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

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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.

Persons Living with Diagnosed HIV Infection

Figure 9. Rates of Adults and Adolescents Living with Diagnosed HIV Infection, Year-end 2018—United States and 6 Dependent Areas

At year-end 2018 in the United States and 6 dependent areas, 1,040,352 adults and adolescents were living with diagnosed HIV infection. The prevalence of diagnosed HIV infection was 374.6 per 100,000 population. Data are based on address of residence as of December 31, 2018 (i.e., most recent known address). Persons living with a diagnosis of HIV infection are classified as adult or adolescent based on age at year-end 2018.

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

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. 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. The Asian category includes Asian/Pacific Islander legacy cases (cases that were diagnosed and reported under the pre-1997 Office of Management and Budget race/ethnicity classification system). Hispanics/Latinos can be of any race. Unknown race/ethnicity is not displayed because it comprises less than 1% of cases. Persons living with diagnosed HIV infection are classified as adult or adolescent based on age at year-end 2018.

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.

Data Tables, Definitions, and Acronyms Used on this Page

Table 14a. Persons living with diagnosed HIV infection, by year and selected characteristics, 2014–2018—United States
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.

Table 14b. Persons living with diagnosed HIV infection, by year and selected characteristics, 2014–2018—United States and 6 dependent areas
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

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Page last reviewed: May 7, 2020
Content source: Division of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention