.0 5
California 793 23.1 13 961 17.9 9 1,048 13.0 7 1,070 8.0 9
Colorado 64 13.4 34 102 11.0 20 111 8.5 18 79 4.6 24
Connecticut 73 21.1 15 56 14.0 11 42 6.0 27 48 3.4 28
Delaware 21 26.1 9 24 11.3 18 21 7.5 20 7 3.4
District of Columbia 38 43.6 1 29 64.2 1 29 33.0 1 65 19.7 1
Florida 1,660 37.3 4 1,078 21.5 5 686 15.6 5 279 9.0 8
Georgia 860 39.8 3 559 27.0 2 430 22.1 2 259 13.8 2
Hawaii 3 4.9 6 4.5 18 5.2 31 25 4.2 25
Idaho 21 7.4 39 8 1.7 12 2.8 7 4.1
Illinois 417 24.7 11 298 12.9 14 241 8.5 17 174 5.6 17
Indiana 255 20.0 17 111 7.3 32 84 5.2 30 30 4.0 26
Iowa 23 6.3 42 26 2.9 42 22 2.6 41 5 1.5
Kansas 56 11.3 37 39 5.3 40 22 4.3 38 27 5.6 18
Kentucky 159 11.9 36 111 10.4 22 43 6.7 25 16 4.0 27
Louisiana 476 32.9 5 188 19.8 7 78 10.7 12 51 13.0 3
Maine 5 2.3 10 2.6 9 2.4 2 1.5
Maryland 94 25.8 10 178 26.0 3 208 19.2 3 240 9.1 7
Massachusetts 90 16.5 24 58 8.4 28 95 7.1 23 137 4.6 23
Michigan 284 14.9 28 133 5.8 37 91 4.3 39 38 2.5 34
Minnesota 55 13.6 32 89 8.8 25 83 5.7 28 45 3.1 30
Mississippi 211 18.8 20 69 10.5 21 24 7.4 21 11 7.8
Missouri 181 13.7 31 97 6.6 34 61 5.3 29 21 2.6 33
Montana 6 3.0 9 2.9 3 1.1 1 1.6
Nebraska 30 13.5 33 38 7.0 33 18 4.5 36 10 3.3
Nevada 160 31.0 6 121 20.8 6 107 14.3 6 48 9.3 6
New Hampshire 1 1.3 7 3.7 9 2.4 10 2.1
New Jersey 313 40.7 2 199 22.2 4 216 12.6 8 190 5.0 20
New Mexico 49 6.9 40 27 6.6 35 15 4.5 35 7 4.3
New York 686 26.2 8 368 12.0 15 453 10.9 11 410 7.0 12
North Carolina 576 24.1 12 379 15.0 10 213 12.3 9 103 7.5 11
North Dakota 4 5.0 14 8.6 27 8 3.3 3 2.9
Ohio 450 18.6 21 195 7.6 31 124 5.0 34 47 2.9 31
Oklahoma 168 15.9 26 73 8.0 30 48 7.3 22 28 8.0 10
Oregon 28 6.0 43 52 5.5 39 59 5.2 32 38 5.0 21
Pennsylvania 343 18.2 22 180 6.2 36 129 4.4 37 66 2.7 32
Puerto Rico 358 13.8 30 9 11.2 3 12.7 0 0.0
Rhode Island 25 17.3 23 13 8.7 26 18 6.2 26 10 3.4
South Carolina 261 20.3 16 165 12.9 13 75 8.5 19 32 6.5 14
South Dakota 10 7.1 8 3.7 6 2.5 1 1.6
Tennessee 384 21.8 14 177 11.1 19 107 9.4 16 40 4.9 22
Texas 1,400 26.9 7 998 19.7 8 835 15.7 4 590 10.3 4
Utah 13 6.6 41 38 8.1 29 39 5.1 33 28 3.3 29
Vermont 2 2.6 4 2.8 1 0.5 1 1.1
Virginia 189 19.4 19 169 12.0 16 152 10.4 13 163 5.8 16
Washington 63 12.0 35 103 9.4 24 117 6.7 24 140 5.5 19
West Virginia 66 10.0 38 26 5.7 38 8 3.0 2 3.9
Wisconsin 93 14.3 29 70 4.8 41 51 3.2 40 21 2.5 35
Wyoming 0 0.0 2 1.3 4 2.4 0 0.0
Region of residence
Northeast 1,538 23.0 895 10.2 972 8.0 874 5.0
Midwest 1,858 16.9 1,118 7.4 811 5.2 422 3.7
South 7,014 26.1 4,424 17.1 3,079 13.9 1,930 9.1
West 1,420 17.1 1,616 13.1 1,681 9.9 1,537 6.9
Totalb 12,188 22.0 8,062 13.0 6,546 9.8 4,763 6.6

Abbreviation: SDOH, 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. Rates are per 100,000 population. Numbers less than 12, and rates based on these numbers, should be interpreted with caution. For the definitions of SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Based on rate. Ranks were not assigned to areas with rates that were based on reported numbers less than 12.
b Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.

Table 7. Diagnoses of HIV infection among adults aged ≥18 years, by percentage without health insurance, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Without health insurance (%)
Male
<4 4.00–7.99 8.00–13.99 ≥14
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 35 17.5 6 87 19.9 8 134 21.5 17 170 28.5 20
Alaska 2 10.4 3 7.2 9 9.1 8 6.1
Arizona 49 9.1 24 98 16.0 15 159 20.6 19 243 31.6 15
Arkansas 23 16.4 8 53 15.5 19 75 18.0 25 76 34.4 14
California 556 12.7 13 905 20.5 7 975 27.4 8 965 36.0 10
Colorado 44 7.9 26 82 12.2 25 88 14.6 32 97 24.2 26
Connecticut 45 6.4 34 40 10.5 33 45 27.0 9 41 30.2 18
Delaware 13 10.0 18 21 15.8 17 22 23.6 15 1 6.3
District of Columbia 64 38.6 1 43 61.5 1 16 64.5 1 1 63.3
Florida 98 13.7 11 237 16.7 12 761 29.9 6 1,874 51.7 3
Georgia 95 27.6 2 194 34.6 2 397 37.6 3 1,008 52.1 2
Hawaii 19 6.2 35 20 9.9 35 4 7.2 2 23.7
Idaho 1 1.7 6 4.1 15 6.2 42 19 8.3 37
Illinois 159 10.7 17 233 15.4 20 286 26.3 10 279 35.9 11
Indiana 42 7.9 27 100 11.1 28 136 18.4 23 109 31.0 17
Iowa 22 4.2 38 21 4.8 42 12 6.3 41 9 16.1
Kansas 16 7.1 31 34 10.6 32 27 8.7 38 43 17.6 32
Kentucky 58 10.0 19 101 15.8 16 84 22.3 16 28 28.3 21
Louisiana 63 24.3 3 134 26.9 3 231 37.9 2 175 49.7 5
Maine 7 7.3 6 3.3 9 4.3 1 2.0
Maryland 156 16.6 7 171 23.0 4 109 30.1 5 110 46.8 7
Massachusetts 156 7.9 28 77 13.9 22 28 20.5 20 8 27.7
Michigan 127 9.2 21 143 9.5 37 145 18.1 24 46 27.1 23
Minnesota 55 5.5 37 90 11.3 26 52 17.4 29 18 28.2 22
Mississippi 14 23.1 4 11 8.2 56 17.4 28 151 26.7 25
Missouri 29 7.4 30 54 9.9 36 93 12.8 34 142 21.9 28
Montana 1 2.4 9 5.1 7 4.4 0 0.0
Nebraska 8 5.2 21 8.7 38 25 12.4 35 25 19.2 31
Nevada 21 15.7 9 58 20.8 6 98 26.1 11 205 51.5 4
New Hampshire 3 1.8 11 5.3 9 5.6 0 0.0
New Jersey 119 9.1 23 94 10.9 30 164 26.0 12 334 48.9 6
New Mexico 7 5.1 27 13.3 23 29 12.2 36 23 10.4 36
New York 378 11.4 15 517 22.3 5 453 33.0 4 223 34.9 13
North Carolina 56 13.6 12 158 19.5 10 329 25.2 13 498 36.7 9
North Dakota 3 4.7 4 3.2 8 9.3 1 3.6
Ohio 132 9.1 22 203 12.6 24 192 18.6 22 114 31.4 16
Oklahoma 8 12.1 28 16.0 14 56 14.5 33 166 19.7 30
Oregon 28 7.8 29 72 10.8 31 39 8.6 39 18 10.8 35
Pennsylvania 138 6.5 33 195 11.3 27 152 19.1 21 83 23.3 27
Puerto Rico 32 17.8 5 98 16.7 11 115 27.9 7 52 60.8 1
Rhode Island 24 10.8 16 14 11.0 29 11 20.9 7 30.7
South Carolina 24 12.6 14 58 14.2 21 142 21.4 18 189 29.8 19
South Dakota 0 0.0 6 4.9 7 6.6 8 12.4
Tennessee 21 8.4 25 92 15.6 18 172 17.9 27 295 38.1 8
Texas 88 13.9 10 242 19.7 9 527 24.3 14 2,309 35.3 12
Utah 9 4.0 28 8.6 39 29 8.6 40 43 16.8 33
Vermont 1 0.9 5 4.1 2 7.4 0 0.0
Virginia 52 6.9 32 171 16.5 13 166 18.0 26 151 27.0 24
Washington 84 9.7 20 107 9.9 34 113 15.6 30 47 15.5 34
West Virginia 10 8.0 25 7.8 40 26 12.2 37 5 10.2
Wisconsin 53 5.9 36 57 6.6 41 58 15.1 31 28 21.7 29
Wyoming 0 0.0 0 0.0 2 2.0 3 4.0
Region of residence
Northeast 871 8.7 959 14.8 873 24.6 697 36.0
Midwest 646 7.9 966 10.8 1,041 17.5 822 27.2
South 878 14.7 1,826 19.1 3,303 25.3 7,207 39.2
West 821 10.8 1,415 16.0 1,567 20.3 1,673 29.4
Totalb 3,248 10.2 5,264 15.3 6,899 22.5 10,451 35.9
Table 7. Diagnoses of HIV infection among adults aged ≥18 years, by percentage without health insurance, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Without health insurance (%)
Female
<4 4.00–7.99 8.00–13.99 ≥14
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 8 3.7 19 4.0 11 30 4.4 16 55 8.4 16
Alaska 0 0.0 0 0.0 1 1.1 4 3.5
Arizona 8 1.4 18 2.8 21 14 1.8 26 35 4.6 26
Arkansas 6 4.0 9 2.5 18 4.0 19 22 9.8 9
California 76 1.7 11 141 3.1 16 145 4.0 20 122 4.6 27
Colorado 2 0.4 12 1.8 28 11 1.9 20 5.3 24
Connecticut 10 1.4 17 4.2 10 8 4.3 13 9.2 13
Delaware 2 1.4 4 2.8 9 8.9 1 6.1
District of Columbia 22 11.8 1 14 17.5 1 1 3.6 1 58.6
Florida 16 2.0 6 45 3.0 18 182 6.7 6 513 13.7 4
Georgia 13 3.7 3 31 5.2 5 106 9.1 3 277 13.3 6
Hawaii 8 2.7 1 0.5 1 1.8 0 0.0
Idaho 0 0.0 0 0.0 5 2.1 2 0.9
Illinois 20 1.3 14 38 2.4 25 66 5.6 10 54 7.0 20
Indiana 5 0.9 29 3.1 15 24 3.1 25 37 10.1 8
Iowa 2 0.4 6 1.4 2 1.1 2 3.7
Kansas 2 0.9 5 1.5 5 1.6 12 5.0 25
Kentucky 11 1.8 17 2.5 24 22 5.6 11 10 9.7
Louisiana 19 7.0 2 38 7.0 3 82 12.5 1 56 15.5 2
Maine 0 0.0 1 0.5 1 0.5 1 2.1
Maryland 29 2.9 5 66 8.0 2 39 9.7 2 41 17.2 1
Massachusetts 62 2.9 4 36 6.1 4 10 7.2 4 14.2
Michigan 17 1.2 15 33 2.1 26 31 3.7 22 11 6.3
Minnesota 11 1.1 23 2.9 20 19 6.4 7 6 10.0
Mississippi 3 4.4 6 4.1 20 5.7 8 58 9.4 11
Missouri 1 0.2 8 1.4 7 0.9 26 3.8 28
Montana 0 0.0 1 0.6 1 0.6 0 0.0
Nebraska 1 0.6 2 0.8 4 2.0 10 7.9
Nevada 2 1.5 6 2.1 10 2.7 36 9.4 12
New Hampshire 3 1.8 1 0.5 1 0.6 0 0.0
New Jersey 27 1.9 7 34 3.7 12 48 7.2 5 102 14.4 3
New Mexico 1 0.7 3 1.4 3 1.3 5 2.2
New York 66 1.9 9 114 4.5 8 125 8.4 4 64 9.8 10
North Carolina 9 2.2 26 2.9 19 65 4.6 14 131 9.0 14
North Dakota 3 4.8 3 2.5 7 8.7 0 0.0
Ohio 28 1.8 10 54 3.2 14 46 4.2 18 50 13.4 5
Oklahoma 1 1.5 5 2.6 8 2.0 46 5.4 23
Oregon 5 1.3 8 1.2 4 0.9 4 2.4
Pennsylvania 35 1.6 13 49 2.7 23 46 5.5 12 23 6.3 21
Puerto Rico 7 3.4 30 4.4 9 25 5.3 13 12 12.9 7
Rhode Island 7 2.9 2 1.5 0 0.0 1 4.2
South Carolina 3 1.5 22 4.9 6 41 5.7 9 56 8.2 17
South Dakota 0 0.0 0 0.0 2 2.0 2 3.3
Tennessee 3 1.1 17 2.7 22 39 3.8 21 71 8.5 15
Texas 12 1.9 8 38 3.0 17 76 3.4 23 535 8.0 19
Utah 0 0.0 3 0.9 1 0.3 5 2.0
Vermont 0 0.0 0 0.0 0 0.0 0 0.0
Virginia 13 1.7 12 35 3.2 13 42 4.3 17 46 8.1 18
Washington 10 1.2 13 1.2 29 33 4.6 15 17 5.9 22
West Virginia 5 3.8 16 4.8 7 10 4.6 5 10.7
Wisconsin 6 0.7 16 1.8 27 13 3.3 24 4 3.2
Wyoming 1 8.9 0 0.0 0 0.0 0 0.0
Region of residence
Northeast 210 2.0 254 3.7 239 6.3 208 10.4
Midwest 96 1.1 217 2.3 226 3.6 214 7.0
South 175 2.8 408 4.0 790 5.7 1,924 10.0
West 113 1.4 206 2.3 229 3.0 250 4.5
Totalb 601 1.8 1,115 3.1 1,509 4.7 2,608 8.7
Table 7. Diagnoses of HIV infection among adults aged ≥18 years, by percentage without health insurance, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Without health insurance (%)
Total
<4 4.00–7.99 8.00–13.99 ≥14
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 43 10.3 5 106 11.6 7 164 12.6 19 225 18.0 23
Alaska 2 6.2 3 3.7 10 5.2 12 4.9 38
Arizona 57 5.2 25 116 9.3 16 173 11.1 24 278 18.2 22
Arkansas 29 10.0 7 62 8.8 21 93 10.8 27 98 22.0 12
California 632 7.1 13 1,046 11.6 6 1,120 15.6 10 1,087 20.3 16
Colorado 46 4.1 32 94 7.0 29 99 8.3 34 117 15.0 27
Connecticut 55 3.8 35 57 7.2 24 53 15.1 12 54 19.5 18
Delaware 15 5.6 20 25 9.0 18 31 15.9 8 2 6.2
District of Columbia 86 24.4 1 57 38.0 1 17 32.5 1 2 60.8
Florida 114 7.6 12 282 9.6 14 943 17.9 6 2,387 32.4 2
Georgia 108 15.6 2 225 19.4 2 503 22.7 3 1,285 32.0 4
Hawaii 27 4.5 29 21 5.2 39 5 4.5 2 11.4
Idaho 1 0.8 6 2.0 20 4.1 42 21 4.6 39
Illinois 179 5.9 17 271 8.8 22 352 15.6 11 333 21.4 14
Indiana 47 4.3 30 129 7.0 28 160 10.6 29 146 20.3 17
Iowa 24 2.2 39 27 3.1 43 14 3.7 43 11 10.1
Kansas 18 3.9 34 39 6.0 34 32 5.1 39 55 11.3 33
Kentucky 69 5.8 18 118 9.0 19 106 13.7 16 38 18.8 20
Louisiana 82 15.4 3 172 16.5 3 313 24.7 2 231 32.4 3
Maine 7 3.5 7 1.8 10 2.4 2 2.0
Maryland 185 9.5 8 237 15.1 4 148 19.3 5 151 31.9 5
Massachusetts 218 5.3 24 113 9.9 12 38 13.8 15 12 21.0 15
Michigan 144 5.1 26 176 5.8 36 176 10.8 26 57 16.5 26
Minnesota 66 3.3 38 113 7.1 27 71 11.9 21 24 19.3 19
Mississippi 17 13.2 4 17 6.1 33 76 11.3 22 209 17.7 24
Missouri 30 3.7 36 62 5.6 37 100 6.7 38 168 12.6 30
Montana 1 1.2 10 2.8 8 2.6 0 0.0
Nebraska 9 2.9 23 4.7 41 29 7.1 36 35 13.6 29
Nevada 23 8.5 9 64 11.4 8 108 14.4 14 241 30.9 7
New Hampshire 6 1.8 12 2.9 44 10 3.1 0 0.0
New Jersey 146 5.4 23 128 7.2 25 212 16.3 7 436 31.3 6
New Mexico 8 2.9 30 7.2 26 32 6.7 37 28 6.3 37
New York 444 6.5 16 631 13.0 5 578 20.2 4 287 22.2 11
North Carolina 65 7.8 11 184 10.9 10 394 14.5 13 629 22.4 9
North Dakota 6 4.8 7 2.9 15 9.0 32 1 1.9
Ohio 160 5.4 22 257 7.8 23 238 11.2 23 164 22.3 10
Oklahoma 9 6.7 33 9.0 17 64 8.2 35 212 12.5 32
Oregon 33 4.5 28 80 5.9 35 43 4.7 40 22 6.6 36
Pennsylvania 173 4.0 33 244 6.8 30 198 12.1 20 106 14.7 28
Puerto Rico 39 10.0 6 128 10.1 11 140 15.9 9 64 35.8 1
Rhode Island 31 6.7 15 16 6.1 32 11 10.2 8 17.1
South Carolina 27 6.9 14 80 9.4 15 183 13.2 18 245 18.6 21
South Dakota 0 0.0 6 2.5 9 4.3 10 7.9
Tennessee 24 4.6 27 109 8.9 20 211 10.7 28 366 22.8 8
Texas 100 7.9 10 280 11.2 9 603 13.6 17 2,844 21.5 13
Utah 9 2.0 31 4.8 40 30 4.4 41 48 9.4 35
Vermont 1 0.5 5 2.0 2 3.7 0 0.0
Virginia 65 4.3 31 206 9.7 13 208 10.9 25 197 17.4 25
Washington 94 5.4 21 120 5.5 38 146 10.1 30 64 10.8 34
West Virginia 15 5.8 19 41 6.3 31 36 8.4 33 10 10.5
Wisconsin 59 3.3 37 73 4.2 42 71 9.2 31 32 12.5 31
Wyoming 1 4.3 0 0.0 2 1.0 3 2.1
Region of residence
Northeast 1,081 5.2 1,213 9.0 1,112 15.2 905 23.0
Midwest 742 4.5 1,183 6.5 1,267 10.4 1,036 17.0
South 1,053 8.6 2,234 11.3 4,093 15.2 9,131 24.3
West 934 6.1 1,621 9.0 1,796 11.6 1,923 17.1
Totalb 3,849 5.9 6,379 9.0 8,408 13.4 13,059 22.1

Abbreviation: SDOH, 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. Numbers less than 12, and rates based on these numbers, should be interpreted with caution. For the definitions of SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Based on rate. Ranks were not assigned to areas with rates that were based on reported numbers less than 12.
b Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.

Table 8. Diagnoses of HIV infection among adults aged ≥18 years, by Gini index percentage, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Gini index (%)
Male
<37 37.00–40.99 41.00–45.99 ≥46
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 68 21.5 8 89 21.3 11 130 21.5 10 139 26.9 14
Alaska 7 9.1 6 6.1 6 8.0 3 8.0
Arizona 168 19.1 11 121 18.3 15 133 20.2 16 127 25.8 17
Arkansas 25 16.1 14 49 19.6 12 55 14.9 26 98 28.3 13
California 718 20.9 9 810 21.8 10 997 22.8 9 874 25.2 18
Colorado 84 11.1 24 64 12.6 25 83 14.5 28 80 20.2 25
Connecticut 15 6.0 36 43 11.7 27 62 15.1 25 51 14.4 36
Delaware 10 10.6 12 11.1 29 21 20.7 13 14 20.6 24
District of Columbia 12 38.4 16 55.2 1 34 47.3 1 62 48.5 2
Florida 553 30.5 2 679 33.0 3 849 37.1 4 887 41.9 3
Georgia 443 41.7 1 341 37.9 2 425 41.4 2 485 53.5 1
Hawaii 10 5.6 13 9.2 36 5 3.6 17 15.4 32
Idaho 13 6.0 35 7 4.5 15 8.1 41 6 5.1
Illinois 143 13.0 19 204 15.5 20 254 19.3 17 356 31.7 9
Indiana 120 15.8 15 85 11.3 28 107 17.3 22 75 19.2 27
Iowa 12 4.4 38 20 5.0 42 17 5.0 43 15 7.9 43
Kansas 42 11.5 23 30 9.9 33 28 10.8 35 20 11.6 41
Kentucky 45 13.9 17 54 13.8 22 95 19.2 18 77 15.9 31
Louisiana 60 25.7 4 95 32.6 5 185 33.6 5 263 40.9 4
Maine 5 5.1 4 2.8 6 3.6 8 6.1
Maryland 189 23.6 6 136 21.9 9 121 23.6 8 100 29.2 12
Massachusetts 27 6.3 34 51 7.6 40 96 11.4 34 95 12.6 38
Michigan 105 10.9 25 115 10.3 32 116 11.5 32 125 16.6 30
Minnesota 45 7.7 32 66 9.7 35 47 8.0 42 57 18.9 28
Mississippi 34 18.7 13 37 17.4 17 55 18.9 19 106 26.7 16
Missouri 57 9.3 28 99 15.4 21 73 11.5 33 89 21.2 22
Montana 7 12.3 3 3.2 3 1.9 4 3.6
Nebraska 19 9.4 27 19 9.1 37 23 11.8 29 18 14.6 35
Nevada 82 23.3 7 95 32.8 4 114 37.7 3 91 37.6 5
New Hampshire 3 1.8 9 6.3 5 3.3 6 6.6
New Jersey 88 11.6 21 171 16.8 18 188 20.8 12 264 32.9 7
New Mexico 16 12.0 20 20 10.7 30 24 10.2 36 26 10.7 42
New York 141 11.6 22 231 13.6 23 383 17.9 21 811 31.9 8
North Carolina 191 24.5 5 259 27.4 7 301 25.6 7 290 29.9 11
North Dakota 1 2.2 3 3.6 7 6.6 5 7.3
Ohio 105 8.7 30 171 13.3 24 176 15.8 24 189 22.4 21
Oklahoma 44 13.7 18 70 18.4 14 69 14.9 27 75 24.3 20
Oregon 35 9.3 29 40 9.1 38 43 8.7 40 39 11.7 40
Pennsylvania 81 7.9 31 114 7.9 39 176 11.6 31 197 19.7 26
Puerto Rico 5 29.2 21 23.9 8 65 20.4 15 206 24.5 19
Rhode Island 9 9.6 12 9.7 34 20 18.8 20 15 14.7 34
South Carolina 68 19.1 12 81 18.6 13 115 21.1 11 149 26.8 15
South Dakota 3 3.8 7 7.6 4 4.0 7 11.1
Tennessee 113 20.7 10 107 17.5 16 153 20.6 14 207 31.0 10
Texas 862 26.3 3 717 29.2 6 819 31.2 6 768 35.1 6
Utah 40 7.3 33 33 12.2 26 21 10.2 37 15 12.5 39
Vermont 1 2.9 2 3.2 3 3.1 2 3.2
Virginia 165 14.5 16 127 15.6 19 132 17.3 23 116 21.0 23
Washington 91 10.3 26 83 10.4 31 92 11.7 30 85 17.0 29
West Virginia 7 8.4 6 3.6 23 9.3 39 30 14.2 37
Wisconsin 30 5.3 37 56 7.4 41 64 10.0 38 46 14.8 33
Wyoming 0 0.0 2 3.3 2 3.4 1 2.2
Region of residence
Northeast 370 9.1 637 11.2 939 14.8 1,449 24.8
Midwest 682 10.1 875 11.5 916 13.2 1,002 21.1
South 2,889 25.1 2,875 25.9 3,582 27.8 3,866 33.9
West 1,271 16.0 1,297 17.5 1,538 18.6 1,368 22.0
Totalb 5,217 17.2 5,705 17.9 7,040 20.3 7,891 27.2
Table 8. Diagnoses of HIV infection among adults aged ≥18 years, by Gini index percentage, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Gini index (%)
Female
<37 37.00–40.99 41.00–45.99 ≥46
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 16 4.8 8 18 4.0 15 42 6.3 7 36 6.3 13
Alaska 1 1.4 0 0.0 3 4.4 1 2.9
Arizona 20 2.3 19 20 3.0 20 17 2.5 28 18 3.6 28
Arkansas 9 5.5 12 4.5 10 16 4.1 19 18 4.9 22
California 92 2.7 14 135 3.5 17 134 3.0 26 123 3.4 29
Colorado 12 1.6 21 15 3.0 21 13 2.3 29 5 1.3
Connecticut 2 0.8 10 2.6 15 3.4 23 21 5.4 20
Delaware 1 1.0 7 5.9 5 4.4 3 4.0
District of Columbia 3 9.7 4 11.8 9 11.7 22 14.6 1
Florida 146 7.7 2 185 8.5 3 216 8.9 3 209 9.3 5
Georgia 108 9.6 1 104 10.6 1 96 8.8 4 119 12.0 2
Hawaii 5 2.9 2 1.4 1 0.7 2 1.7
Idaho 1 0.5 3 1.9 3 1.6 0 0.0
Illinois 19 1.7 20 31 2.3 27 48 3.5 22 80 6.5 11
Indiana 21 2.7 13 20 2.6 24 30 4.6 14 24 5.7 18
Iowa 3 1.1 2 0.5 4 1.2 3 1.5
Kansas 5 1.4 5 1.6 9 3.3 5 2.9
Kentucky 31 15 4.5 9 13 3.2 19 16 3.1 25 16 3.1
Louisiana 13 5.4 5 32 10.1 2 69 11.6 1 81 11.8 3
Maine 0 0.0 0 0.0 1 0.6 2 1.4
Maryland 47 5.5 4 43 6.4 5 51 9.2 2 34 8.6 7
Massachusetts 9 2.0 18 2.5 25 39 4.3 16 46 5.5 19
Michigan 15 1.5 23 15 1.3 29 24 2.3 30 38 4.7 24
Minnesota 9 1.5 19 2.8 22 19 3.1 24 12 3.8 26
Mississippi 11 5.6 16 6.9 4 17 5.5 9 43 9.7 4
Missouri 9 1.4 15 2.2 28 8 1.2 10 2.2
Montana 1 1.8 0 0.0 1 0.6 0 0.0
Nebraska 7 3.4 5 2.4 4 2.0 1 0.8
Nevada 13 3.7 10 12 4.2 13 13 4.2 18 16 6.9 9
New Hampshire 1 0.6 1 0.7 3 1.9 0 0.0
New Jersey 26 3.3 12 57 5.3 9 51 5.3 11 77 8.8 6
New Mexico 2 1.4 2 1.0 6 2.5 2 0.8
New York 33 2.6 16 69 3.9 16 100 4.4 15 167 5.8 17
North Carolina 40 4.9 6 60 5.9 6 66 5.2 12 65 6.1 16
North Dakota 1 2.3 2 2.6 3 3.0 7 10.7
Ohio 33 2.7 15 46 3.4 18 55 4.6 13 44 4.8 23
Oklahoma 10 3.0 17 4.4 11 13 2.7 27 20 6.3 14
Oregon 7 1.8 2 0.4 6 1.2 6 1.7
Pennsylvania 17 1.6 22 37 2.5 26 57 3.6 21 42 3.8 27
Puerto Rico 2 9.8 8 7.8 14 3.9 20 50 5.2 21
Rhode Island 1 1.1 0 0.0 6 5.2 3 2.6
South Carolina 18 4.8 7 26 5.5 8 32 5.4 10 46 7.5 8
South Dakota 1 1.3 2 2.2 1 1.0 0 0.0
Tennessee 20 3.5 11 28 4.3 12 34 4.3 17 48 6.6 10
Texas 189 5.7 3 143 5.7 7 183 6.8 5 146 6.4 12
Utah 3 0.6 5 1.8 1 0.5 0 0.0
Vermont 0 0.0 0 0.0 0 0.0 0 0.0
Virginia 27 2.3 18 34 4.1 14 48 5.9 8 27 4.5 25
Washington 21 2.4 17 22 2.8 23 17 2.1 31 13 2.6 31
West Virginia 3 3.5 3 1.8 16 6.3 6 14 6.3 15
Wisconsin 7 1.2 10 1.3 12 1.8 32 10 3.1
Wyoming 0 0.0 0 0.0 1 1.7 0 0.0
Region of residence
Northeast 89 2.1 192 3.2 272 4.0 358 5.5
Midwest 130 1.9 172 2.2 217 3.0 234 4.6
South 676 5.7 745 6.4 929 6.8 947 7.7
West 178 2.3 218 2.9 216 2.6 186 2.9
Totalb 1,075 3.5 1,335 4.0 1,648 4.5 1,775 5.7
Table 8. Diagnoses of HIV infection among adults aged ≥18 years, by Gini index percentage, assigned sex at birth, and area of residence, 2021—census tract level, United States and Puerto Rico
Area of residence Gini index (%)
Total
<37 37.00–40.99 41.00–45.99 ≥46
No. Rate Ranka No. Rate Ranka No. Rate Ranka No. Rate Ranka
Alabama 84 12.9 9 107 12.4 11 172 13.5 9 175 16.1 16
Alaska 8 5.5 6 3.2 9 6.3 4 5.6
Arizona 188 10.6 15 141 10.6 18 150 11.2 20 145 14.6 18
Arkansas 34 10.7 14 61 11.8 13 71 9.4 25 116 16.3 15
California 810 11.8 12 945 12.6 10 1,131 12.7 12 997 14.1 20
Colorado 96 6.4 26 79 7.8 26 96 8.4 28 85 10.8 28
Connecticut 17 3.4 37 53 7.0 28 77 9.0 26 72 9.7 32
Delaware 11 5.8 19 8.4 24 26 12.2 14 17 11.9 24
District of Columbia 15 24.1 2 20 31.8 1 43 28.9 1 84 30.2 2
Florida 699 18.8 3 864 20.4 4 1,065 22.6 3 1,096 25.1 4
Georgia 551 25.2 1 445 23.7 2 521 24.6 2 604 31.8 1
Hawaii 15 4.3 34 15 5.3 36 6 2.1 19 8.4 37
Idaho 14 3.2 39 10 3.1 18 4.9 42 6 2.6
Illinois 162 7.3 21 235 8.7 20 302 11.3 19 436 18.6 8
Indiana 141 9.2 16 105 6.9 29 137 10.8 23 99 12.2 23
Iowa 15 2.7 40 22 2.7 42 21 3.1 43 18 4.7 44
Kansas 47 6.4 24 35 5.7 35 37 6.9 32 25 7.3 40
Kentucky 60 9.2 17 67 8.4 23 111 11.0 21 93 9.3 33
Louisiana 73 15.4 5 127 20.9 3 254 22.2 4 344 25.9 3
Maine 5 2.5 4 1.4 7 2.0 10 3.6
Maryland 236 14.3 7 179 13.8 9 172 16.1 7 134 18.1 10
Massachusetts 36 4.1 35 69 5.0 38 135 7.7 30 141 8.9 35
Michigan 120 6.2 28 130 5.7 34 140 6.8 35 163 10.4 29
Minnesota 54 4.6 33 85 6.2 31 66 5.5 39 69 11.2 27
Mississippi 45 11.9 10 53 12.0 12 72 12.0 15 149 17.7 12
Missouri 66 5.3 31 114 8.6 22 81 6.2 37 99 11.3 25
Montana 8 7.1 3 1.6 4 1.3 4 1.8
Nebraska 26 6.4 25 24 5.7 33 27 6.8 34 19 7.7 39
Nevada 95 13.5 8 107 18.6 5 127 20.7 5 107 22.6 5
New Hampshire 4 1.2 10 3.4 8 2.6 6 3.3
New Jersey 114 7.4 20 228 10.9 16 239 12.8 11 341 20.3 7
New Mexico 18 6.6 23 22 5.8 32 30 6.3 36 28 5.7 43
New York 174 7.1 22 300 8.6 21 483 10.9 22 978 18.0 11
North Carolina 231 14.5 6 319 16.3 7 367 15.0 8 355 17.4 13
North Dakota 2 2.2 5 3.1 10 4.9 12 9.0 34
Ohio 138 5.7 29 217 8.2 25 231 10.0 24 233 13.3 21
Oklahoma 54 8.3 19 87 11.3 15 82 8.8 27 95 15.2 17
Oregon 42 5.5 30 42 4.7 39 49 4.9 41 45 6.6 41
Pennsylvania 98 4.7 32 151 5.2 37 233 7.5 31 239 11.3 26
Puerto Rico 7 18.6 29 15.3 8 79 11.7 17 256 14.2 19
Rhode Island 10 5.3 12 4.7 40 26 11.8 16 18 8.3 38
South Carolina 86 11.7 13 107 11.7 14 147 12.9 10 195 16.7 14
South Dakota 4 2.6 9 4.9 5 2.5 7 5.5
Tennessee 133 11.9 11 135 10.7 17 187 12.2 13 255 18.2 9
Texas 1,051 15.9 4 860 17.3 6 1,002 18.9 6 914 20.5 6
Utah 43 4.0 36 38 7.0 27 22 5.3 40 15 6.3 42
Vermont 1 1.4 2 1.6 3 1.5 2 1.6
Virginia 192 8.4 18 161 9.8 19 180 11.4 18 143 12.4 22
Washington 112 6.4 27 105 6.6 30 109 6.9 33 98 9.8 31
West Virginia 10 6.0 9 2.7 39 7.8 29 44 10.1 30
Wisconsin 37 3.3 38 66 4.4 41 76 5.9 38 56 8.8 36
Wyoming 0 0.0 2 1.7 3 2.5 1 1.1
Region of residence
Northeast 459 5.6 829 7.1 1,211 9.3 1,807 14.6
Midwest 812 6.0 1,047 6.7 1,133 8.0 1,236 12.6
South 3,565 15.2 3,620 15.9 4,511 17.0 4,813 20.3
West 1,449 9.1 1,515 10.1 1,754 10.5 1,554 12.4
Totalb 6,292 10.3 7,040 10.8 8,688 12.2 9,666 16.0

Abbreviation: SDOH, 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 income inequality as measured by the Gini index within the census tract. Rates are per 100,000 population. Numbers less than 12, and rates based on these numbers, should be interpreted with caution. For the definitions of SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Based on rate. Ranks were not assigned to areas with rates that were based on reported numbers less than 12.
b Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.

Table 9. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among adults aged ≥18 years, by age at diagnosis, assigned sex at birth, and selected social determinants of health—census tract level, 47 states and the District of Columbia
  18‒24 years 25–34 years
Total diagnosesa Linkage to care Viral suppression Total diagnosesa Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. %
Male
Below federal poverty level (%)
<6 748 612 81.8 539 72.1 1,527 1,276 83.6 1,116 73.1
6.00–9.99 836 688 82.3 607 72.6 1,798 1,477 82.1 1,301 72.4
10.00–16.99 1,383 1,132 81.9 986 71.3 2,698 2,259 83.7 1,919 71.1
≥17 2,119 1,656 78.2 1,433 67.6 3,436 2,798 81.4 2,375 69.1
Less than high school diploma (%)
<5 823 687 83.5 594 72.2 1,710 1,432 83.7 1,256 73.5
5.00–8.99 910 731 80.3 648 71.2 1,677 1,398 83.4 1,236 73.7
9.00–15.99 1,311 1,037 79.1 914 69.7 2,543 2,106 82.8 1,796 70.6
≥16 2,043 1,634 80.0 1,410 69.0 3,531 2,875 81.4 2,423 68.6
Median household income (U.S. $)
<49,000 2,087 1,643 78.7 1,394 66.8 3,408 2,749 80.7 2,307 67.7
49,000–65,999 1,301 1,045 80.3 948 72.9 2,533 2,106 83.1 1,818 71.8
66,000–89,999 1,008 820 81.3 725 71.9 2,042 1,690 82.8 1,486 72.8
≥90,000 658 553 84.0 473 71.9 1,436 1,229 85.6 1,074 74.8
Without health insurance (%)
<4 539 460 85.3 397 73.7 1,079 927 85.9 804 74.5
4.00–7.99 943 783 83.0 690 73.2 1,870 1,554 83.1 1,374 73.5
8.00–13.99 1,362 1,097 80.5 954 70.0 2,621 2,166 82.6 1,905 72.7
≥14 2,243 1,749 78.0 1,525 68.0 3,889 3,163 81.3 2,628 67.6
Gini index (%)
<37 1,095 889 81.2 763 69.7 1,985 1,634 82.3 1,415 71.3
37.00–40.99 1,094 885 80.9 786 71.8 2,141 1,734 81.0 1,522 71.1
41.00–45.99 1,379 1,103 80.0 963 69.8 2,596 2,170 83.6 1,847 71.1
≥46 1,516 1,209 79.7 1,051 69.3 2,734 2,269 83.0 1,926 70.4
Subtotalb 5,260 4,213 80.1 3,682 70.0 9,777 8,060 82.4 6,927 70.8
Female
Below federal poverty level (%)
<6 77 68 88.3 57 74.0 196 165 84.2 138 70.4
6.00–9.99 112 90 80.4 85 75.9 252 210 83.3 182 72.2
10.00–16.99 164 121 73.8 102 62.2 388 309 79.6 280 72.2
≥17 295 245 83.1 207 70.2 668 554 82.9 449 67.2
Less than high school diploma (%)
<5 80 65 81.3 54 67.5 178 152 85.4 131 73.6
5.00–8.99 103 76 73.8 76 73.8 289 243 84.1 210 72.7
9.00–15.99 173 147 85.0 122 70.5 409 342 83.6 277 67.7
≥16 292 236 80.8 199 68.2 628 501 79.8 431 68.6
Median household income (U.S. $)
<49,000 292 240 82.2 194 66.4 685 560 81.8 459 67.0
49,000–65,999 161 124 77.0 117 72.7 403 331 82.1 289 71.7
66,000–89,999 125 102 81.6 91 72.8 238 197 82.8 170 71.4
≥90,000 68 56 82.4 47 69.1 175 148 84.6 130 74.3
Without health insurance (%)
<4 65 53 81.5 45 69.2 139 114 82.0 101 72.7
4.00–7.99 123 98 79.7 92 74.8 277 236 85.2 192 69.3
8.00–13.99 152 125 82.2 105 69.1 374 310 82.9 262 70.1
≥14 308 248 80.5 209 67.9 714 578 81.0 494 69.2
Gini index (%)
<37 125 104 83.2 82 65.6 289 236 81.7 208 72.0
37.00–40.99 148 116 78.4 104 70.3 353 287 81.3 252 71.4
41.00–45.99 179 145 81.0 131 73.2 416 345 82.9 284 68.3
≥46 196 159 81.1 134 68.4 446 370 83.0 305 68.4
Subtotalb 662 533 80.5 461 69.6 1,551 1,274 82.1 1,082 69.8
Total 5,922 4,746 80.1 4,143 70.0 11,328 9,334 82.4 8,009 70.7
Table 9. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among adults aged ≥18 years, by age at diagnosis, assigned sex at birth, and selected social determinants of health—census tract level, 47 states and the District of Columbia
  35–44 years 45–54 years
Total diagnosesa Linkage to care Viral suppression Total diagnosesa Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. %
Male
Below federal poverty level (%)
<6 792 684 86.4 574 72.5 469 408 87.0 360 76.8
6.00–9.99 926 784 84.7 676 73.0 553 459 83.0 394 71.2
10.00–16.99 1,385 1,160 83.8 988 71.3 728 621 85.3 529 72.7
≥17 1,692 1,364 80.6 1,119 66.1 886 732 82.6 579 65.3
Less than high school diploma (%)
<5 854 733 85.8 634 74.2 464 397 85.6 337 72.6
5.00–8.99 862 708 82.1 627 72.7 501 420 83.8 368 73.5
9.00–15.99 1,231 1,030 83.7 859 69.8 684 591 86.4 503 73.5
≥16 1,850 1,523 82.3 1,238 66.9 988 812 82.2 654 66.2
Median household income (U.S. $)
<49,000 1,644 1,310 79.7 1,052 64.0 867 709 81.8 567 65.4
49,000–65,999 1,241 1,055 85.0 885 71.3 665 570 85.7 484 72.8
66,000–89,999 1,087 906 83.3 793 73.0 613 515 84.0 440 71.8
≥90,000 803 702 87.4 614 76.5 484 422 87.2 366 75.6
Without health insurance (%)
<4 628 541 86.1 458 72.9 369 313 84.8 267 72.4
4.00–7.99 979 831 84.9 732 74.8 576 487 84.5 404 70.1
8.00–13.99 1,224 1,025 83.7 857 70.0 675 568 84.1 496 73.5
≥14 1,964 1,595 81.2 1,310 66.7 1,016 852 83.9 695 68.4
Gini index (%)
<37 959 807 84.2 668 69.7 547 454 83.0 406 74.2
37.00–40.99 1,091 896 82.1 767 70.3 578 500 86.5 412 71.3
41.00–45.99 1,278 1,068 83.6 904 70.7 713 604 84.7 492 69.0
≥46 1,464 1,218 83.2 1,016 69.4 798 662 83.0 552 69.2
Subtotalb 4,964 4,131 83.2 3,482 70.1 2,712 2,281 84.1 1,911 70.5
Female
Below federal poverty level (%)
<6 182 155 85.2 139 76.4 151 131 86.8 113 74.8
6.00–9.99 219 185 84.5 158 72.1 167 137 82.0 116 69.5
10.00–16.99 404 333 82.4 286 70.8 280 233 83.2 210 75.0
≥17 585 476 81.4 381 65.1 404 332 82.2 278 68.8
Less than high school diploma (%)
<5 149 127 85.2 118 79.2 119 101 84.9 95 79.8
5.00–8.99 212 180 84.9 134 63.2 158 127 80.4 110 69.6
9.00–15.99 404 336 83.2 293 72.5 302 257 85.1 216 71.5
≥16 625 506 81.0 419 67.0 423 348 82.3 296 70.0
Median household income (U.S. $)
<49,000 627 515 82.1 411 65.6 424 343 80.9 292 68.9
49,000–65,999 335 267 79.7 230 68.7 248 208 83.9 175 70.6
66,000–89,999 240 213 88.8 178 74.2 193 165 85.5 145 75.1
≥90,000 183 150 82.0 141 77.0 133 113 85.0 102 76.7
Without health insurance (%)
<4 131 104 79.4 99 75.6 113 100 88.5 93 82.3
4.00–7.99 253 210 83.0 190 75.1 188 162 86.2 142 75.5
8.00–13.99 369 309 83.7 255 69.1 253 214 84.6 176 69.6
≥14 637 526 82.6 420 65.9 448 357 79.7 306 68.3
Gini index (%)
<37 266 232 87.2 189 71.1 186 151 81.2 120 64.5
37.00–40.99 310 254 81.9 229 73.9 250 201 80.4 188 75.2
41.00–45.99 393 323 82.2 259 65.9 276 235 85.1 205 74.3
≥46 421 340 80.8 287 68.2 290 246 84.8 204 70.3
Subtotalb 1,436 1,185 82.5 994 69.2 1,044 870 83.3 744 71.3
Total 6,400 5,316 83.1 4,476 69.9 3,756 3,151 83.9 2,655 70.7
Table 9. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among adults aged ≥18 years, by age at diagnosis, assigned sex at birth, and selected social determinants of health—census tract level, 47 states and the District of Columbia
  ≥55 years Total
Total diagnosesa Linkage to care Viral suppression Total diagnosesa Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. %
Male
Below federal poverty level (%)
<6 436 388 89.0 295 67.7 3,972 3,368 84.8 2,884 72.6
6.00–9.99 444 382 86.0 297 66.9 4,557 3,790 83.2 3,275 71.9
10.00–16.99 634 543 85.6 447 70.5 6,828 5,715 83.7 4,869 71.3
≥17 754 621 82.4 490 65.0 8,887 7,171 80.7 5,996 67.5
Less than high school diploma (%)
<5 443 390 88.0 315 71.1 4,294 3,639 84.7 3,136 73.0
5.00–8.99 425 371 87.3 290 68.2 4,375 3,628 82.9 3,169 72.4
9.00–15.99 549 476 86.7 379 69.0 6,318 5,240 82.9 4,451 70.4
≥16 851 697 81.9 545 64.0 9,263 7,541 81.4 6,270 67.7
Median household income (U.S. $)
<49,000 765 630 82.4 499 65.2 8,771 7,041 80.3 5,819 66.3
49,000–65,999 559 471 84.3 387 69.2 6,299 5,247 83.3 4,522 71.8
66,000–89,999 489 434 88.8 332 67.9 5,239 4,365 83.3 3,776 72.1
≥90,000 447 393 87.9 305 68.2 3,828 3,299 86.2 2,832 74.0
Without health insurance (%)
<4 343 304 88.6 240 70.0 2,958 2,545 86.0 2,166 73.2
4.00–7.99 503 441 87.7 346 68.8 4,871 4,096 84.1 3,546 72.8
8.00–13.99 571 496 86.9 406 71.1 6,453 5,352 82.9 4,618 71.6
≥14 851 693 81.4 537 63.1 9,963 8,052 80.8 6,695 67.2
Gini index (%)
<37 444 386 86.9 286 64.4 5,030 4,170 82.9 3,538 70.3
37.00–40.99 488 409 83.8 327 67.0 5,392 4,424 82.0 3,814 70.7
41.00–45.99 630 542 86.0 423 67.1 6,596 5,487 83.2 4,629 70.2
≥46 706 597 84.6 493 69.8 7,218 5,955 82.5 5,038 69.8
Subtotalb 2,335 1,984 85.0 1,573 67.4 25,048 20,669 82.5 17,575 70.2
Female
Below federal poverty level (%)
<6 121 103 85.1 82 67.8 727 622 85.6 529 72.8
6.00–9.99 147 124 84.4 103 70.1 897 746 83.2 644 71.8
10.00–16.99 243 199 81.9 172 70.8 1,479 1,195 80.8 1,050 71.0
≥17 333 281 84.4 220 66.1 2,285 1,888 82.6 1,535 67.2
Less than high school diploma (%)
<5 106 88 83.0 76 71.7 632 533 84.3 474 75.0
5.00–8.99 142 123 86.6 98 69.0 904 749 82.9 628 69.5
9.00–15.99 246 200 81.3 167 67.9 1,534 1,282 83.6 1,075 70.1
≥16 350 296 84.6 236 67.4 2,318 1,887 81.4 1,581 68.2
Median household income (U.S. $)
<49,000 354 298 84.2 234 66.1 2,382 1,956 82.1 1,590 66.8
49,000–65,999 220 191 86.8 152 69.1 1,367 1,121 82.0 963 70.4
66,000–89,999 151 115 76.2 108 71.5 947 792 83.6 692 73.1
≥90,000 113 98 86.7 78 69.0 672 565 84.1 498 74.1
Without health insurance (%)
<4 84 73 86.9 62 73.8 532 444 83.5 400 75.2
4.00–7.99 161 130 80.7 113 70.2 1,002 836 83.4 729 72.8
8.00–13.99 237 196 82.7 159 67.1 1,385 1,154 83.3 957 69.1
≥14 362 308 85.1 243 67.1 2,469 2,017 81.7 1,672 67.7
Gini index (%)
<37 163 132 81.0 110 67.5 1,029 855 83.1 709 68.9
37.00–40.99 169 144 85.2 116 68.6 1,230 1,002 81.5 889 72.3
41.00–45.99 259 220 84.9 179 69.1 1,523 1,268 83.3 1,058 69.5
≥46 253 211 83.4 172 68.0 1,606 1,326 82.6 1,102 68.6
Subtotalb 867 724 83.5 591 68.2 5,560 4,586 82.5 3,872 69.6
Total 3,202 2,708 84.6 2,164 67.6 30,608 25,255 82.5 21,447 70.1

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, the Centers for Disease Control and Prevention [footnotes only]; SDOH, 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 after diagnosis of HIV infection. A VL test result of <200 copies/mL indicates HIV viral suppression. VL test results are within 6 months of diagnosis of HIV infection during 2021. 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. Areas with incomplete reporting: New Jersey, Pennsylvania (excluding Philadelphia), and Puerto Rico. For the definitions of SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.
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 SDOH subpopulations.

Table 10. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among adults aged ≥18 years, by race/ethnicity, assigned sex at birth, and selected social determinants of health—census tract level, 47 states and the District of Columbia
American Indian/Alaska Native Asian Black/African American
Total diagnosesb Linkage to care Viral suppression Total diagnosesb Linkage to care Viral suppression Total diagnosesb Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. % No. No. % No. %
Male
Below federal poverty level (%)
<6 17 14 82.4 13 76.5 148 138 93.2 118 79.7 1,145 929 81.1 771 67.3
6.00–9.99 24 20 83.3 17 70.8 137 122 89.1 114 83.2 1,389 1,115 80.3 952 68.5
10.00–16.99 34 30 88.2 26 76.5 137 121 88.3 111 81.0 2,397 1,945 81.1 1,606 67.0
≥17 48 38 79.2 27 56.3 142 119 83.8 109 76.8 4,213 3,271 77.6 2,692 63.9
Less than high school diploma (%)
<5 24 22 91.7 20 83.3 146 133 91.1 120 82.2 1,300 1,050 80.8 895 68.8
5.00–8.99 23 19 82.6 16 69.6 111 99 89.2 94 84.7 1,610 1,274 79.1 1,103 68.5
9.00–15.99 37 31 83.8 27 73.0 138 125 90.6 107 77.5 2,701 2,195 81.3 1,811 67.0
≥16 39 30 76.9 20 51.3 169 143 84.6 131 77.5 3,538 2,745 77.6 2,214 62.6
Median household income (U.S. $)
<49,000 46 38 82.6 29 63.0 102 88 86.3 77 75.5 4,348 3,370 77.5 2,730 62.8
49,000–65,999 35 29 82.9 24 68.6 113 96 85.0 90 79.6 2,196 1,770 80.6 1,510 68.8
66,000–89,999 26 20 76.9 17 65.4 145 126 86.9 116 80.0 1,576 1,286 81.6 1,077 68.3
≥90,000 16 15 93.8 13 81.3 199 185 93.0 165 82.9 974 794 81.5 670 68.8
Without health insurance (%)
<4 9 8 88.9 6 66.7 134 123 91.8 113 84.3 866 712 82.2 581 67.1
4.00–7.99 25 22 88.0 17 68.0 162 147 90.7 133 82.1 1,687 1,380 81.8 1,157 68.6
8.00–13.99 35 30 85.7 28 80.0 152 135 88.8 127 83.6 2,457 1,978 80.5 1,674 68.1
≥14 54 42 77.8 32 59.3 116 95 81.9 79 68.1 4,135 3,191 77.2 2,610 63.1
Gini index (%)
<37 24 20 83.3 17 70.8 134 119 88.8 106 79.1 1,824 1,460 80.0 1,237 67.8
37.00–40.99 25 19 76.0 15 60.0 109 99 90.8 91 83.5 1,928 1,518 78.7 1,279 66.3
41.00–45.99 38 32 84.2 26 68.4 155 141 91.0 122 78.7 2,369 1,886 79.6 1,571 66.3
≥46 36 31 86.1 25 69.4 165 140 84.8 133 80.6 3,022 2,395 79.3 1,934 64.0
Subtotalc 134 113 84.3 91 67.9 580 513 88.4 465 80.2 9,498 7,523 79.2 6,248 65.8
Female
Below federal poverty level (%)
<6 2 2 100 2 100 20 18 90.0 13 65.0 344 298 86.6 257 74.7
6.00–9.99 6 6 100 5 83.3 22 19 86.4 16 72.7 430 359 83.5 311 72.3
10.00–16.99 12 10 83.3 9 75.0 24 20 83.3 18 75.0 790 637 80.6 572 72.4
≥17 12 10 83.3 8 66.7 15 13 86.7 13 86.7 1,403 1,167 83.2 955 68.1
Less than high school diploma (%)
<5 7 7 100 6 85.7 18 17 94.4 11 61.1 310 261 84.2 235 75.8
5.00–8.99 13 13 100 11 84.6 13 13 100 10 76.9 489 406 83.0 343 70.1
9.00–15.99 5 5 100 4 80.0 16 16 100 14 87.5 881 731 83.0 630 71.5
≥16 7 3 42.9 3 42.9 34 24 70.6 25 73.5 1,287 1,063 82.6 887 68.9
Median household income (U.S. $)
<49,000 13 10 76.9 7 53.8 13 10 76.9 11 84.6 1,451 1,196 82.4 976 67.3
49,000–65,999 9 8 88.9 7 77.8 19 17 89.5 14 73.7 710 572 80.6 503 70.8
66,000–89,999 5 5 100 5 100 26 23 88.5 21 80.8 475 405 85.3 356 74.9
≥90,000 5 5 100 5 100 23 20 87.0 14 60.9 317 275 86.8 248 78.2
Without health insurance (%)
<4 0 0 0 0 0 15 13 86.7 8 53.3 267 228 85.4 214 80.1
4.00–7.99 10 10 100 9 90.0 29 26 89.7 22 75.9 489 409 83.6 364 74.4
8.00–13.99 10 8 80.0 8 80.0 14 12 85.7 10 71.4 765 646 84.4 541 70.7
≥14 12 10 83.3 7 58.3 23 19 82.6 20 87.0 1,446 1,178 81.5 976 67.5
Gini index (%)
<37 5 5 100 4 80.0 17 15 88.2 11 64.7 545 459 84.2 382 70.1
37.00–40.99 4 3 75.0 2 50.0 21 17 81.0 18 85.7 656 537 81.9 476 72.6
41.00–45.99 11 10 90.9 8 72.7 18 15 83.3 11 61.1 816 689 84.4 580 71.1
≥46 12 10 83.3 10 83.3 25 23 92.0 20 80.0 950 776 81.7 657 69.2
Subtotalc 35 28 80.0 24 68.6 82 71 86.6 61 74.4 3,057 2,540 83.1 2,154 70.5
Total 169 141 83.4 115 68.0 662 584 88.2 526 79.5 12,555 10,063 80.2 8,402 66.9
Table 10. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among adults aged ≥18 years, by race/ethnicity, assigned sex at birth, and selected social determinants of health—census tract level, 47 states and the District of Columbia
Hispanic/Latinoa Native Hawaiian/other Pacific Islander
Total diagnosesb Linkage to care Viral suppression Total diagnosesb Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. %
Male
Below federal poverty level (%)
<6 1,099 969 88.2 853 77.6 16 14 87.5 14 87.5
6.00–9.99 1,425 1,202 84.4 1,058 74.2 10 5 50.0 8 80.0
10.00–16.99 2,348 2,009 85.6 1,746 74.4 15 13 86.7 6 40.0
≥17 2,644 2,226 84.2 1,919 72.6 16 13 81.3 11 68.8
Less than high school diploma (%)
<5 965 845 87.6 733 76.0 9 7 77.8 5 55.6
5.00–8.99 1,023 880 86.0 781 76.3 15 11 73.3 11 73.3
9.00–15.99 1,579 1,349 85.4 1,199 75.9 18 14 77.8 12 66.7
≥16 3,950 3,332 84.4 2,863 72.5 15 13 86.7 11 73.3
Median household income (U.S. $)
<49,000 2,453 2,056 83.8 1,760 71.7 15 13 86.7 10 66.7
49,000–65,999 2,107 1,802 85.5 1,564 74.2 13 9 69.2 8 61.5
66,000–89,999 1,791 1,526 85.2 1,358 75.8 14 10 71.4 8 57.1
≥90,000 1,133 992 87.6 869 76.7 15 13 86.7 13 86.7
Without health insurance (%)
<4 648 575 88.7 517 79.8 9 9 100 8 88.9
4.00–7.99 1,225 1,059 86.4 941 76.8 13 10 76.9 10 76.9
8.00–13.99 1,866 1,584 84.9 1,396 74.8 18 13 72.2 11 61.1
≥14 3,777 3,188 84.4 2,722 72.1 17 13 76.5 10 58.8
Gini index (%)
<37 1,625 1,382 85.0 1,179 72.6 15 12 80.0 10 66.7
37.00–40.99 1,786 1,510 84.5 1,331 74.5 12 8 66.7 9 75.0
41.00–45.99 2,103 1,805 85.8 1,552 73.8 13 11 84.6 8 61.5
≥46 1,999 1,706 85.3 1,512 75.6 17 14 82.4 12 70.6
Subtotalc 7,693 6,548 85.1 5,703 74.1 61 48 78.7 42 68.9
Female
Below federal poverty level (%)
<6 116 95 81.9 79 68.1 1 1 100 1 100
6.00–9.99 162 135 83.3 126 77.8 2 2 100 2 100
10.00–16.99 272 229 84.2 204 75.0 2 0 0 0 0
≥17 394 325 82.5 289 73.4 2 2 100 2 100
Less than high school diploma (%)
<5 81 67 82.7 60 74.1 2 2 100 2 100
5.00–8.99 114 95 83.3 83 72.8 1 1 100 1 100
9.00–15.99 209 183 87.6 157 75.1 2 1 50.0 1 50.0
≥16 540 439 81.3 398 73.7 2 1 50.0 1 50.0
Median household income (U.S. $)
<49,000 386 317 82.1 285 73.8 2 1 50.0 1 50.0
49,000–65,999 250 213 85.2 191 76.4 2 1 50.0 1 50.0
66,000–89,999 182 154 84.6 137 75.3 1 1 100 1 100
≥90,000 123 97 78.9 83 67.5 2 2 100 2 100
Without health insurance (%)
<4 72 56 77.8 52 72.2 2 2 100 2 100
4.00–7.99 134 111 82.8 96 71.6 2 2 100 2 100
8.00–13.99 217 183 84.3 162 74.7 1 0 0 0 0
≥14 521 434 83.3 388 74.5 2 1 50.0 1 50.0
Gini index (%)
<37 208 166 79.8 147 70.7 2 2 100 2 100
37.00–40.99 205 173 84.4 155 75.6 3 2 66.7 2 66.7
41.00–45.99 275 227 82.5 204 74.2 1 1 100 1 100
≥46 256 218 85.2 192 75.0 1 0 0 0 0
Subtotalc 964 799 82.9 714 74.1 7 5 71.4 5 71.4
Total 8,657 7,347 84.9 6,417 74.1 68 53 77.9 47 69.1
Table 10. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among adults aged ≥18 years, by race/ethnicity, assigned sex at birth, and selected social determinants of health—census tract level, 47 states and the District of Columbia
White Multiracial
Total diagnosesb Linkage to care Viral suppression Total diagnosesb Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. %
Male
Below federal poverty level (%)
<6 1,419 1,197 84.4 1,023 72.1 128 107 83.6 92 71.9
6.00–9.99 1,428 1,206 84.5 1,027 71.9 144 120 83.3 99 68.8
10.00–16.99 1,746 1,469 84.1 1,262 72.3 151 128 84.8 112 74.2
≥17 1,580 1,304 82.5 1,070 67.7 244 200 82.0 168 68.9
Less than high school diploma (%)
<5 1,698 1,452 85.5 1,253 73.8 152 130 85.5 110 72.4
5.00–8.99 1,457 1,237 84.9 1,069 73.4 136 108 79.4 95 69.9
9.00–15.99 1,673 1,379 82.4 1,169 69.9 172 147 85.5 126 73.3
≥16 1,345 1,108 82.4 891 66.2 207 170 82.1 140 67.6
Median household income (U.S. $)
<49,000 1,580 1,286 81.4 1,055 66.8 227 190 83.7 158 69.6
49,000–65,999 1,668 1,402 84.1 1,205 72.2 167 139 83.2 121 72.5
66,000–89,999 1,540 1,281 83.2 1,104 71.7 147 116 78.9 96 65.3
≥90,000 1,368 1,192 87.1 1,008 73.7 123 108 87.8 94 76.4
Without health insurance (%)
<4 1,187 1,025 86.4 863 72.7 105 93 88.6 78 74.3
4.00–7.99 1,607 1,349 83.9 1,175 73.1 152 129 84.9 113 74.3
8.00–13.99 1,750 1,472 84.1 1,260 72.0 175 140 80.0 122 69.7
≥14 1,629 1,330 81.6 1,084 66.5 235 193 82.1 158 67.2
Gini index (%)
<37 1,251 1,044 83.5 875 69.9 157 133 84.7 114 72.6
37.00–40.99 1,413 1,172 82.9 1,004 71.1 119 98 82.4 85 71.4
41.00–45.99 1,745 1,474 84.5 1,233 70.7 173 138 79.8 117 67.6
≥46 1,762 1,484 84.2 1,268 72.0 217 185 85.3 154 71.0
Subtotalc 6,392 5,352 83.7 4,541 71.0 690 572 82.9 485 70.3
Female
Below federal poverty level (%)
<6 223 192 86.1 164 73.5 21 16 76.2 13 61.9
6.00–9.99 244 201 82.4 161 66.0 31 24 77.4 23 74.2
10.00–16.99 338 268 79.3 219 64.8 41 31 75.6 28 68.3
≥17 391 314 80.3 223 57.0 68 57 83.8 45 66.2
Less than high school diploma (%)
<5 188 160 85.1 145 77.1 26 19 73.1 15 57.7
5.00–8.99 248 200 80.6 161 64.9 26 21 80.8 19 73.1
9.00–15.99 378 309 81.7 237 62.7 43 37 86.0 32 74.4
≥16 382 306 80.1 224 58.6 66 51 77.3 43 65.2
Median household income (U.S. $)
<49,000 436 355 81.4 255 58.5 81 67 82.7 55 67.9
49,000–65,999 342 282 82.5 222 64.9 35 28 80.0 25 71.4
66,000–89,999 236 188 79.7 158 66.9 22 16 72.7 14 63.6
≥90,000 179 149 83.2 131 73.2 23 17 73.9 15 65.2
Without health insurance (%)
<4 156 128 82.1 108 69.2 20 17 85.0 16 80.0
4.00–7.99 310 257 82.9 214 69.0 28 21 75.0 22 78.6
8.00–13.99 344 278 80.8 216 62.8 34 27 79.4 20 58.8
≥14 386 312 80.8 229 59.3 79 63 79.7 51 64.6
Gini index (%)
<37 232 190 81.9 149 64.2 20 18 90.0 14 70.0
37.00–40.99 303 243 80.2 208 68.6 38 27 71.1 28 73.7
41.00–45.99 345 282 81.7 217 62.9 57 44 77.2 37 64.9
≥46 316 260 82.3 193 61.1 46 39 84.8 30 65.2
Subtotalc 1,246 1,009 81.0 797 64.0 169 134 79.3 117 69.2
Total 7,638 6,361 83.3 5,338 69.9 859 706 82.2 602 70.1

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, the Centers for Disease Control and Prevention [footnotes only]; SDOH, 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. Numbers less than 12, and rates based on these numbers, should be interpreted with caution. Linkage to HIV medical care was measured by documentation of ≥1 CD4 or VL tests ≤1 month after diagnosis of HIV infection. A VL test result of <200 copies/mL indicates HIV viral suppression. VL test results are within 6 months of diagnosis of HIV infection during 2021. 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. Areas with incomplete reporting: New Jersey, Pennsylvania (excluding Philadelphia), and Puerto Rico. For the definitions of SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Hispanic/Latino persons can be of any race.
b Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.
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 SDOH subpopulations.

Table 11. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among adults aged ≥18 years, by transmission category, assigned sex at birth, and selected social determinants of health—census tract level, 47 states and the District of Columbia
  Male-to-male sexual contacta Injection drug useb
Total diagnosesd Linkage to care Viral suppression Total diagnosesd Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. %
Male
Below federal poverty level (%)
<6 3,365 2,870 85.3 2,480 73.7 146 118 80.9 87 59.3
6.00–9.99 3,834 3,207 83.7 2,813 73.4 162 117 72.3 89 54.5
10.00–16.99 5,753 4,838 84.1 4,211 73.2 264 201 75.9 135 50.9
≥17 7,354 5,986 81.4 5,105 69.4 382 280 73.1 192 50.3
Less than high school diploma (%)
<5 3,747 3,204 85.5 2,778 74.1 115 87 75.3 61 53.1
5.00–8.99 3,659 3,045 83.2 2,709 74.0 170 139 81.9 91 53.7
9.00–15.99 5,225 4,354 83.3 3,764 72.0 273 203 74.4 149 54.4
≥16 7,678 6,301 82.1 5,360 69.8 398 286 72.1 201 50.5
Median household income (U.S. $)
<49,000 7,192 5,825 81.0 4,922 68.4 395 277 70.3 192 48.8
49,000–65,999 5,289 4,434 83.8 3,883 73.4 220 168 76.5 116 52.7
66,000–89,999 4,460 3,744 84.0 3,274 73.4 200 150 74.9 116 57.9
≥90,000 3,276 2,822 86.1 2,466 75.3 137 117 85.4 76 55.6
Without health insurance (%)
<4 2,470 2,139 86.6 1,850 74.9 130 98 75.8 74 56.8
4.00–7.99 4,075 3,450 84.7 3,037 74.5 244 191 78.2 133 54.2
8.00–13.99 5,439 4,543 83.5 3,977 73.1 255 189 74.0 136 53.2
≥14 8,324 6,770 81.3 5,746 69.0 326 238 73.0 160 49.1
Gini index (%)
<37 4,258 3,532 83.0 3,047 71.6 166 132 79.5 89 53.5
37.00–40.99 4,510 3,727 82.7 3,254 72.2 197 150 75.8 114 57.6
41.00–45.99 5,486 4,604 83.9 3,964 72.3 295 218 73.9 145 49.2
≥46 6,046 5,032 83.2 4,340 71.8 296 216 72.9 154 52.1
Subtotale 20,967 17,424 83.1 15,081 71.9 992 738 74.4 519 52.3
Female
Below federal poverty level (%)
<6 104 88 84.7 65 62.4
6.00–9.99 132 105 78.9 82 61.9
10.00–16.99 205 152 74.1 116 56.5
≥17 362 289 79.9 196 54.2
Less than high school diploma (%)
<5 95 76 79.7 61 64.0
5.00–8.99 126 104 82.6 77 61.2
9.00–15.99 236 184 78.0 128 54.2
≥16 346 270 77.9 193 55.7
Median household income (U.S. $)
<49,000 369 291 79.0 198 53.7
49,000–65,999 212 164 77.4 122 57.5
66,000–89,999 124 97 78.4 78 62.7
≥90,000 98 81 82.6 61 62.5
Without health insurance (%)
<4 97 75 77.5 56 58.0
4.00–7.99 175 137 78.3 104 59.3
8.00–13.99 214 171 79.6 121 56.6
≥14 317 251 79.1 178 56.0
Gini index (%)
<37 146 113 77.3 86 58.9
37.00–40.99 156 122 78.2 95 60.9
41.00–45.99 237 187 78.7 134 56.3
≥46 265 213 80.4 145 54.6
Subtotale 838 660 78.7 479 57.1
Total 20,967 17,424 83.1 15,081 71.9 1,830 1,397 76.4 998 54.5
Table 11. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among adults aged ≥18 years, by transmission category, assigned sex at birth, and selected social determinants of health—census tract level, 47 states and the District of Columbia
  Male-to-male sexual contacta and injection drug useb Heterosexual contactc
Total diagnosesd Linkage to care Viral suppression Total diagnosesd Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. %
Male
Below federal poverty level (%)
<6 190 150 78.9 132 69.5 267 227 84.9 182 68.3
6.00–9.99 226 184 81.2 150 66.5 332 279 84.1 221 66.6
10.00–16.99 281 231 82.2 181 64.5 525 441 84.0 339 64.4
≥17 353 272 77.1 210 59.7 791 627 79.3 485 61.2
Less than high school diploma (%)
<5 207 165 79.8 143 69.1 222 182 81.7 153 68.7
5.00–8.99 214 171 80.0 148 69.1 328 269 82.1 219 66.6
9.00–15.99 278 222 79.8 171 61.7 537 456 85.0 363 67.6
≥16 351 278 79.3 212 60.4 829 669 80.6 493 59.4
Median household income (U.S. $)
<49,000 344 266 77.2 199 57.8 832 666 80.0 500 60.1
49,000–65,999 302 243 80.3 194 64.3 485 400 82.4 327 67.3
66,000–89,999 223 172 77.1 153 68.6 352 295 83.9 230 65.4
≥90,000 175 151 86.6 125 71.3 237 206 86.8 163 68.6
Without health insurance (%)
<4 158 135 85.7 115 72.7 198 171 85.9 126 63.7
4.00–7.99 232 188 81.0 157 67.7 315 263 83.3 215 68.3
8.00–13.99 288 227 78.8 182 63.2 469 391 83.5 322 68.7
≥14 372 287 77.0 221 59.3 933 750 80.4 562 60.3
Gini index (%)
<37 202 165 81.6 135 66.7 401 338 84.3 265 66.0
37.00–40.99 249 188 75.4 158 63.3 431 355 82.3 285 66.1
41.00–45.99 288 233 80.9 188 65.3 519 425 81.8 326 62.8
≥46 309 249 80.6 192 62.2 564 456 80.9 350 62.2
Subtotale 1,098 873 79.5 703 64.0 1,971 1,617 82.0 1,258 63.8
Female
Below federal poverty level (%)
<6 618 530 85.8 462 74.7
6.00–9.99 758 636 83.9 557 73.5
10.00–16.99 1,263 1,034 81.9 927 73.4
≥17 1,908 1,587 83.2 1,328 69.6
Less than high school diploma (%)
<5 532 453 85.1 409 76.9
5.00–8.99 771 639 82.8 546 70.8
9.00–15.99 1,289 1,091 84.6 940 72.9
≥16 1,956 1,606 82.1 1,378 70.4
Median household income (U.S. $)
<49,000 1,999 1,653 82.7 1,382 69.1
49,000–65,999 1,146 950 82.9 835 72.9
66,000–89,999 815 687 84.3 608 74.6
≥90,000 569 481 84.4 433 76.1
Without health insurance (%)
<4 430 365 84.9 339 78.9
4.00–7.99 818 691 84.5 619 75.6
8.00–13.99 1,161 975 84.0 829 71.4
≥14 2,139 1,756 82.1 1,486 69.5
Gini index (%)
<37 876 737 84.1 620 70.7
37.00–40.99 1,063 872 82.1 785 73.9
41.00–45.99 1,278 1,075 84.1 919 71.9
≥46 1,331 1,104 82.9 950 71.3
Subtotale 4,685 3,897 83.2 3,367 71.9
Total 1,098 873 79.5 703 64.0 6,656 5,514 82.8 4,624 69.5

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, the Centers for Disease Control and Prevention [footnotes only]; SDOH, 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 after diagnosis of HIV infection. A VL test result of <200 copies/mL indicates HIV viral suppression. VL test results are within 6 months of diagnosis of HIV infection during 2021. 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. Areas with incomplete reporting: New Jersey, Pennsylvania (excluding Philadelphia), and Puerto Rico. For the definitions of SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf. Transmission category is classified based on a hierarchy of the risk factors most likely responsible for HIV transmission; classification is determined based on the person’s assigned sex at birth. Data have been statistically adjusted to account for missing transmission category; therefore, values may not sum to column subtotals and total.

a Includes individuals assigned male sex at birth, regardless of current gender identity, who have had sexual contact with other males, and individuals assigned male sex at birth who have had sexual contact with both males and females (i.e., bisexual contact).
b Includes persons who injected nonprescription drugs or who injected prescription drugs for nonmedical purposes. Also includes injection of drugs prescribed to persons if there is evidence that injection equipment was shared (e.g., syringes, needles, cookers).
c Heterosexual contact with a person known to have, or with a risk factor for, HIV infection.
d Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.
e 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 SDOH subpopulations.

Table 12. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among males aged ≥18 years, based on assigned sex at birth, with infection attributed to male-to-male sexual contact, by race/ethnicity and selected social determinants of health—census tract level, 47 states and the District of Columbia
American Indian/Alaska Native Asian Black/African American
Total diagnosesb Linkage to care Viral suppression Total diagnosesb Linkage to care Viral suppression Total diagnosesb Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. % No. No. % No. %
Below federal poverty level (%)
<6 14 12 86.1 11 79.2 136 126 92.9 111 81.4 964 787 81.7 659 68.3
6.00–9.99 18 14 79.9 13 74.9 123 110 89.7 105 85.6 1,150 933 81.1 807 70.2
10.00–16.99 30 27 87.7 25 81.1 116 104 89.6 93 80.0 1,973 1,605 81.4 1,359 68.9
≥17 40 31 75.9 23 56.6 127 104 82.3 96 75.9 3,422 2,666 77.9 2,234 65.3
Less than high school diploma (%)
<5 21 19 91.0 18 86.2 129 117 90.9 105 81.8 1,141 936 82.0 796 69.7
5.00–8.99 18 15 79.3 13 71.2 99 87 88.2 84 85.2 1,343 1,071 79.8 943 70.3
9.00–15.99 33 28 85.0 24 73.1 125 114 91.3 100 80.4 2,233 1,811 81.1 1,517 68.0
≥16 30 22 72.3 17 55.0 149 126 84.7 115 77.1 2,795 2,176 77.9 1,803 64.5
Median household income (U.S. $)
<49,000 39 32 80.6 25 63.2 89 77 85.9 65 73.2 3,521 2,737 77.7 2,262 64.2
49,000–65,999 30 24 81.7 22 73.6 99 85 85.3 82 82.6 1,806 1,468 81.3 1,270 70.4
66,000–89,999 22 17 77.7 15 68.8 130 111 86.0 104 80.1 1,323 1,093 82.6 929 70.2
≥90,000 12 11 91.5 10 87.3 179 167 93.5 150 83.9 815 660 81.0 566 69.5
Without health insurance (%)
<4 5 4 81.1 4 71.7 117 108 92.7 100 85.8 717 593 82.7 487 67.9
4.00–7.99 23 20 88.0 16 70.2 152 137 90.3 124 81.9 1,409 1,161 82.4 986 70.0
8.00–13.99 27 22 81.8 23 85.4 133 118 88.8 110 82.8 2,055 1,661 80.8 1,426 69.4
≥14 48 37 78.4 29 61.1 101 82 81.2 71 70.2 3,329 2,578 77.4 2,161 64.9
Gini index (%)
<37 19 16 84.0 15 78.7 118 105 88.6 94 79.3 1,512 1,212 80.2 1,044 69.0
37.00–40.99 22 17 75.5 13 60.0 98 91 92.6 83 84.4 1,586 1,253 79.0 1,075 67.8
41.00–45.99 31 25 81.0 23 72.9 137 124 90.6 110 80.9 1,928 1,545 80.1 1,306 67.7
≥46 31 26 84.8 22 69.4 148 124 84.1 118 79.7 2,482 1,981 79.8 1,634 65.8
Totalc 112 93 83.1 80 71.1 516 456 88.4 417 80.7 7,803 6,214 79.6 5,255 67.3
Table 12. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among males aged ≥18 years, based on assigned sex at birth, with infection attributed to male-to-male sexual contact, by race/ethnicity and selected social determinants of health—census tract level, 47 states and the District of Columbia
Hispanic/Latinoa Native Hawaiian/other Pacific Islander
Total diagnosesb Linkage to care Viral suppression Total diagnosesb Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. %
Below federal poverty level (%)
<6 973 859 88.3 759 78.0 16 14 87.3 14 87.3
6.00–9.99 1,274 1,080 84.8 949 74.5 9 5 55.2 8 88.5
10.00–16.99 2,100 1,792 85.3 1,586 75.5 14 12 85.3 5 36.0
≥17 2,340 1,978 84.5 1,734 74.1 14 12 85.3 9 64.7
Less than high school diploma (%)
<5 878 773 88.0 672 76.5 9 7 77.8 5 55.6
5.00–8.99 915 784 85.7 698 76.3 13 10 78.2 10 77.4
9.00–15.99 1,406 1,199 85.3 1,087 77.3 18 14 77.3 12 68.2
≥16 3,488 2,954 84.7 2,571 73.7 12 11 91.5 8 66.7
Median household income (U.S. $)
<49,000 2,163 1,823 84.3 1,587 73.3 14 12 85.2 9 64.4
49,000–65,999 1,877 1,603 85.4 1,410 75.1 10 8 78.9 6 61.1
66,000–89,999 1,599 1,365 85.4 1,219 76.3 14 10 71.3 8 55.9
≥90,000 1,021 893 87.5 791 77.4 15 13 86.7 13 86.7
Without health insurance (%)
<4 582 514 88.3 465 79.9 9 9 100 8 88.9
4.00–7.99 1,085 942 86.8 849 78.3 11 9 83.2 9 83.2
8.00–13.99 1,675 1,430 85.4 1,266 75.6 18 13 71.4 11 61.1
≥14 3,345 2,824 84.4 2,449 73.2 14 11 78.3 7 50.7
Gini index (%)
<37 1,442 1,223 84.8 1,062 73.6 14 11 79.2 10 66.0
37.00–40.99 1,588 1,340 84.4 1,190 74.9 10 8 80.0 8 80.0
41.00–45.99 1,857 1,599 86.1 1,399 75.4 11 9 81.1 6 56.6
≥46 1,796 1,544 85.9 1,375 76.6 17 14 82.5 12 69.9
Totalc 6,838 5,832 85.3 5,141 75.2 56 45 80.4 38 68.5
Table 12. Linkage to HIV medical care within 1 month and viral suppression within 6 months of HIV diagnosis during 2021 among males aged ≥18 years, based on assigned sex at birth, with infection attributed to male-to-male sexual contact, by race/ethnicity and selected social determinants of health—census tract level, 47 states and the District of Columbia
White Multiracial Total
Total diagnosesb Linkage to care Viral suppression Total diagnosesb Linkage to care Viral suppression Total diagnosesb Linkage to care Viral suppression
≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months ≥1 CD4 or VL tests ≤1 month VL <200 copies/mL ≤6 months
No. No. % No. % No. No. % No. % No. No. % No. %
Below federal poverty level (%)
<6 1,150 976 84.8 845 73.5 112 95 85.0 82 73.4 3,365 2,870 85.3 2,480 73.7
6.00–9.99 1,141 966 84.7 848 74.4 119 98 82.7 82 68.9 3,834 3,207 83.7 2,813 73.4
10.00–16.99 1,397 1,192 85.3 1,049 75.1 124 107 86.8 95 76.5 5,753 4,838 84.1 4,211 73.2
≥17 1,205 1,022 84.8 858 71.2 207 174 83.8 151 72.7 7,354 5,986 81.4 5,105 69.4
Less than high school diploma (%)
<5 1,435 1,238 86.2 1,084 75.5 134 114 85.3 97 72.7 3,747 3,204 85.5 2,778 74.1
5.00–8.99 1,162 991 85.2 882 75.9 109 87 79.7 78 71.5 3,659 3,045 83.2 2,709 74.0
9.00–15.99 1,272 1,068 84.0 919 72.3 139 121 87.0 104 74.5 5,225 4,354 83.3 3,764 72.0
≥16 1,024 860 83.9 716 70.0 180 153 84.8 131 72.6 7,678 6,301 82.1 5,360 69.8
Median household income (U.S. $)
<49,000 1,177 983 83.6 834 70.8 189 162 85.9 141 74.6 7,192 5,825 81.0 4,922 68.4
49,000–65,999 1,328 1,129 85.0 991 74.6 140 117 83.8 102 73.1 5,289 4,434 83.8 3,883 73.4
66,000–89,999 1,251 1,050 84.0 916 73.2 122 98 80.6 83 67.8 4,460 3,744 84.0 3,274 73.4
≥90,000 1,127 983 87.3 855 75.9 108 95 88.0 82 75.5 3,276 2,822 86.1 2,466 75.3
Without health insurance (%)
<4 948 831 87.6 716 75.5 92 80 87.4 71 76.9 2,470 2,139 86.6 1,850 74.9
4.00–7.99 1,274 1,077 84.5 960 75.4 121 104 85.4 92 76.1 4,075 3,450 84.7 3,037 74.5
8.00–13.99 1,389 1,183 85.1 1,039 74.8 143 117 82.4 103 72.1 5,439 4,543 83.5 3,977 73.1
≥14 1,282 1,065 83.1 886 69.2 206 174 84.1 144 69.7 8,324 6,770 81.3 5,746 69.0
Gini index (%)
<37 1,014 846 83.4 724 71.4 138 119 86.3 99 72.2 4,258 3,532 83.0 3,047 71.6
37.00–40.99 1,108 938 84.6 816 73.7 98 81 82.8 69 71.2 4,510 3,727 82.7 3,254 72.2
41.00–45.99 1,381 1,186 85.8 1,018 73.7 142 116 82.2 102 71.9 5,486 4,604 83.9 3,964 72.3
≥46 1,389 1,186 85.3 1,042 75.0 184 158 85.7 138 74.9 6,046 5,032 83.2 4,340 71.8
Totalc 5,064 4,296 84.8 3,730 73.7 578 488 84.4 421 72.8 20,967 17,424 83.1 15,081 71.9

Abbreviations: CD4, CD4+ T-lymphocyte count (cells/µL) or percentage; VL, viral load (copies/mL); CDC, the Centers for Disease Control and Prevention [footnotes only]; SDOH, social determinants of health [footnotes only].

Note. Male-to-male sexual contact includes individuals assigned male sex at birth, regardless of current gender identity, who have had sexual contact with other males, and individuals assigned male sex at birth who have had sexual contact with both males and females (i.e., bisexual contact). Numbers less than 12, and rates based on these numbers, should be interpreted with caution. 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 after diagnosis of HIV infection. A VL test result of <200 copies/mL indicates HIV viral suppression. VL test results are within 6 months of diagnosis of HIV infection during 2021. 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. Areas with incomplete reporting: New Jersey, Pennsylvania (excluding Philadelphia), and Puerto Rico. For the definitions of SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Hispanic/Latino persons can be of any race.
b Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.
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 SDOH subpopulations.

Table 13. Diagnoses of HIV infection among adults aged ≥18 years, by age at diagnosis, race/ethnicity, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
American Indian/Alaska Native
18–24 years 25–34 years 35–44 years 45–54 years ≥55 years
No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 3 20,206 14.8 8 27,033 29.6 3 25,400 11.8 0 26,276 0.0 3 42,315 7.1
6.00–9.99 3 24,626 12.2 10 35,214 28.4 7 33,610 20.8 3 28,807 10.4 2 50,556 4.0
10.00–16.99 6 40,678 14.7 14 61,336 22.8 9 53,306 16.9 2 43,433 4.6 3 78,234 3.8
≥17 11 65,333 16.8 21 90,852 23.1 11 72,349 15.2 5 63,668 7.9 1 108,912 0.9
Less than high school diploma (%)
<5 5 22,096 22.6 11 24,001 45.8 3 20,970 14.3 1 19,730 5.1 4 31,730 12.6
5.00–8.99 0 24,951 0.0 10 35,680 28.0 10 31,425 31.8 2 28,303 7.1 2 53,724 3.7
9.00–15.99 9 44,271 20.3 18 64,214 28.0 7 54,249 12.9 4 46,138 8.7 0 85,607 0.0
≥16 9 60,561 14.9 14 92,746 15.1 10 79,741 12.5 3 68,986 4.3 3 109,492 2.7
Median household income (U.S. $)
<49,000 14 61,612 22.7 17 84,845 20.0 12 69,068 17.4 3 59,962 5.0 1 109,420 0.9
49,000–65,999 3 40,773 7.4 18 60,529 29.7 9 52,336 17.2 3 42,977 7.0 2 74,368 2.7
66,000–89,999 4 28,813 13.9 12 42,676 28.1 4 38,320 10.4 2 32,670 6.1 4 55,275 7.2
≥90,000 2 18,412 10.9 6 24,914 24.1 5 23,915 20.9 2 25,750 7.8 2 39,572 5.1
Without health insurance (%)
<4 0 13,722 0.0 3 16,690 18.0 3 16,063 18.7 0 16,442 0.0 3 30,746 9.8
4.00–7.99 4 24,741 16.2 12 37,107 32.3 4 32,235 12.4 3 28,615 10.5 3 53,277 5.6
8.00–13.99 4 38,613 10.4 18 53,680 33.5 10 48,419 20.7 4 41,198 9.7 0 71,341 0.0
≥14 15 74,020 20.3 20 106,970 18.7 13 87,948 14.8 3 75,929 4.0 3 124,653 2.4
Gini index (%)
<37 3 25,607 11.7 13 36,849 35.3 5 34,380 14.5 3 28,399 10.6 1 42,678 2.3
37.00–40.99 4 33,178 12.1 9 48,387 18.6 8 41,426 19.3 2 35,536 5.6 3 62,036 4.8
41.00–45.99 9 48,295 18.6 14 68,960 20.3 12 57,285 20.9 0 51,721 0.0 3 91,069 3.3
≥46 7 43,376 16.1 17 59,992 28.3 5 51,267 9.8 5 46,263 10.8 2 84,100 2.4
Subtotalb 25 151,879 16.5 58 216,641 26.8 32 186,385 17.2 13 163,157 8.0 9 280,553 3.2
Female
Below federal poverty level (%)
<6 0 17,163 0.0 1 25,613 3.9 1 26,540 3.8 0 25,872 0.0 0 44,979 0.0
6.00–9.99 0 22,820 0.0 4 34,194 11.7 1 31,522 3.2 1 28,234 3.5 0 57,515 0.0
10.00–16.99 1 39,084 2.6 2 56,920 3.5 4 47,270 8.5 4 43,932 9.1 1 86,118 1.2
≥17 2 67,363 3.0 4 82,791 4.8 2 71,486 2.8 3 64,778 4.6 1 130,535 0.8
Less than high school diploma (%)
<5 0 20,601 0.0 2 24,665 8.1 3 21,173 14.2 2 20,003 10.0 0 38,116 0.0
5.00–8.99 0 26,785 0.0 7 34,588 20.2 2 32,132 6.2 3 29,382 10.2 1 58,457 1.7
9.00–15.99 1 41,395 2.4 0 61,449 0.0 2 53,319 3.8 2 49,035 4.1 0 98,527 0.0
≥16 2 58,193 3.4 2 78,977 2.5 1 70,457 1.4 1 64,430 1.6 1 124,068 0.8
Median household income (U.S. $)
<49,000 2 62,259 3.2 2 79,816 2.5 5 68,068 7.3 3 62,782 4.8 1 128,596 0.8
49,000–65,999 1 39,219 2.5 4 54,862 7.3 1 48,366 2.1 2 42,671 4.7 1 87,066 1.1
66,000–89,999 0 27,716 0.0 4 40,329 9.9 0 34,910 0.0 1 32,771 3.1 0 60,784 0.0
≥90,000 0 16,067 0.0 1 23,588 4.2 2 24,983 8.0 2 24,072 8.3 0 41,529 0.0
Without health insurance (%)
<4 0 12,378 0.0 0 15,685 0.0 0 15,334 0.0 0 16,307 0.0 0 32,830 0.0
4.00–7.99 0 24,126 0.0 3 35,537 8.4 3 31,989 9.4 3 28,788 10.4 1 59,157 1.7
8.00–13.99 2 39,304 5.1 4 51,177 7.8 1 44,687 2.2 2 43,163 4.6 1 81,133 1.2
≥14 1 70,981 1.4 4 97,125 4.1 4 84,808 4.7 3 74,558 4.0 0 146,035 0.0
Gini index (%)
<37 0 23,764 0.0 2 34,973 5.7 2 32,147 6.2 1 28,085 3.6 0 47,138 0.0
37.00–40.99 0 30,750 0.0 1 42,365 2.4 1 39,555 2.5 1 35,980 2.8 1 69,863 1.4
41.00–45.99 1 45,572 2.2 6 66,063 9.1 2 56,553 3.5 1 52,506 1.9 1 102,956 1.0
≥46 2 46,174 4.3 2 56,060 3.6 3 48,492 6.2 5 46,140 10.8 0 99,153 0.0
Subtotalb 3 146,974 2.0 12 199,679 6.0 9 177,081 5.1 9 162,850 5.5 2 319,168 0.6
Totalc 28 298,853 9.4 70 416,320 16.8 41 363,466 11.3 22 326,007 6.7 11 599,721 1.8
Table 13. Diagnoses of HIV infection among adults aged ≥18 years, by age at diagnosis, race/ethnicity, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
Asian
18–24 years 25–34 years 35–44 years 45–54 years ≥55 years
No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 26 237,495 10.9 58 493,582 11.8 34 635,146 5.4 27 564,139 4.8 15 822,899 1.8
6.00–9.99 22 168,562 13.1 58 392,791 14.8 36 352,108 10.2 14 291,742 4.8 7 501,813 1.4
10.00–16.99 22 178,072 12.4 44 359,873 12.2 37 278,967 13.3 22 241,784 9.1 15 441,515 3.4
≥17 28 258,113 10.8 67 267,374 25.1 23 162,705 14.1 16 136,914 11.7 12 264,536 4.5
Less than high school diploma (%)
<5 28 353,348 7.9 62 527,254 11.8 34 553,551 6.1 20 438,668 4.6 11 579,697 1.9
5.00–8.99 22 173,707 12.7 41 348,064 11.8 27 348,883 7.7 15 296,103 5.1 7 475,768 1.5
9.00–15.99 24 165,114 14.5 52 329,674 15.8 32 277,256 11.5 23 244,283 9.4 14 468,431 3.0
≥16 24 161,210 14.9 72 310,783 23.2 37 250,626 14.8 21 256,430 8.2 17 507,284 3.4
Median household income (U.S. $)
<49,000 17 175,594 9.7 44 182,000 24.2 20 111,176 18.0 18 98,951 18.2 9 190,493 4.7
49,000–65,999 26 142,020 18.3 41 265,226 15.5 23 187,231 12.3 15 160,921 9.3 9 297,640 3.0
66,000–89,999 21 188,492 11.1 66 392,504 16.8 32 327,247 9.8 16 272,969 5.9 11 502,927 2.2
≥90,000 32 316,303 10.1 74 668,696 11.1 55 800,746 6.9 30 699,151 4.3 19 1,035,591 1.8
Without health insurance (%)
<4 19 278,221 6.8 64 468,753 13.7 34 534,568 6.4 17 457,780 3.7 9 696,372 1.3
4.00–7.99 28 254,698 11.0 60 453,670 13.2 38 415,608 9.1 23 356,927 6.4 16 589,697 2.7
8.00–13.99 33 188,375 17.5 57 351,011 16.2 35 287,007 12.2 21 247,338 8.5 8 437,415 1.8
≥14 18 130,530 13.8 46 240,620 19.1 23 191,771 12.0 18 172,538 10.4 16 307,283 5.2
Gini index (%)
<37 24 185,965 12.9 50 375,675 13.3 28 408,837 6.8 20 343,748 5.8 15 503,926 3.0
37.00–40.99 17 178,264 9.5 46 365,775 12.6 31 357,737 8.7 13 308,133 4.2 7 497,540 1.4
41.00–45.99 21 204,361 10.3 64 399,385 16.0 38 371,691 10.2 21 327,695 6.4 17 569,871 3.0
≥46 36 268,969 13.4 66 372,225 17.7 33 290,411 11.4 25 254,788 9.8 10 459,172 2.2
Subtotalb 101 853,379 11.8 240 1,515,775 15.8 134 1,430,316 9.4 85 1,235,484 6.9 50 2,031,180 2.5
Female
Below federal poverty level (%)
<6 3 231,671 1.3 5 549,884 0.9 5 727,629 0.7 6 625,131 1.0 2 997,498 0.2
6.00–9.99 3 168,900 1.8 3 409,801 0.7 9 395,368 2.3 2 340,038 0.6 5 636,055 0.8
10.00–16.99 2 171,741 1.2 4 372,616 1.1 13 312,777 4.2 2 278,012 0.7 4 555,641 0.7
≥17 0 250,724 0.0 8 259,270 3.1 2 174,997 1.1 2 151,091 1.3 3 329,900 0.9
Less than high school diploma (%)
<5 2 354,257 0.6 4 565,638 0.7 9 625,837 1.4 2 490,557 0.4 1 715,197 0.1
5.00–8.99 1 174,011 0.6 3 377,449 0.8 4 397,868 1.0 3 341,486 0.9 3 605,616 0.5
9.00–15.99 2 151,218 1.3 4 339,308 1.2 5 310,160 1.6 3 283,245 1.1 3 593,572 0.5
≥16 3 153,292 2.0 9 309,599 2.9 11 276,971 4.0 4 279,018 1.4 7 604,778 1.2
Median household income (U.S. $)
<49,000 1 164,222 0.6 7 176,697 4.0 2 121,302 1.6 3 108,715 2.8 0 241,676 0.0
49,000–65,999 2 136,443 1.5 3 264,517 1.1 8 210,157 3.8 3 190,195 1.6 4 384,576 1.0
66,000–89,999 3 180,633 1.7 6 410,260 1.5 10 356,887 2.8 0 321,960 0.0 7 634,930 1.1
≥90,000 2 320,739 0.6 4 736,345 0.5 9 920,018 1.0 6 770,699 0.8 3 1,251,886 0.2
Without health insurance (%)
<4 2 282,478 0.7 2 512,627 0.4 7 614,238 1.1 3 509,316 0.6 1 858,441 0.1
4.00–7.99 2 249,226 0.8 8 478,665 1.7 6 466,850 1.3 4 405,988 1.0 9 745,163 1.2
8.00–13.99 2 179,920 1.1 4 356,091 1.1 5 318,845 1.6 2 283,966 0.7 2 537,669 0.4
≥14 2 120,701 1.7 6 244,392 2.5 11 210,856 5.2 3 195,002 1.5 2 377,829 0.5
Gini index (%)
<37 1 174,728 0.6 2 405,311 0.5 9 454,630 2.0 4 376,592 1.1 1 620,456 0.2
37.00–40.99 2 171,203 1.2 4 383,934 1.0 9 399,334 2.3 2 344,390 0.6 6 616,898 1.0
41.00–45.99 3 197,924 1.5 5 416,530 1.2 4 422,103 0.9 3 373,726 0.8 3 699,283 0.4
≥46 2 273,743 0.7 9 385,568 2.3 7 334,671 2.1 3 299,446 1.0 4 582,314 0.7
Subtotalb 9 832,778 1.1 20 1,591,994 1.3 30 1,610,836 1.9 13 1,394,306 0.9 14 2,519,163 0.6
Totalc 110 1,686,157 6.5 260 3,107,769 8.4 164 3,041,152 5.4 98 2,629,790 3.7 64 4,550,343 1.4
Table 13. Diagnoses of HIV infection among adults aged ≥18 years, by age at diagnosis, race/ethnicity, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
Black/African American
18–24 years 25–34 years 35–44 years 45–54 years ≥55 years
No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 350 349,817 100.1 470 513,337 91.6 191 500,059 38.2 102 502,345 20.3 99 746,731 13.3
6.00–9.99 388 361,325 107.4 604 572,075 105.6 245 485,607 50.5 114 455,180 25.0 103 738,674 13.9
10.00–16.99 725 549,416 132.0 1,017 837,983 121.4 383 684,986 55.9 179 624,011 28.7 208 1,111,513 18.7
≥17 1,339 929,790 144.0 1,707 1,208,784 141.2 669 921,565 72.6 356 865,953 41.1 406 1,753,067 23.2
Less than high school diploma (%)
<5 407 408,725 99.6 577 470,314 122.7 201 386,134 52.1 91 363,843 25.0 91 545,769 16.7
5.00–8.99 511 420,865 121.4 668 611,659 109.2 265 520,729 50.9 132 491,353 26.9 124 826,371 15.0
9.00–15.99 813 633,048 128.4 1,170 941,833 124.2 452 780,185 57.9 207 754,176 27.4 215 1,350,804 15.9
≥16 1,072 752,095 142.5 1,385 1,142,058 121.3 572 931,376 61.4 321 856,050 37.5 386 1,640,633 23.5
Median household income (U.S. $)
<49,000 1,388 938,762 147.9 1,758 1,240,733 141.7 682 950,224 71.8 347 894,654 38.8 421 1,838,667 22.9
49,000–65,999 634 519,111 122.1 978 803,532 121.7 378 637,506 59.3 158 574,139 27.5 166 1,001,099 16.6
66,000–89,999 490 403,940 121.3 658 631,997 104.1 242 541,832 44.7 149 503,368 29.6 118 798,891 14.8
≥90,000 269 301,085 89.3 385 429,116 89.7 177 440,615 40.2 95 458,267 20.7 107 684,394 15.6
Without health insurance (%)
<4 271 300,821 90.1 362 393,949 91.9 173 353,031 49.0 82 348,178 23.6 73 598,066 12.2
4.00–7.99 519 503,396 103.1 704 695,798 101.2 265 582,306 45.5 164 569,646 28.8 148 1,012,879 14.6
8.00–13.99 742 624,539 118.8 1,093 887,508 123.2 385 739,601 52.1 192 704,755 27.2 213 1,255,420 17.0
≥14 1,271 769,598 165.2 1,639 1,155,142 141.9 665 917,298 72.5 313 824,944 37.9 382 1,483,650 25.7
Gini index (%)
<37 549 479,447 114.5 774 706,889 109.5 268 633,324 42.3 160 589,306 27.2 131 860,652 15.2
37.00–40.99 574 463,160 123.9 797 689,740 115.6 324 583,350 55.5 163 541,965 30.1 164 917,281 17.9
41.00–45.99 741 568,398 130.4 995 839,663 118.5 388 673,570 57.6 189 642,397 29.4 208 1,191,018 17.5
≥46 938 672,009 139.6 1,232 887,187 138.9 507 694,119 73.0 239 668,081 35.8 313 1,376,300 22.7
Subtotalb 2,909 2,214,733 131.3 3,966 3,165,864 125.3 1,562 2,618,424 59.7 774 2,465,422 31.4 848 4,363,577 19.4
Female
Below federal poverty level (%)
<6 35 313,395 11.2 96 484,037 19.8 97 524,196 18.5 76 528,181 14.4 64 883,922 7.2
6.00–9.99 63 330,446 19.1 112 556,823 20.1 108 518,098 20.8 89 501,939 17.7 89 931,505 9.6
10.00–16.99 87 528,607 16.5 211 859,940 24.5 220 738,456 29.8 174 703,419 24.7 152 1,453,151 10.5
≥17 227 974,209 23.3 447 1,349,935 33.1 348 1,076,547 32.3 246 1,013,081 24.3 238 2,331,748 10.2
Less than high school diploma (%)
<5 41 422,513 9.7 96 474,939 20.2 69 430,753 16.0 64 401,247 16.0 56 680,686 8.2
5.00–8.99 66 419,355 15.7 165 648,257 25.5 122 585,676 20.8 101 560,407 18.0 81 1,049,988 7.7
9.00–15.99 115 631,084 18.2 251 1,007,905 24.9 237 877,150 27.0 181 872,083 20.8 177 1,788,173 9.9
≥16 190 687,499 27.6 354 1,121,091 31.6 345 964,429 35.8 239 913,423 26.2 229 2,081,772 11.0
Median household income (U.S. $)
<49,000 222 970,432 22.9 445 1,404,138 31.7 367 1,127,358 32.6 259 1,063,514 24.4 256 2,468,047 10.4
49,000–65,999 90 497,736 18.1 223 813,627 27.4 176 686,126 25.7 142 645,735 22.0 130 1,301,912 10.0
66,000–89,999 62 375,066 16.5 117 614,760 19.0 136 575,891 23.6 113 550,172 20.5 85 1,010,815 8.4
≥90,000 36 276,228 13.0 78 403,706 19.3 92 455,541 20.2 67 476,825 14.1 68 792,122 8.6
Without health insurance (%)
<4 39 276,514 14.1 75 371,529 20.2 67 355,035 18.9 72 358,138 20.1 52 737,492 7.1
4.00–7.99 71 490,906 14.5 146 700,246 20.8 127 649,253 19.6 100 634,389 15.8 89 1,294,131 6.9
8.00–13.99 105 614,266 17.1 209 952,259 21.9 221 834,652 26.5 144 805,021 17.9 154 1,638,476 9.4
≥14 197 776,248 25.4 436 1,226,902 35.5 358 1,018,362 35.2 269 949,072 28.3 248 1,930,234 12.8
Gini index (%)
<37 74 431,978 17.1 155 679,361 22.8 144 673,823 21.4 100 644,807 15.5 99 1,035,663 9.6
37.00–40.99 86 438,216 19.6 195 710,793 27.4 175 630,427 27.8 141 610,402 23.1 106 1,171,843 9.0
41.00–45.99 105 558,376 18.8 228 875,395 26.0 203 751,104 27.0 167 722,793 23.1 174 1,556,278 11.2
≥46 147 713,095 20.6 288 984,479 29.3 251 801,245 31.3 177 768,256 23.0 164 1,836,005 8.9
Subtotalb 420 2,160,451 19.4 899 3,252,192 27.6 798 2,858,008 27.9 612 2,747,160 22.3 559 5,600,619 10.0
Totalc 3,329 4,375,184 76.1 4,865 6,418,056 75.8 2,360 5,476,432 43.1 1,386 5,212,582 26.6 1,407 9,964,196 14.1
Table 13. Diagnoses of HIV infection among adults aged ≥18 years, by age at diagnosis, race/ethnicity, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
Hispanic/Latinoa
18–24 years 25–34 years 35–44 years 45–54 years ≥55 years
No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 196 624,273 31.4 507 886,295 57.2 260 925,666 28.1 117 779,779 15.0 76 907,098 8.4
6.00–9.99 277 717,027 38.6 611 1,045,683 58.4 339 994,272 34.1 171 792,736 21.6 95 954,396 10.0
10.00–16.99 448 1,024,837 43.7 1,045 1,492,303 70.0 556 1,342,587 41.4 271 1,085,043 25.0 170 1,357,666 12.5
≥17 632 1,297,630 48.7 1,261 1,643,294 76.7 666 1,460,182 45.6 343 1,189,683 28.8 201 1,801,806 11.2
Less than high school diploma (%)
<5 183 505,553 36.2 454 602,769 75.3 230 548,226 42.0 94 438,416 21.4 56 543,164 10.3
5.00–8.99 200 506,761 39.5 483 740,399 65.2 239 702,866 34.0 114 548,450 20.8 65 685,286 9.5
9.00–15.99 326 797,128 40.9 759 1,152,870 65.8 375 1,077,711 34.8 193 858,480 22.5 112 1,117,903 10.0
≥16 844 1,878,949 44.9 1,728 2,599,746 66.5 977 2,415,308 40.5 502 2,013,951 24.9 309 2,681,562 11.5
Median household income (U.S. $)
<49,000 563 1,183,729 47.6 1,200 1,503,532 79.8 622 1,349,510 46.1 328 1,105,867 29.7 195 1,741,427 11.2
49,000–65,999 441 963,921 45.8 922 1,363,066 67.6 467 1,218,450 38.3 248 971,317 25.5 143 1,184,160 12.1
66,000–89,999 344 871,425 39.5 784 1,282,389 61.1 442 1,187,629 37.2 198 948,664 20.9 131 1,133,371 11.6
≥90,000 197 613,703 32.1 502 897,541 55.9 286 947,317 30.2 125 804,821 15.5 71 940,700 7.5
Without health insurance (%)
<4 153 439,773 34.8 301 551,264 54.6 157 538,053 29.2 75 456,249 16.4 38 641,499 5.9
4.00–7.99 242 708,266 34.2 589 970,208 60.7 311 898,037 34.6 148 742,357 19.9 96 1,082,010 8.9
8.00–13.99 393 888,577 44.2 886 1,287,558 68.8 424 1,164,566 36.4 220 946,310 23.2 144 1,269,898 11.3
≥14 765 1,635,684 46.8 1,648 2,258,769 73.0 929 2,122,060 43.8 459 1,702,329 27.0 264 2,027,579 13.0
Gini index (%)
<37 340 913,101 37.2 696 1,258,358 55.3 361 1,225,990 29.4 176 982,903 17.9 104 1,080,301 9.6
37.00–40.99 365 890,251 41.0 804 1,268,485 63.4 428 1,190,505 36.0 178 947,331 18.8 135 1,180,901 11.4
41.00–45.99 428 974,557 43.9 969 1,362,776 71.1 496 1,250,793 39.7 251 1,025,664 24.5 145 1,374,733 10.5
≥46 419 876,742 47.8 953 1,172,555 81.3 536 1,050,645 51.0 297 888,124 33.4 158 1,382,056 11.4
