Diagnoses of HIV Infection in the United States and Dependent Areas 2020: National Profile

Data presented in this report are based on case data reported to CDC through December 31, 2021, and allows for a 12-month reporting delay and assessment of diagnosis, death, and prevalence for the year 2020. The statements in this section, unless otherwise indicated, are based on 12 or more cases. All rates are per 100,000 population.

When presenting rates by race/ethnicity, data are only provided for the United States (50 states and the District of Columbia) because denominator data are not available by race/ethnicity for all U.S. dependencies.

Please use caution when interpreting data for AGI persons, transgender men, American Indian/Alaska Native and Native Hawaiian/other Pacific Islander persons as many percentages and/or rates were based on small numbers.

For disparity measures, reference groups are based on the rate of the lowest group with more than five percent of cases.

Deaths of persons with diagnosed HIV infection may be due to any cause (i.e., may or may not be related to HIV infection). Data for the year 2020 are preliminary and based on deaths reported to CDC as of December 2021.

Important note. Data for 2020 should be interpreted with caution due to the impact of the COVID-19 pandemic on access to HIV testing, care-related services, and case surveillance activities in state/local jurisdictions.

Please read all titles and footnotes carefully to ensure a complete understanding of the displayed data. See Technical Notes for information on definitions and data specifications.

Diagnoses

Diagnoses of HIV Infection

In 2020, in the United States and 6 dependent areas, there were 30,692 diagnoses of HIV infection (persons aged ≥13 years: 30,635) (Tables 1b, 3b). The overall HIV diagnosis rate was 9.2 (persons aged ≥13 years: 10.9) (Figure 1).

HIV diagnosis percentages and/or rates among persons aged ≥ 13 years were as follows:

• Gender (Figure 2):
  • Male: 80%
  • Female: 18%
  • Transgender woman/girl: 2%
  • Transgender man/boy: < 1%
  • AGI: < 1%

• Age group (Figure 3):
  • 13–24 years: 20%
  • 25–34 years: 37%
  • 35–44 years: 20%
  • 45–54 years: 13%
  • ≥55 years: 10%

For additional data by 5-year age groups, see Table 3b.

• Rates (U.S. only) (Figure 4):
  • Highest: persons aged 25–34 years (24.4)
  • Lowest: persons aged ≥ 55 years (3.2)

  For additional data by 5-year age groups, see Table 3a.

  • • Disparities by age group:
      • Absolute disparity (rate difference)—If persons aged 25–34 years had the same rate as persons aged ≥ 55 years, 21 cases per 100,000 population would have been prevented.
      • Relative disparity (rate ratio)—Persons aged 25–34 years had a rate that was 7.6 times as high as persons aged ≥ 55 years.
• Rates (U.S. only) (Figure 4):
  • Highest: Black/African American (37.4)
  • Lowest: Asian (3.8)
    • Disparities by race/ethnicity:
      • Absolute disparity (rate difference)—If Black/African American persons aged ≥ 13 years had the same rate as White persons aged ≥ 13 years (4.6), 33 cases per 100,000 population would have been prevented.
      • Relative disparity (rate ratio)—Black/African American persons aged ≥ 13 years had a rate that was 8.1 times as high as White persons aged ≥ 13 years.
• Rates (U.S. only) (Figure 4):
  • Highest: South (14.7)
  • Lowest: Midwest (7.2)
    • Disparities by region:
      • Absolute disparities (rate difference): if the South had the same rate as the Midwest, 8 cases per 100,000 population would have been prevented.
      • Relative disparities (rate ratio): the South had a rate that was 2.0 times as high as the Midwest.

• Race/ethnicity (Figure 5):
  • American Indian/Alaska Native: 1%
  • Asian: 2%
  • Black/African American: 42%
  • Hispanic/Latino: 27%
  • Native Hawaiian/other Pacific Islander: < 1%
  • White: 26%
  • Multiracial: 3%

• Sex assigned at birth and transmission category—highest percentages (Figure 6, Table 1b):
  • Overall: infections attributed to male-to-male sexual contact (MMSC) (68%)
  • Among male sex at birth: MMSC (83%)
  • Among female sex at birth: heterosexual contact (83%)

• Gender and exposure category—highest percentages (Table 4b):
  • Among transgender women: sexual contact (90%)
  • Among transgender men: sexual contact (73%)
  • Among AGI: sexual contact (82%)
• Region of residence, all persons (Table 1b):
  • Northeast: 14%
  • Midwest: 13%
  • South: 51%
  • West: 21%
  • U.S. dependent areas: 1%

Deaths

Deaths of Persons With Diagnosed HIV Infection

In 2020, in the United States and 6 dependent areas, there were 18,493 deaths among persons with diagnosed HIV infection (persons aged ≥13 years: 18,489) (Tables 12b). The overall rate of deaths was 5.6 (persons aged ≥13 years: 6.6) (Figure 7).

Deaths of persons aged ≥ 13 years with a diagnosis of HIV infection percentages and/or rates were as follows:

• Gender, all persons (Table 11b):
  • Male: 74%
  • Female: 24%
  • Transgender woman/girl: 1%
  • Transgender man/boy: <1%
  • AGI: 0%
• Age group (Figure 8):
  • 13–24 years: 1%
  • 25–34 years: 6%
  • 35–44 years: 11%
  • 45–54 years: 20%
  • ≥ 55 years: 62%%

  For additional data by 5-year age groups, see Table 11b.

• Race/ethnicity (Figure 8):
  • American Indian/Alaska Native: <1%
  • Asian: 1%
  • Black/African American: 43%
  • Hispanic/Latino: 19%
  • Native Hawaiian/other Pacific Islander: <1%
  • White: 30%
  • Multiracial: 7%

• Rates (U.S. only) (Figure 9):
  • Highest: persons aged ≥55 years (11.5)
  • Lowest: persons aged 13–24 years (0.3)

  For additional rates by age group, see Table 11a.

  • • Disparities by age group:
      • Absolute disparity (rate difference)—If persons aged ≥55 years had the same rate as persons aged 25–34 years, 9 cases per 100,000 population would have been prevented.
      • Relative disparity (rate ratio)—Persons aged ≥55 years had a rate that was 4.4 times as high as persons aged 25–34 years.
• Rates (U.S. only) (Figure 9):
  • Highest: Multiracial (25.7)
  • Lowest: Asian (0.6)
    • Disparities by race/ethnicity:
      • Absolute disparity (rate difference)—If multiracial persons aged ≥13 years had the same rate as White persons aged ≥13 years (3.2), 23 cases per 100,000 population would have been prevented.
      • Relative disparity (rate ratio)—Multiracial persons aged ≥13 years had a rate that was 8.0 times as high as White persons aged ≥13 years.
• Rates (U.S. only) (Figure 9):
  • Highest: Northeast (9.3)
  • Lowest: Midwest (3.9)
    • Disparities by region:
      • Absolute disparities (rate difference): if the Northeast had the same rate as the Midwest, 5 cases per 100,000 population would have been prevented.
      • Relative disparities (rate ratio): the Northeast had a rate that was 2.4 times as high as the Midwest.

• Sex assigned at birth and transmission category—highest percentages (Table 11b):
  • Overall: infections attributed to MMSC (43%)
  • Among male sex at birth: MMSC (56%)
  • Among female sex at birth: heterosexual contact (66%)
• Gender and exposure category—highest percentages (Table 14b):
  • Among transgender women: sexual contact (68%)
  • Among transgender men: sexual contact (67%)
  • Among AGI: no deaths
• Region of residence, all persons (Table 11b):
  • Northeast: 24%
  • Midwest: 12%
  • South: 47%
  • West: 16%
  • U.S. dependent areas: 2%

Prevalence

Persons Living With Diagnosed HIV Infection

At year-end 2020 in the United States and 6 dependent areas, 1,072,051 persons were living with diagnosed HIV infection (persons aged ≥13 years: 1,070,604) (Table 15b, 17b). The overall rate of persons living with diagnosed HIV infection was 321.9 (persons aged ≥13 years: 381.4) (Figure 10).

Persons living with diagnosed HIV infection percentages and/or rates were as follows:

• Gender (Table 15b):
  • Male: 76%
  • Female: 23%
  • Transgender woman/girl: 1%
  • Transgender man/boy: <1%
  • AGI: <1%
• Age group (Table 15b):
  • 13–24 years: 3%
  • 25–34 years: 15%
  • 35–44 years: 19%
  • 45–54 years: 24%
  • ≥55 years: 39%

  For additional data by 5-year age groups, see Table 15b.

• Race/ethnicity (Figure 11):
  • American Indian/Alaska Native: <1%
  • Asian: 2%
  • Black/African American: 40%
  • Hispanic/Latino: 24%
  • Native Hawaiian/other Pacific Islander: <1%
  • White: 29%
  • Multiracial: 5%
• Sex assigned at birth and race/ethnicity, persons aged ≥13 years (Figure 11):
  • Highest among male sex at birth: Black/African American (35%)
  • Highest among female sex at birth: Black/African American (57%)

• Rates (U.S. only) (Table 15a):
  • American Indian/Alaska Native: 133.5
  • Asian: 83.6
  • Black/African American: 1,038.0
  • Hispanic/Latino: 401.4
  • Native Hawaiian/other Pacific Islander: 152.6
  • White: 155.5
  • Multiracial: 693.7
• Sex assigned at birth and transmission category, persons aged ≥13 years—highest percentages (Table 17b):
  • Overall: infections attributed to MMSC (56%)
  • Among male sex at birth: MMSC (74%)
  • Among female sex at birth: heterosexual contact (77%)
• Gender and exposure category, persons aged ≥13 years—highest percentages (Table 18b):
  • Among transgender women: sexual contact (85%)
  • Among transgender men: sexual contact (75%)
  • Among AGI: sexual contact (87%)
• Region of residence (Table 15b):
  • Northeast: 22%
  • Midwest: 12%
  • South: 45%
  • West: 20%
  • U.S. dependent areas: 2%
• Rates (U.S. only) (Table 15b):
  • Highest: Northeast (421.4)
  • Lowest: Midwest (185.8)