Diagnoses of HIV Infection in the United States and Dependent Areas, 2018: Persons Living with HIV

All rates are per 100,000 population. The standard used for reporting trends in numbers and rates is an increase or a decrease of 5% or more during the specified time frame (e.g., when comparing 2014 and 2018). The exceptions to this standard are where numbers were small (i.e., less than 12) or rates were based on small numbers.
Please read all titles and footnotes carefully to ensure a complete understanding of the displayed data.
Figure 9. Rates of Adults and Adolescents Living with Diagnosed HIV Infection, Year-end 2018—United States and 6 Dependent Areas

Note: Data for the year 2018 are preliminary and based on deaths reported to CDC as of December 2019. Data are based on address of residence as of December 31, 2018 (i.e., most recent known address). Asterisk (*) indicates incomplete reporting. See Data Tables, Definitions, and Acronyms for more information on prevalence.
From 2014 through 2018 in the United States and 6 dependent areas, the number and rate of persons living with diagnosed HIV infection increased (Table 14b). At year-end 2018 in the United States and 6 dependent areas, 1,040,352 adults and adolescents were living with diagnosed HIV infection (Figure 9). The prevalence of diagnosed HIV infection was 374.6 per 100,000 population. From 2014 through 2018, by region, the rates of persons living with HIV in the Midwest, South, and West increased (Table 14a and Table 14b). The rate in the Northeast remained stable. The largest percentage increase in the rate (11%) was in the Midwest (from 162.7 in 2014 to 179.8 in 2018). At year-end 2018, the rate was highest in the Northeast at 420.5 followed by 371.6 in the South, 260.7 in the West, and 179.8 in the Midwest (Table 14a and Table 14b). Data for the year 2018 are preliminary and based on deaths reported to CDC through December 2019.
Gender
From 2014 through 2018 in the United States and 6 dependent areas, the largest percentage increase (24%) in the number of persons living with diagnosed HIV infection was among transgender MTF (Table 14b). At year-end 2018, the largest percentage (75%) of persons living with diagnosed HIV infection were male, followed by females (24%) (Table 14b). Transgender MTF, transgender FTM, and AGI each accounted for less than 1%.
Age Group
From 2014 through 2018 in the United States and 6 dependent areas, the largest percentage increase (51%) in the rate of persons living with diagnosed HIV infection was among persons aged 65 years and older (from 130.0 in 2014 to 196.6 in 2018) (Table 14b). At year-end 2018, persons aged 50–54 years made up the largest percentage (15%) of persons living with diagnosed HIV (Table 14b). The highest rate (762.6) was among persons aged 50–54 years, followed by those aged 55–59 years (704.3), and those aged 45–49 years (600.0).
Race/Ethnicity
At year-end 2018 in the United States, the highest rate (1,034.2) and the largest percentage (41%) were those for blacks/African Americans (Table 14a). Among the remaining race/ethnicity groups, the rates were 665.7 for persons of multiple races, 386.4 for Hispanics/Latinos, 154.0 for whites, 150.3 for Native Hawaiians/other Pacific Islanders, 129.6 for American Indians/Alaska Natives, and 80.9 for Asians.
Figure 10. Adults and Adolescents Living with Diagnosed HIV Infection, by Sex at Birth and Race/Ethnicity, Year-end 2018—United States and 6 Dependent Areas

Note: Data for the year 2018 are preliminary and based on deaths reported to CDC as of December 2019. See Data Tables, Definitions, and Acronyms for more information on prevalence and race/ethnicity.
a Includes Asian/Pacific Islander legacy cases.
b Hispanics/Latinos can be of any race.
At the end of 2018, 1,040,352 adults and adolescents were living with diagnosed HIV infection in the United States and 6 dependent areas (Figure 10). Among 795,198 males living with diagnosed HIV infection, 35% were black/African American, 33% were white, 25% were Hispanic/Latino, 5% were males of multiple races, and 2% were Asian. Less than 1% each were American Indian/Alaska Native and Native Hawaiian/other Pacific Islander. Among 245,154 females living with diagnosed HIV infection, 58% were black/African American, 20% were Hispanic/Latino, 16% were white, 5% were females of multiple races, and 1% were Asian. Less than 1% each were American Indian/Alaska Native and Native Hawaiian/other Pacific Islander.
Sex (at Birth) and Transmission Category
At year-end 2018 in the United States and 6 dependent areas, the rates were 585.8 for male adults and adolescents, 172.7 for female adults and adolescents, and 3.6 for children (aged less than 13 years) (Table14b). Among a total of 795,198 male adults and adolescents, 73% of infections were attributed to male-to-male sexual contact, 10% to heterosexual contact, 9% to IDU, 7% to male-to-male sexual contact and IDU, and 1% to perinatal transmission. Among a total of 245,154 female adults and adolescents, 77% of infections were attributed to heterosexual contact, 20% to IDU, and 2% to perinatal transmission. Among a total of 1,918 children (aged less than 13 years), 81% of infections were attributed to perinatal transmission.
2014 | 2015 | 2016 | 2017 | 2018 | ||||||
---|---|---|---|---|---|---|---|---|---|---|
No. | Ratea | No. | Ratea | No. | Ratea | No. | Ratea | No. | Ratea | |
Gender | ||||||||||
Male | 695,219 | — | 715,831 | — | 735,894 | — | 755,232 | — | 774,422 | — |
Female | 225,016 | — | 228,909 | — | 232,931 | — | 236,895 | — | 240,787 | — |
Transgender male-to-femaleb | 8,052 | — | 8,514 | — | 9,031 | — | 9,496 | — | 9,959 | — |
Transgender female-to-maleb | 281 | — | 308 | — | 326 | — | 355 | — | 403 | — |
Additional gender identityc | 118 | — | 128 | — | 141 | — | 156 | — | 173 | — |
Age at end of year | ||||||||||
<13 | 2,477 | 4.7 | 2,344 | 4.4 | 2,226 | 4.2 | 2,072 | 3.9 | 1,912 | 3.6 |
13–14 | 736 | 8.8 | 723 | 8.8 | 675 | 8.2 | 668 | 8.1 | 664 | 8.0 |
15–19 | 5,257 | 25.0 | 4,945 | 23.5 | 4,622 | 21.9 | 4,505 | 21.3 | 4,322 | 20.5 |
20–24 | 31,626 | 138.2 | 30,774 | 135.7 | 29,787 | 133.2 | 28,382 | 128.6 | 26,914 | 123.0 |
25–29 | 61,103 | 278.3 | 65,169 | 290.7 | 68,350 | 298.2 | 70,411 | 301.7 | 70,839 | 300.7 |
30–34 | 73,860 | 343.5 | 75,856 | 350.6 | 79,204 | 362.9 | 82,881 | 377.8 | 87,843 | 396.8 |
35–39 | 84,192 | 423.5 | 87,003 | 428.2 | 89,689 | 431.4 | 91,934 | 433.8 | 93,817 | 435.1 |
40–44 | 108,357 | 527.5 | 101,481 | 503.7 | 97,570 | 495.4 | 96,257 | 491.3 | 96,965 | 491.9 |
45–49 | 147,654 | 708.8 | 142,709 | 686.9 | 136,556 | 652.6 | 130,515 | 624.0 | 123,900 | 597.2 |
50–54 | 163,186 | 724.7 | 166,612 | 748.3 | 167,011 | 765.7 | 163,471 | 765.8 | 158,278 | 757.9 |
55–59 | 118,865 | 553.8 | 127,938 | 588.4 | 136,131 | 620.1 | 144,797 | 659.4 | 153,473 | 699.5 |
60–64 | 71,989 | 388.5 | 79,336 | 417.1 | 87,775 | 451.0 | 96,359 | 483.2 | 104,620 | 514.6 |
≥65 | 59,384 | 128.6 | 68,800 | 144.3 | 78,727 | 159.9 | 89,882 | 177.0 | 102,197 | 194.9 |
Race/ethnicity | ||||||||||
American Indian/Alaska Native | 2,525 | 107.4 | 2,644 | 111.6 | 2,819 | 118.1 | 2,987 | 124.3 | 3,134 | 129.6 |
Asiand | 11,399 | 68.3 | 12,331 | 71.6 | 13,279 | 74.8 | 14,250 | 78.1 | 15,160 | 80.9 |
Black/African American | 382,232 | 967.7 | 392,725 | 984.9 | 403,100 | 1001.7 | 413,043 | 1017.8 | 422,994 | 1034.2 |
Hispanic/Latinoe | 200,121 | 362.7 | 207,740 | 368.6 | 215,670 | 374.6 | 223,516 | 380.7 | 231,317 | 386.4 |
Native Hawaiian/other Pacific Islander | 695 | 127.9 | 757 | 136.5 | 783 | 138.3 | 825 | 143.2 | 881 | 150.3 |
White | 284,426 | 143.8 | 289,722 | 146.5 | 294,546 | 148.9 | 299,300 | 151.4 | 304,131 | 154.0 |
Multiple races | 46,512 | 730.0 | 47,001 | 716.3 | 47,360 | 701.6 | 47,449 | 684.4 | 47,363 | 665.7 |
Transmission categoryf | ||||||||||
Male adult or adolescentg | ||||||||||
Male-to-male sexual contact | 494,027 | — | 514,232 | — | 533,999 | — | 553,173 | — | 571,934 | — |
Injection drug use | 72,006 | — | 71,061 | — | 70,085 | — | 69,360 | — | 68,794 | — |
Male-to-male sexual contact and injection drug use |
55,544 | — | 55,615 | — | 55,702 | — | 55,760 | — | 55,781 | — |
Heterosexual contacth | 73,276 | — | 74,996 | — | 76,683 | — | 77,962 | — | 79,401 | — |
Perinatali | 4,496 | — | 4,608 | — | 4,698 | — | 4,787 | — | 4,876 | — |
Otherj | 2,865 | — | 2,847 | — | 2,828 | — | 2,839 | — | 2,830 | — |
Subtotal | 702,214 | 541.0 | 723,360 | 552.3 | 743,996 | 563.1 | 763,881 | 573.5 | 783,616 | 583.6 |
Female adult or adolescentg | ||||||||||
Injection drug use | 49,903 | — | 49,607 | — | 49,281 | — | 49,056 | — | 48,916 | — |
Heterosexual contacth | 167,411 | — | 171,553 | — | 175,835 | — | 179,961 | — | 183,954 | — |
Perinatali | 5,048 | — | 5,174 | — | 5,309 | — | 5,476 | — | 5,643 | — |
Otherj | 1,633 | — | 1,652 | — | 1,676 | — | 1,688 | — | 1,703 | — |
Subtotal | 223,995 | 164.8 | 227,986 | 166.4 | 232,101 | 168.0 | 236,181 | 169.6 | 240,216 | 171.2 |
Child (<13 yrs at end of year) | ||||||||||
Perinatal | 2,028 | — | 1,917 | — | 1,818 | — | 1,694 | — | 1,538 | — |
Otherj | 449 | — | 427 | — | 408 | — | 378 | — | 374 | — |
Subtotal | 2,477 | 4.7 | 2,344 | 4.4 | 2,226 | 4.2 | 2,072 | 3.9 | 1,912 | 3.6 |
Region of residencek | ||||||||||
Northeast | 225,433 | 402.4 | 227,551 | 406.0 | 231,643 | 413.2 | 233,669 | 416.7 | 235,944 | 420.5 |
Midwest | 110,203 | 162.7 | 112,877 | 166.3 | 116,541 | 171.4 | 119,675 | 175.6 | 122,844 | 179.8 |
South | 413,704 | 345.7 | 427,482 | 353.2 | 437,957 | 357.8 | 450,981 | 364.9 | 463,643 | 371.6 |
West | 179,346 | 239.3 | 185,780 | 245.1 | 192,182 | 250.8 | 197,809 | 255.8 | 203,313 | 260.7 |
Totall | 928,686 | 291.7 | 953,690 | 297.3 | 978,323 | 302.8 | 1,002,134 | 308.2 | 1,025,744 | 313.5 |
Note: Data for the year 2018 are preliminary and based on deaths reported to CDC as of December 2019.
