HIV in the U.S. by the Numbers – 2021

HIV prevention and treatment

Also included are the latest estimates for several indicators of progress in HIV prevention and treatment, including pre-exposure prophylaxis (PrEP) use, linkage to care, and viral suppression. State- and city-level HIV data are available here.

Because there are gaps in epidemiology data for HIV among transgender women, this fact sheet includes the best available data on HIV incidence, prevalence, PrEP use, and receipt of medical care and treatment for this population from CDC's National HIV Behavioral Surveillance.

Table 1. Estimated new HIV infections, 2021^a

Source: Table 1 in CDC. Estimated HIV incidence and prevalence in the United States, 2017–2021. HIV Surveillance Supplemental Report, 2023; 28 (No.3). Published May 2023. Accessed July 2023.

Abbreviations: RSE, relative standard error; CD4, CD4+ T-lymphocyte count (cells/μL) or percentage [footnotes only].

Note. Estimates derived by using HIV surveillance data and CD4 data for persons aged ≥13 years at diagnosis.

Estimates rounded to the nearest 100 for estimates >1,000 and to the nearest 10 for estimates ≤1,000 to reflect model uncertainty.

Estimates with an RSE 30%‒50%, preceded by an asterisk (*), should be used with caution.

Estimates with an RSE >50% are not shown and are replaced with an ellipsis (…).

• a. Estimates for years 2020 and 2021 should be interpreted with caution due to adjustments made to the monthly distribution of reported diagnoses during those years to account for the impact of COVID-19 on HIV testing and diagnosis in the United States. See Technical Notes for more information.

• b. Rates are per 100,000 population. Rates are not calculated by transmission category because of the lack of denominator data.
• c. Hispanic/Latino persons can be of any race.
• d. 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.
• e. 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).
• f. Heterosexual contact with a person known to have, or with a risk factor for, HIV infection.
• g. 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).
• h. Includes persons with other risk factors, including hemophilia, blood transfusion, and risk factor not reported or not identified. Data not displayed because the numbers were too small to be meaningful.
• i. Indicates that difference from 2017 estimate was deemed statistically significantly (P<.05).

Table 2. People with HIV (Combines total number diagnosed and undiagnosed), 2021^a

Source: Table 8 in CDC. Estimated HIV incidence and prevalence in the United States, 2017–2021. HIV Surveillance Supplemental Report, 2023; 28 (No.3). Published May 2023. Accessed July 2023.

Abbreviations: RSE, relative standard error; CD4, CD4+ T-lymphocyte count (cells/μL) or percentage [footnotes only]; CDC, the Centers for Disease Control and Prevention [footnotes only].

Note. Estimates for the year 2021 are preliminary and based on deaths reported to CDC through December 2022.

Estimates derived by using HIV surveillance data and CD4 data for persons aged ≥13 years at diagnosis.

Estimates rounded to the nearest 100 for estimates >1,000 and to the nearest 10 for estimates ≤1,000 to reflect model uncertainty.

• a. Estimates for years 2020 and 2021 should be interpreted with caution due to adjustments made to the monthly distribution of reported diagnoses during those years to account for the impact of COVID-19 on HIV testing and diagnosis in the United States. See Technical Notes for more information.
• b. Rates are per 100,000 population. Reported to the National HIV Surveillance System.
• c. Hispanic/Latino persons can be of any race.
• d. Includes Asian/Pacific Islander legacy cases.
• e. 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.
• f. 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).
• g. Heterosexual contact with a person known to have, or with a risk factor for, HIV infection.
• h. 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).
• i. Includes persons with other risk factors, including hemophilia, blood transfusion, and risk factor not reported or not identified. Data not displayed because the numbers were too small to be meaningful.

Table 3. HIV-related deaths, through 2022

Source: CDC National Center for Health Statistics

Table 4. Pre-exposure prophylaxis (PrEP) prescriptions, 2021

Source: Table 9a in CDC.  Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2021. HIV Surveillance Supplemental Report 2023;28(4).