Subtotalb 1,609 3,688,391 43.6 3,519 5,095,784 69.1 1,876 4,744,111 39.5 933 3,859,297 24.2 554 5,027,915 11.0
Female
Below federal poverty level (%)
<6 14 589,740 2.4 32 835,511 3.8 32 890,500 3.6 27 769,499 3.5 21 1,029,543 2.0
6.00–9.99 19 670,649 2.8 50 975,372 5.1 51 920,201 5.5 36 768,936 4.7 18 1,085,486 1.7
10.00–16.99 42 982,717 4.3 88 1,374,145 6.4 68 1,231,730 5.5 55 1,035,096 5.3 39 1,528,132 2.6
≥17 54 1,260,988 4.3 128 1,546,549 8.3 147 1,392,586 10.6 97 1,193,165 8.1 87 2,133,290 4.1
Less than high school diploma (%)
<5 12 520,632 2.3 19 597,336 3.2 24 550,417 4.4 17 463,256 3.7 17 647,488 2.6
5.00–8.99 15 495,342 3.0 40 716,848 5.6 40 670,070 6.0 21 553,966 3.8 11 817,383 1.3
9.00–15.99 28 765,361 3.7 59 1,078,868 5.5 63 1,012,072 6.2 56 842,288 6.6 38 1,312,451 2.9
≥16 74 1,737,433 4.3 180 2,339,732 7.7 171 2,203,272 7.8 121 1,907,441 6.3 99 2,999,314 3.3
Median household income (U.S. $)
<49,000 49 1,139,431 4.3 124 1,424,900 8.7 147 1,291,673 11.4 92 1,117,557 8.2 86 2,067,681 4.2
49,000–65,999 36 910,648 4.0 84 1,243,925 6.8 54 1,116,008 4.8 61 921,626 6.6 38 1,328,710 2.9
66,000–89,999 28 833,340 3.4 58 1,187,039 4.9 49 1,106,399 4.4 37 923,527 4.0 27 1,279,595 2.1
≥90,000 16 593,360 2.7 32 862,573 3.7 46 907,569 5.1 23 791,744 2.9 14 1,080,910 1.3
Without health insurance (%)
<4 11 426,865 2.6 21 535,542 3.9 26 530,294 4.9 15 465,810 3.2 10 766,987 1.3
4.00–7.99 21 691,528 3.0 42 945,495 4.4 51 877,549 5.8 34 761,336 4.5 29 1,292,670 2.2
8.00–13.99 24 867,745 2.8 76 1,198,822 6.3 65 1,106,919 5.9 54 932,588 5.8 41 1,483,190 2.8
≥14 73 1,530,573 4.8 159 2,051,847 7.7 156 1,920,266 8.1 112 1,606,998 7.0 85 2,233,604 3.8
Gini index (%)
<37 19 846,499 2.2 71 1,174,182 6.0 57 1,143,572 5.0 41 934,769 4.4 31 1,176,458 2.6
37.00–40.99 34 849,912 4.0 67 1,175,619 5.7 67 1,104,510 6.1 50 931,668 5.4 25 1,331,951 1.9
41.00–45.99 44 922,010 4.8 80 1,270,465 6.3 80 1,174,693 6.8 57 1,008,974 5.6 52 1,583,189 3.3
≥46 32 878,766 3.6 80 1,110,827 7.2 94 1,011,909 9.3 67 890,992 7.5 57 1,684,546 3.4
Subtotalb 132 3,518,768 3.8 306 4,732,784 6.5 305 4,435,831 6.9 221 3,766,951 5.9 172 5,776,636 3.0
Totalc 1,741 7,207,159 24.2 3,825 9,828,568 38.9 2,181 9,179,942 23.8 1,154 7,626,248 15.1 726 10,804,551 6.7
Table 13. Diagnoses of HIV infection among adults aged ≥18 years, by age at diagnosis, race/ethnicity, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
Native Hawaiian/other Pacific Islander
18–24 years 25–34 years 35–44 years 45–54 years ≥55 years
No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 2 7,377 27.1 6 14,068 42.6 5 12,433 40.2 2 10,889 18.4 1 17,115 5.8
6.00–9.99 1 8,927 11.2 5 12,205 41.0 1 12,325 8.1 2 9,418 21.2 1 15,642 6.4
10.00–16.99 2 9,970 20.1 4 15,454 25.9 5 12,539 39.9 2 9,185 21.8 2 16,077 12.4
≥17 1 9,289 10.8 7 11,980 58.4 5 9,820 50.9 1 6,132 16.3 2 9,882 20.2
Less than high school diploma (%)
<5 0 8,736 0.0 4 10,547 37.9 2 10,141 19.7 2 8,132 24.6 1 13,479 7.4
5.00–8.99 2 7,903 25.3 4 13,372 29.9 6 11,173 53.7 3 8,450 35.5 0 14,689 0.0
9.00–15.99 4 10,725 37.3 8 14,699 54.4 3 13,967 21.5 1 10,906 9.2 2 16,107 12.4
≥16 0 8,583 0.0 6 15,371 39.0 5 12,051 41.5 1 8,220 12.2 3 14,546 20.6
Median household income (U.S. $)
<49,000 1 7,118 14.0 6 10,059 59.6 5 7,514 66.5 1 4,707 21.2 2 7,784 25.7
49,000–65,999 3 9,088 33.0 5 12,022 41.6 2 9,615 20.8 1 7,148 14.0 2 10,356 19.3
66,000–89,999 2 10,090 19.8 4 15,981 25.0 6 14,613 41.1 2 9,941 20.1 0 17,699 0.0
≥90,000 0 8,771 0.0 7 15,403 45.4 3 15,072 19.9 3 13,645 22.0 2 22,357 8.9
Without health insurance (%)
<4 0 7,711 0.0 3 10,805 27.8 1 10,647 9.4 3 8,318 36.1 2 16,991 11.8
4.00–7.99 2 10,485 19.1 4 14,977 26.7 5 13,546 36.9 2 12,382 16.2 0 19,138 0.0
8.00–13.99 2 9,281 21.5 9 14,344 62.7 5 12,482 40.1 1 8,217 12.2 1 13,354 7.5
≥14 2 8,102 24.7 6 13,581 44.2 5 10,442 47.9 1 6,707 14.9 3 9,233 32.5
Gini index (%)
<37 0 10,008 0.0 7 15,796 44.3 6 15,084 39.8 2 11,001 18.2 0 16,677 0.0
37.00–40.99 3 8,552 35.1 6 14,674 40.9 2 11,434 17.5 1 9,301 10.8 0 15,792 0.0
41.00–45.99 1 9,110 11.0 5 12,479 40.1 2 12,014 16.6 0 8,951 0.0 5 14,629 34.2
≥46 2 7,801 25.6 4 10,714 37.3 6 8,501 70.6 4 6,353 63.0 1 11,587 8.6
Subtotalb 7 35,947 19.5 24 53,989 44.5 17 47,332 35.9 7 35,708 19.6 6 58,821 10.2
Female
Below federal poverty level (%)
<6 0 7,425 0.0 0 11,744 0.0 0 10,502 0.0 1 10,585 9.4 0 18,749 0.0
6.00–9.99 1 7,769 12.9 1 13,303 7.5 1 11,984 8.3 0 9,619 0.0 0 18,535 0.0
10.00–16.99 0 7,600 0.0 1 14,894 6.7 1 12,072 8.3 1 9,925 10.1 0 17,165 0.0
≥17 0 9,230 0.0 0 11,496 0.0 2 8,873 22.5 0 6,758 0.0 0 11,692 0.0
Less than high school diploma (%)
<5 0 7,450 0.0 1 9,591 10.4 1 8,355 12.0 0 7,564 0.0 0 14,511 0.0
5.00–8.99 0 7,582 0.0 0 12,171 0.0 0 10,991 0.0 1 9,140 10.9 0 16,992 0.0
9.00–15.99 1 8,368 12.0 0 15,129 0.0 2 12,654 15.8 1 10,945 9.1 0 18,279 0.0
≥16 0 8,776 0.0 1 14,581 6.9 1 11,431 8.7 0 9,238 0.0 0 16,359 0.0
Median household income (U.S. $)
<49,000 0 7,359 0.0 1 9,327 10.7 1 7,013 14.3 0 4,865 0.0 0 8,727 0.0
49,000–65,999 0 7,034 0.0 0 12,833 0.0 2 9,755 20.5 0 8,746 0.0 0 13,034 0.0
66,000–89,999 1 8,887 11.3 0 14,992 0.0 1 12,816 7.8 1 11,265 8.9 0 19,612 0.0
≥90,000 0 8,523 0.0 1 13,986 7.2 0 13,676 0.0 1 11,834 8.5 0 24,153 0.0
Without health insurance (%)
<4 0 6,568 0.0 1 10,412 9.6 1 9,200 10.9 0 8,924 0.0 0 18,954 0.0
4.00–7.99 1 9,173 10.9 0 13,787 0.0 1 13,956 7.2 1 11,346 8.8 0 21,437 0.0
8.00–13.99 0 8,790 0.0 0 14,726 0.0 1 10,857 9.2 0 9,029 0.0 0 15,647 0.0
≥14 0 7,564 0.0 1 12,512 8.0 1 9,418 10.6 1 7,588 13.2 0 10,103 0.0
Gini index (%)
<37 0 8,702 0.0 1 15,224 6.6 1 14,621 6.8 0 11,911 0.0 0 18,382 0.0
37.00–40.99 1 8,480 11.8 1 13,146 7.6 1 9,815 10.2 1 8,831 11.3 0 17,354 0.0
41.00–45.99 0 7,588 0.0 0 13,244 0.0 1 11,319 8.8 0 9,387 0.0 0 17,263 0.0
≥46 0 7,229 0.0 0 9,823 0.0 1 7,675 13.0 1 6,758 14.8 0 13,103 0.0
Subtotalb 1 32,176 3.1 2 51,472 3.9 4 43,431 9.2 2 36,887 5.4 0 66,141 0.0
Totalc 8 68,123 11.7 26 105,461 24.7 21 90,763 23.1 9 72,595 12.4 6 124,962 4.8
Table 13. Diagnoses of HIV infection among adults aged ≥18 years, by age at diagnosis, race/ethnicity, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
White
18–24 years 25–34 years 35–44 years 45–54 years ≥55 years
No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 172 2,445,946 7.0 513 3,910,369 13.1 328 4,453,871 7.4 241 4,998,395 4.8 268 12,072,228 2.2
6.00–9.99 146 1,830,702 8.0 536 3,287,438 16.3 317 3,141,915 10.1 257 3,309,041 7.8 246 8,801,559 2.8
10.00–16.99 191 1,868,739 10.2 654 3,237,129 20.2 434 2,836,477 15.3 277 2,932,382 9.4 258 7,839,588 3.3
≥17 203 1,993,773 10.2 559 2,053,661 27.2 428 1,577,590 27.1 263 1,598,010 16.5 197 4,127,178 4.8
Less than high school diploma (%)
<5 198 3,081,052 6.4 617 3,918,801 15.7 411 3,890,549 10.6 259 4,174,051 6.2 299 10,435,586 2.9
5.00–8.99 179 2,204,022 8.1 532 3,544,242 15.0 351 3,471,743 10.1 257 3,705,267 6.9 241 9,553,330 2.5
9.00–15.99 175 1,901,596 9.2 615 3,223,826 19.1 415 3,011,989 13.8 300 3,219,401 9.3 234 8,432,309 2.8
≥16 160 1,019,597 15.7 498 1,824,907 27.3 330 1,654,803 19.9 222 1,753,910 12.7 195 4,433,196 4.4
Median household income (U.S. $)
<49,000 189 1,864,085 10.1 572 2,089,815 27.4 416 1,680,917 24.7 274 1,788,383 15.3 203 5,019,296 4.0
49,000–65,999 199 1,994,746 10.0 630 3,234,569 19.5 390 2,847,123 13.7 257 2,978,364 8.6 255 8,250,230 3.1
66,000–89,999 164 2,025,556 8.1 566 3,599,744 15.7 388 3,392,404 11.4 266 3,517,210 7.6 247 9,249,548 2.7
≥90,000 158 2,147,985 7.4 489 3,536,848 13.8 306 4,063,883 7.5 239 4,529,002 5.3 263 10,271,742 2.6
Without health insurance (%)
<4 127 2,434,063 5.2 404 3,371,596 12.0 299 3,620,513 8.3 209 4,066,569 5.1 249 10,451,051 2.4
4.00–7.99 189 2,503,543 7.5 587 3,748,180 15.7 402 3,636,105 11.1 276 3,843,850 7.2 259 9,893,077 2.6
8.00–13.99 209 1,961,681 10.7 669 3,167,418 21.1 408 2,863,222 14.2 284 2,967,667 9.6 242 7,560,771 3.2
≥14 187 1,282,660 14.6 602 2,201,945 27.3 398 1,890,113 21.1 269 1,959,787 13.7 219 4,936,066 4.4
Gini index (%)
<37 167 1,895,087 8.8 451 3,147,939 14.3 302 3,190,775 9.5 199 3,263,421 6.1 199 7,379,248 2.7
37.00–40.99 146 1,966,112 7.4 548 3,257,793 16.8 344 3,188,747 10.8 240 3,452,633 7.0 208 8,724,629 2.4
41.00–45.99 210 2,166,875 9.7 647 3,422,109 18.9 402 3,253,170 12.4 289 3,545,648 8.2 285 9,486,116 3.0
≥46 188 2,087,399 9.0 616 2,653,730 23.2 458 2,370,790 19.3 310 2,570,706 12.1 277 7,243,552 3.8
Subtotalb 743 8,206,267 9.1 2356 12,511,776 18.8 1,579 12,029,084 13.1 1,072 12,852,629 8.3 1,013 32,854,421 3.1
Female
Below federal poverty level (%)
<6 27 2,214,167 1.2 65 3,869,588 1.7 51 4,443,308 1.1 50 4,970,657 1.0 40 13,203,016 0.3
6.00–9.99 30 1,709,123 1.8 85 3,233,335 2.6 57 3,032,125 1.9 47 3,253,591 1.4 38 9,851,215 0.4
10.00–16.99 34 1,785,817 1.9 89 3,125,545 2.8 111 2,738,744 4.1 57 2,870,363 2.0 62 8,923,089 0.7
≥17 33 2,036,681 1.6 109 1,928,690 5.7 128 1,497,073 8.6 84 1,529,955 5.5 49 4,715,089 1.0
Less than high school diploma (%)
<5 22 2,999,307 0.7 55 3,850,590 1.4 43 3,854,859 1.1 38 4,161,090 0.9 35 11,612,611 0.3
5.00–8.99 27 2,078,332 1.3 86 3,472,993 2.5 59 3,404,435 1.7 47 3,666,520 1.3 52 10,726,720 0.5
9.00–15.99 41 1,791,737 2.3 104 3,135,582 3.3 113 2,928,237 3.9 79 3,163,836 2.5 52 9,471,913 0.5
≥16 34 926,998 3.7 103 1,700,621 6.1 132 1,525,679 8.7 74 1,634,131 4.5 50 4,882,038 1.0
Median household income (U.S. $)
<49,000 39 1,854,296 2.1 121 1,987,258 6.1 151 1,641,215 9.2 92 1,750,552 5.3 51 5,861,962 0.9
49,000–65,999 32 1,885,102 1.7 100 3,118,009 3.2 103 2,736,945 3.8 54 2,928,127 1.8 64 9,422,545 0.7
66,000–89,999 33 1,910,535 1.7 67 3,522,418 1.9 54 3,274,643 1.6 51 3,455,429 1.5 41 10,316,405 0.4
≥90,000 20 1,994,285 1.0 60 3,512,357 1.7 38 4,043,580 0.9 41 4,472,585 0.9 31 11,049,008 0.3
Without health insurance (%)
<4 19 2,307,432 0.8 50 3,331,955 1.5 36 3,608,670 1.0 38 4,050,414 0.9 27 11,664,366 0.2
4.00–7.99 37 2,389,177 1.5 94 3,660,632 2.6 93 3,550,768 2.6 57 3,805,188 1.5 50 11,039,165 0.5
8.00–13.99 35 1,883,630 1.9 94 3,063,863 3.1 98 2,754,111 3.6 68 2,888,007 2.4 59 8,479,492 0.7
≥14 33 1,212,598 2.7 110 2,101,095 5.2 120 1,797,721 6.7 75 1,880,988 4.0 53 5,509,572 1.0
Gini index (%)
<37 32 1,698,423 1.9 58 3,077,429 1.9 61 3,105,197 2.0 50 3,216,619 1.6 37 8,051,899 0.5
37.00–40.99 29 1,865,924 1.6 95 3,170,928 3.0 74 3,122,786 2.4 69 3,382,727 2.0 51 9,735,724 0.5
41.00–45.99 34 2,058,490 1.7 110 3,327,152 3.3 112 3,180,736 3.5 58 3,497,870 1.7 48 10,674,177 0.4
≥46 29 2,101,650 1.4 85 2,580,301 3.3 100 2,301,540 4.3 61 2,526,656 2.4 53 8,229,479 0.6
Subtotalb 128 7,796,374 1.6 361 12,159,786 3.0 368 11,713,210 3.1 251 12,625,577 2.0 196 36,693,282 0.5
Totalc 871 16,002,641 5.4 2,717 24,671,562 11.0 1,947 23,742,294 8.2 1,323 25,478,206 5.2 1,209 69,547,703 1.7
Table 13. Diagnoses of HIV infection among adults aged ≥18 years, by age at diagnosis, race/ethnicity, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
Multiracial
18–24 years 25–34 years 35–44 years 45–54 years ≥55 years
No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate No. Pop. Rate
Male
Below federal poverty level (%)
<6 36 322,034 11.2 48 387,786 12.4 25 394,253 6.3 14 321,656 4.4 14 415,320 3.4
6.00–9.99 39 285,278 13.7 58 389,077 14.9 30 342,335 8.8 15 259,108 5.8 10 371,746 2.7
10.00–16.99 46 342,205 13.4 55 479,245 11.5 33 390,178 8.5 19 310,521 6.1 12 449,728 2.7
≥17 65 379,300 17.1 120 444,475 27.0 38 358,449 10.6 19 289,735 6.6 15 461,885 3.2
Less than high school diploma (%)
<5 44 314,417 14.0 63 350,494 18.0 28 299,586 9.3 15 230,906 6.5 10 308,713 3.2
5.00–8.99 39 272,862 14.3 50 342,550 14.6 23 306,463 7.5 15 229,011 6.5 12 337,269 3.6
9.00–15.99 48 314,892 15.2 80 420,023 19.0 31 357,231 8.7 14 280,877 5.0 19 421,938 4.5
≥16 55 434,768 12.7 88 594,714 14.8 44 526,910 8.4 23 443,584 5.2 10 632,785 1.6
Median household income (U.S. $)
<49,000 69 351,062 19.7 104 412,980 25.2 35 338,927 10.3 19 272,205 7.0 15 463,411 3.2
49,000–65,999 46 328,290 14.0 73 431,534 16.9 30 343,897 8.7 18 273,644 6.6 11 394,840 2.8
66,000–89,999 35 322,797 10.8 54 444,977 12.1 38 385,876 9.8 17 297,438 5.7 13 413,761 3.1
≥90,000 35 313,003 11.2 50 404,072 12.4 22 410,802 5.4 13 333,304 3.9 11 419,712 2.6
Without health insurance (%)
<4 32 263,224 12.2 46 287,829 16.0 15 270,755 5.5 14 218,839 6.4 7 318,673 2.2
4.00–7.99 37 325,513 11.4 59 401,307 14.7 31 345,732 9.0 18 270,888 6.6 16 414,232 3.9
8.00–13.99 50 319,952 15.6 68 440,644 15.4 46 359,507 12.8 12 279,172 4.3 11 424,210 2.6
≥14 67 423,875 15.8 108 570,865 18.9 34 509,230 6.7 23 412,135 5.6 17 541,571 3.1
Gini index (%)
<37 46 347,049 13.3 59 429,153 13.7 28 402,126 7.0 15 310,256 4.8 15 373,648 4.0
37.00–40.99 36 322,857 11.2 49 430,149 11.4 25 369,539 6.8 17 299,053 5.7 8 413,597 1.9
41.00–45.99 50 349,020 14.3 78 455,115 17.1 31 392,598 7.9 14 313,988 4.5 12 474,959 2.5
≥46 54 306,174 17.6 95 384,539 24.7 41 319,587 12.8 21 256,688 8.2 16 435,533 3.7
Subtotalb 191 1,336,939 14.3 289 1,707,781 16.9 135 1,490,190 9.1 71 1,184,378 6.0 52 1,700,705 3.1
Female
Below federal poverty level (%)
<6 4 296,263 1.4 10 382,343 2.6 5 393,392 1.3 4 331,259 1.2 2 472,031 0.4
6.00–9.99 5 264,888 1.9 11 377,171 2.9 8 328,694 2.4 4 269,834 1.5 5 427,800 1.2
10.00–16.99 3 329,553 0.9 12 452,847 2.6 11 374,052 2.9 12 318,065 3.8 7 529,080 1.3
≥17 11 389,058 2.8 27 430,202 6.3 20 348,168 5.7 8 300,671 2.7 10 560,102 1.8
Less than high school diploma (%)
<5 7 316,013 2.2 8 349,213 2.3 7 313,500 2.2 3 246,999 1.2 5 359,215 1.4
5.00–8.99 4 272,064 1.5 13 353,381 3.7 7 302,631 2.3 3 243,461 1.2 4 403,772 1.0
9.00–15.99 3 302,749 1.0 19 403,311 4.7 10 348,489 2.9 9 296,777 3.0 7 504,332 1.4
≥16 9 394,952 2.3 20 536,974 3.7 20 479,961 4.2 13 432,660 3.0 8 721,720 1.1
Median household income (U.S. $)
<49,000 10 355,446 2.8 34 400,878 8.5 21 328,924 6.4 12 286,818 4.2 12 574,378 2.1
49,000–65,999 6 304,933 2.0 10 408,061 2.5 10 330,461 3.0 6 280,570 2.1 6 461,989 1.3
66,000–89,999 2 310,204 0.6 6 428,093 1.4 7 373,886 1.9 8 313,005 2.6 1 469,944 0.2
≥90,000 5 297,411 1.7 10 400,383 2.5 6 407,208 1.5 2 335,358 0.6 5 477,086 1.0
Without health insurance (%)
<4 4 251,630 1.6 12 291,342 4.1 6 275,720 2.2 1 223,212 0.4 3 372,784 0.8
4.00–7.99 7 319,830 2.2 9 405,876 2.2 6 345,823 1.7 8 290,312 2.8 2 496,620 0.4
8.00–13.99 4 315,904 1.3 9 413,103 2.2 7 355,626 2.0 7 298,780 2.3 9 502,426 1.8
≥14 8 397,802 2.0 30 532,293 5.6 25 467,137 5.4 12 407,525 2.9 10 617,183 1.6
Gini index (%)
<37 2 314,009 0.6 9 417,713 2.2 4 385,204 1.0 4 312,231 1.3 3 415,294 0.7
37.00–40.99 6 309,183 1.9 12 406,922 2.9 8 362,909 2.2 11 304,812 3.6 3 483,631 0.6
41.00–45.99 10 333,919 3.0 20 440,991 4.5 19 383,479 5.0 7 329,138 2.1 10 555,321 1.8
≥46 5 319,868 1.6 19 376,653 5.0 13 312,546 4.2 6 273,551 2.2 8 534,691 1.5
Subtotalb 24 1,285,778 1.9 62 1,642,879 3.8 48 1,444,581 3.3 31 1,219,897 2.5 25 1,989,039 1.3
Totalc 215 2,622,717 8.2 351 3,350,660 10.5 183 2,934,771 6.2 102 2,404,275 4.2 77 3,689,744 2.1