aRates are per 100,000 population. Rates are not calculated by gender or transmission category because of the lack of denominator data.
b“Transgender male-to-female” includes individuals who were assigned “male” sex at birth but have ever identified as “female” gender. “Transgender female-to-male” includes individuals who were assigned “female” sex at birth but have ever identified as “male” gender.
cAdditional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
dIncludes Asian/Pacific Islander legacy cases (see Technical Notes).
eHispanics/Latinos can be of any race.
fData have been statistically adjusted to account for missing transmission category, therefore values may not sum to column subtotals and total.
gData presented based on sex at birth and includes transgender persons.
hHeterosexual contact with a person known to have, or to be at high risk for, HIV infection.
iIncludes individuals ≥13 years of age at time of diagnosis of HIV infection.
jIncludes hemophilia, blood transfusion, and risk factor not reported or not identified.
kData are based on address of residence at the end of the specified year (i.e., most recent known address).
lIncludes persons whose race/ethnicity is unknown.
2014 | 2015 | 2016 | 2017 | 2018 | ||||||
---|---|---|---|---|---|---|---|---|---|---|
No. | Ratea | No. | Ratea | No. | Ratea | No. | Ratea | No. | Ratea | |
Gender | ||||||||||
Male | 706,838 | — | 727,563 | — | 747,652 | — | 766,842 | — | 785,983 | — |
Female | 230,246 | — | 234,088 | — | 238,057 | — | 241,890 | — | 245,727 | — |
Transgender male-to-femaleb | 8,076 | — | 8,539 | — | 9,056 | — | 9,521 | — | 9,983 | — |
Transgender female-to-maleb | 282 | — | 309 | — | 327 | — | 356 | — | 404 | — |
Additional gender identityc | 118 | — | 128 | — | 141 | — | 156 | — | 173 | — |
Age at end of year | ||||||||||
<13 | 2,495 | 4.7 | 2,357 | 4.4 | 2,240 | 4.2 | 2,081 | 3.9 | 1,918 | 3.6 |
13–14 | 745 | 8.8 | 729 | 8.7 | 678 | 8.2 | 674 | 8.1 | 672 | 8.0 |
15–19 | 5,349 | 25.1 | 5,015 | 23.5 | 4,670 | 21.8 | 4,550 | 21.3 | 4,363 | 20.5 |
20–24 | 32,058 | 138.4 | 31,168 | 135.8 | 30,140 | 133.2 | 28,683 | 128.5 | 27,184 | 122.9 |
25–29 | 61,837 | 278.5 | 65,941 | 290.9 | 69,112 | 298.3 | 71,124 | 301.5 | 71,544 | 300.5 |
30–34 | 74,916 | 344.5 | 76,826 | 351.3 | 80,172 | 363.6 | 83,795 | 378.3 | 88,720 | 397.2 |
35–39 | 85,659 | 425.6 | 88,470 | 430.3 | 91,100 | 433.2 | 93,231 | 435.3 | 95,007 | 436.2 |
40–44 | 110,318 | 530.5 | 103,274 | 506.4 | 99,252 | 498.0 | 97,854 | 493.7 | 98,506 | 494.1 |
45–49 | 150,391 | 713.1 | 145,330 | 691.1 | 138,984 | 656.5 | 132,713 | 627.2 | 125,890 | 600.0 |
50–54 | 166,289 | 729.9 | 169,712 | 753.5 | 170,064 | 770.6 | 166,422 | 770.5 | 161,131 | 762.6 |
55–59 | 121,210 | 558.2 | 130,405 | 593.0 | 138,713 | 624.8 | 147,471 | 664.1 | 156,237 | 704.3 |
60–64 | 73,436 | 391.5 | 80,916 | 420.4 | 89,517 | 454.7 | 98,212 | 486.9 | 106,641 | 518.7 |
≥65 | 60,857 | 130.0 | 70,484 | 145.8 | 80,591 | 161.5 | 91,955 | 178.6 | 104,457 | 196.6 |
Race/ethnicity | ||||||||||
American Indian/Alaska Native | 2,527 | — | 2,646 | — | 2,821 | — | 2,989 | — | 3,136 | — |
Asiand | 11,446 | — | 12,383 | — | 13,332 | — | 14,307 | — | 15,222 | — |
Black/African American | 382,553 | — | 393,041 | — | 403,406 | — | 413,344 | — | 423,304 | — |
Hispanic/Latinoe | 216,503 | — | 224,180 | — | 232,088 | — | 239,649 | — | 247,337 | — |
Native Hawaiian/other Pacific Islander | 719 | — | 784 | — | 814 | — | 861 | — | 916 | — |
White | 284,505 | — | 289,800 | — | 294,624 | — | 299,379 | — | 304,206 | — |
Multiple races | 46,528 | — | 47,020 | — | 47,379 | — | 47,469 | — | 47,382 | — |
Transmission categoryf | ||||||||||
Male adult or adolescentg | ||||||||||
Male-to-male sexual contact | 498,420 | — | 518,787 | — | 538,710 | — | 557,914 | — | 576,787 | — |
Injection drug use | 75,857 | — | 74,835 | — | 73,755 | — | 72,905 | — | 72,227 | — |
Male-to-male sexual contact and injection drug use |
56,379 | — | 56,451 | — | 56,511 | — | 56,528 | — | 56,517 | — |
Heterosexual contacth | 75,668 | — | 77,420 | — | 79,111 | — | 80,380 | — | 81,803 | — |
Perinatali | 4,630 | — | 4,742 | — | 4,827 | — | 4,915 | — | 5,005 | — |
Otherj | 2,895 | — | 2,876 | — | 2,857 | — | 2,869 | — | 2,858 | — |
Subtotal | 713,849 | 543.3 | 735,111 | 554.7 | 755,772 | 565.4 | 775,511 | 575.7 | 795,198 | 585.8 |
Female adult or adolescentg | ||||||||||
Injection drug use | 51,012 | — | 50,693 | — | 50,335 | — | 50,055 | — | 49,885 | — |
Heterosexual contacth | 171,384 | — | 175,495 | — | 179,760 | — | 183,815 | — | 187,793 | — |
Perinatali | 5,173 | — | 5,305 | — | 5,436 | — | 5,602 | — | 5,761 | — |
Otherj | 1,647 | — | 1,667 | — | 1,690 | — | 1,701 | — | 1,715 | — |
Subtotal | 229,216 | 166.5 | 233,159 | 168.0 | 237,221 | 169.6 | 241,173 | 171.1 | 245,154 | 172.7 |
Child (<13 yrs at end of year) | ||||||||||
Perinatal | 2,046 | — | 1,930 | — | 1,832 | — | 1,703 | — | 1,544 | — |
Otherj | 449 | — | 427 | — | 408 | — | 378 | — | 374 | — |
Subtotal | 2,495 | 4.7 | 2,357 | 4.4 | 2,240 | 4.2 | 2,081 | 3.9 | 1,918 | 3.6 |
Region of residencek | ||||||||||
Northeast | 225,433 | 402.4 | 227,551 | 406.0 | 231,643 | 413.2 | 233,669 | 416.7 | 235,944 | 420.5 |
Midwest | 110,203 | 162.7 | 112,877 | 166.3 | 116,541 | 171.4 | 119,675 | 175.6 | 122,844 | 179.8 |
South | 413,704 | 345.7 | 427,482 | 353.2 | 437,957 | 357.8 | 450,981 | 364.9 | 463,643 | 371.6 |
West | 179,346 | 239.3 | 185,780 | 245.1 | 192,182 | 250.8 | 197,809 | 255.8 | 203,313 | 260.7 |
U.S. dependent areas | 16,874 | 428.7 | 16,937 | 437.2 | 16,910 | 444.2 | 16,631 | 446.5 | 16,526 | 459.8 |
Totall | 945,560 | 293.4 | 970,627 | 299.0 | 995,233 | 304.5 | 1,018,765 | 309.8 | 1,042,270 | 315.1 |
Note: Data for the year 2018 are preliminary and based on deaths reported to CDC as of December 2019.