Abbreviations: Pop., population; SDOH, social determinants of health [footnotes only].

Note. Numbers less than 12, and rates based on these numbers, should be interpreted with caution. 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. Rates are per 100,000 population. For the definitions of SDOH indicator variables used in this report, see http://www2.census.gov/programs-surveys/acs/tech_docs/subject_definitions/2021_ACSSubjectDefinitions.pdf.

a Hispanic/Latino persons can be of any race.
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 SDOH subpopulations.
c Totals do not represent all adults aged ≥18 years whose HIV infection was diagnosed during 2021 in these areas. See Technical Notes for exclusion criteria.

Table 14. Diagnoses of HIV infection among adults aged ≥18 years, by transmission category, race/ethnicity, assigned sex at birth, and selected social determinants of health, 2021—census tract level, United States and Puerto Rico
  American Indian/Alaska Native Asian
Male-to-male sexual contactb Injection drug usec Male-to-male sexual contactb and injection drug usec Heterosexual contactd Male-to-male sexual contactb Injection drug usec Male-to-male sexual contactb and injection drug usec Heterosexual contactd
No. % No. % No. % No. % No. % No. % No. % No. %
Male
Below federal poverty level (%)
<6 14 13.9 1 33.3 1 5.1 1 13.3 146 28.2 2 15.8 2 10.5 10 26.1
6.00–9.99 19 18.2 2 50.0 3 30.3 2 19.3 123 23.7 2 15.0 4 23.5 9 23.5
10.00–16.99 30 29.1 0 3.3 1 14.1 2 27.7 118 22.8 5 43.3 6 37.3 11 29.9
≥17 40 38.8 0 13.3 5 50.5 3 39.8 131 25.3 3 25.8 4 28.8 8 20.5
Less than high school diploma (%)
<5 21 20.2 0 0 2 17.2 1 15.7 138 26.6 4 30.8 4 27.5 9 25.1
5.00–8.99 19 18.7 2 50.0 3 27.3 0 4.8 100 19.2 1 11.7 3 17.0 8 22.1
9.00–15.99 33 32.2 1 36.7 0 4.0 3 37.3 130 25.0 2 15.8 3 21.6 10 27.2
≥16 30 28.9 0 13.3 5 51.5 4 42.2 151 29.2 5 41.7 5 34.0 10 25.6
Median household income (U.S. $)
<49,000 39 37.7 0 13.3 4 42.4 3 39.8 94 18.4 3 24.6 4 28.9 6 17.1
49,000–65,999 30 28.4 0 13.3 4 36.4 2 18.1 100 19.5 2 12.7 5 30.3 8 20.4
66,000–89,999 22 21.6 1 33.3 0 4.0 2 26.5 131 25.4 4 29.7 1 8.6 11 28.5
≥90,000 13 12.3 1 40.0 2 17.2 1 15.7 188 36.7 4 33.1 5 32.2 13 34.0
Without health insurance (%)
<4 5 5.1 0 6.7 3 25.3 1 12.0 126 24.2 4 35.0 4 28.8 9 23.2
4.00–7.99 23 21.7 0 3.3 1 9.1 3 30.1 154 29.8 3 24.2 3 17.6 5 12.9
8.00–13.99 28 27.4 2 73.3 3 32.3 2 26.5 134 25.8 4 31.7 4 22.9 13 35.3
≥14 48 45.9 1 16.7 3 33.3 3 31.3 105 20.2 1 9.2 5 30.7 11 28.6
Gini index (%)
<37 20 19.1 1 40.0 1 6.1 3 41.0 121 23.4 4 36.7 2 11.8 9 25.4
37.00–40.99 22 21.2 0 3.3 3 25.3 1 16.9 102 19.8 2 14.2 2 15.0 8 20.3
41.00–45.99 31 29.9 2 50.0 3 31.3 2 28.9 142 27.5 1 9.2 6 37.9 12 32.2
≥46 31 29.9 0 6.7 4 37.4 1 13.3 152 29.3 5 40.0 5 35.3 8 22.2
Subtotale 114 100 3 100 11 100 9 100 541 100 12 100 16 100 40 100
Female
Below federal poverty level (%)
<6 1 6.8 1 5.9 1 27.7 20 25.3
6.00–9.99 3 22.6 3 16.0 1 14.9 21 27.2
10.00–16.99 5 36.1 7 38.5 1 19.1 24 30.6
≥17 5 34.6 7 39.6 2 38.3 13 17.0
Less than high school diploma (%)
<5 3 23.3 4 20.9 2 40.4 16 20.6
5.00–8.99 4 30.1 9 48.1 1 17.0 13 17.0
9.00–15.99 1 8.3 4 20.9 1 14.9 16 21.0
≥16 5 38.3 2 10.2 1 27.7 32 41.5
Median household income (U.S. $)
<49,000 5 39.8 8 41.2 0 4.3 13 16.3
49,000–65,999 3 24.8 6 30.5 2 44.7 18 22.7
66,000–89,999 2 18.0 3 13.9 1 19.1 25 32.3
≥90,000 2 17.3 3 14.4 2 31.9 22 28.8
Without health insurance (%)
<4 0 0 0 0 1 17.0 14 18.1
4.00–7.99 5 40.6 5 24.6 2 42.6 26 34.1
8.00–13.99 2 16.5 8 41.7 1 21.3 14 17.9
≥14 6 42.9 6 33.7 1 19.1 23 29.9
Gini index (%)
<37 2 15.0 3 16.0 1 23.4 16 20.6
37.00–40.99 2 15.8 2 10.2 2 34.0 21 27.2
41.00–45.99 4 30.8 7 36.9