aRates are per 100,000 population. Rates are not calculated by gender or transmission category because of the lack of denominator data. Rates by race/ethnicity are not provided because U.S. census information is limited for U.S. dependent areas.
b“Transgender male-to-female” includes individuals who were assigned “male” sex at birth but have ever identified as “female” gender. “Transgender female-to-male” includes individuals who were assigned “female” sex at birth but have ever identified as “male” gender.
cAdditional gender identity examples include “bigender,” “gender queer,” and “two-spirit.”
dIncludes Asian/Pacific Islander legacy cases (see Technical Notes).
eHispanics/Latinos can be of any race.
fData have been statistically adjusted to account for missing transmission category, therefore values may not sum to column subtotals and total.
gData presented based on sex at birth and includes transgender persons.
hHeterosexual contact with a person known to have, or to be at high risk for, HIV infection.
iIncludes individuals ≥13 years of age at time of diagnosis of HIV infection.
jIncludes hemophilia, blood transfusion, and risk factor not reported or not identified.
kData are based on address of residence at the end of the specified year (i.e., most recent known address).
lIncludes persons whose race/ethnicity is unknown.
Prevalence trends and data reflect persons living with diagnosed HIV infection, regardless of stage of disease, (Figures 9, 10, 30, and 31; Tables 14a/b–17a/b, 19, 20, and A2) at the end of a given year during 2014–2018. Because of delays in the reporting of deaths, prevalence data are based on a 12-month reporting delay to allow data to be reported to CDC. For tables presenting prevalence data, region or area of residence is based on most recent known address as of the end of the specified year. Data for the year 2018 are preliminary and based on death data received by CDC through December 2019. Trends through 2018 should be interpreted with caution. Due to incomplete reporting of deaths for the year 2018, prevalence data for Alabama, Oklahoma, South Carolina, and the U.S. Virgin Islands should be interpreted with caution.
In the Federal Register [6] for October 30, 1997, the Office of Management and Budget (OMB) announced the Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity. Implementation by January 1, 2003 was mandated. At a minimum, data on the following race categories should be collected:
- American Indian or Alaska Native
- Asian
- black or African American
- Native Hawaiian or other Pacific Islander
- white
Additionally, systems must be able to retain information when multiple race categories are reported. In addition to data on race, data on 2 categories of ethnicity should be collected:
- Hispanic or Latino
- not Hispanic or Latino
The Asian or Pacific Islander category displayed in annual surveillance reports published prior to the 2007 surveillance report was split into 2 categories: (1) Asian and (2) Native Hawaiian or other Pacific Islander. The Asian category (in tables where footnoted) includes the cases in Asians/Pacific Islanders (referred to as legacy cases) that were reported before the implementation of the new race categories in 2003 (e.g., cases of HIV infection that were diagnosed and reported to CDC before 2003 but that were classified as stage 3 [AIDS] after 2003) and a small percentage of cases that were reported after 2003 but that were reported according to the old race category (Asian/ Pacific Islander). In tables of diagnoses of HIV infection during 2014–2018, the Asian category does not include Asian/Pacific Islander cases because these cases were diagnosed after 2003 and were reported to CDC in accordance with OMB’s Revisions to the Standards for the Classification of Federal Data on Race and Ethnicity [6].
This report also presents data for persons for whom multiple race categories are reported. In this report, persons categorized by race were not Hispanic or Latino. The number of persons reported in each race category may, however, include persons whose ethnicity was not reported.
AGI: additional gender identity
AIDS: acquired immunodeficiency syndrome
CDC: Centers for Disease Control and Prevention
FTM: female-to-male
HIV: human immunodeficiency virus
IDU: injection drug use
MSA: metropolitan statistical area
MSM: gay, bisexual, and other men who have sex with men
MTF: male-to-female
NHSS: National HIV Surveillance System
NIR: no identified risk factor
OI: opportunistic illness
OMB: Office of Management and Budget
PrEP: preexposure prophylaxis
PWID: persons who inject drugs