Published May 2023. Accessed July 2023.

Abbreviations: PrEP, preexposure prophylaxis; n/a, not available; FDA, Food and Drug Administration [footnotes only].

Note. PrEP coverage data are considered preliminary. Data for year 2021 should be interpreted with caution due to the impact of the COVID-19 pandemic on filling PrEP prescriptions in state/local jurisdictions.

• a. Estimated by using data from IQVIA pharmacy database reported through September 2022 based on an algorithm that included FDA-approved drugs for PrEP. Data for which values are unknown were not reported; therefore, values may not sum to column total.
• b. PrEP coverage, reported as a percentage, was calculated as the number who have been prescribed PrEP divided by the estimated number of persons who had indications for PrEP.
• c. Estimated by using 2018 data from National HIV Surveillance System (NHSS), National Health and Nutrition Examination Survey, and U.S. Census Bureau’s American Community Survey (ACS). Data are rounded to the nearest 10. Data for which values are unknown were not reported; thus, values may not sum to column total. The data sources used to estimate the number of persons with indications for PrEP have different schedules of data availability. Consequently, the availability of a denominator may lag the availability of a numerator.
• d. Race/ethnicity data were only available for <40% of persons prescribed PrEP in each year. Race/ethnicity data were imputed, and the data source was based on a consumer database which might underrepresent certain populations. Number prescribed PrEP and PrEP coverage for race/ethnicity reported in the table were adjusted by applying the distribution of records with known race/ethnicity to records with missing race/ethnicity.
• e. Hispanic/Latino persons can be of any race.

Table 5. Linkage to HIV medical care within one month of HIV diagnosis and viral suppression within six months of HIV diagnosis during 2021

Source: Table 2a in CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 dependent areas, 2021. HIV Surveillance Supplemental Report 2023;28(4). Published May 2023. Accessed July 2023.

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].

Note. 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 are based on residence at time of diagnosis of HIV infection. Data not provided for states and associated jurisdictions 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.

• a. Hispanic/Latino persons can be of any race.
• b. 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.
• c. 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).
• d. Heterosexual contact with a person known to have, or with a risk factor for, HIV infection.
• e. 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).
• f. Other risk factors, including hemophilia, blood transfusion, and risk factor not reported or not identified.

Table 6. Proportion of transgender women with HIV - National HIV behavioral surveillance, 7 U.S. cities, 2019 - 2020^a

Source: Table 2 in CDC. HIV Infection, Risk, Prevention, and Testing Behaviors Among Transgender Women—National HIV Behavioral Surveillance, 7 U.S. Cities, 2019–2020. HIV Surveillance Special Report 27. Published April 2021.

Abbreviation: NHBS, National Behavioral Surveillance [footnotes only].

Note: Data include participants with a valid NHBS HIV test result.

• a. The seven U.S. cities in this report included Atlanta, GA; Los Angeles, CA; New Orleans, LA; New York City, NY; Philadelphia, PA; San Francisco, CA; and Seattle, WA.
• b. Participants with a reactive rapid NHBS HIV test result supported by a second rapid test or supplemental laboratory-based testing.
• c. Hispanic/Latina people can be of any race.

Table 7. Pre-exposure prophylaxis use among transgender women without HIV - National HIV behavioral surveillance, 7 U.S. cities, 2019 - 2020^a

Source: Table 6a in CDC. HIV Infection, Risk, Prevention, and Testing Behaviors Among Transgender Women—National HIV Behavioral Surveillance, 7 U.S. Cities, 2019–2020. HIV Surveillance Special Report 27. Published April 2021.

Abbreviations: NHBS, National HIV Behavioral Surveillance; PrEP, pre-exposure prophylaxis.

• a. The seven U.S. cities in this report included Atlanta, GA; Los Angeles, CA; New Orleans, LA; New York City, NY; Philadelphia, PA; San Francisco, CA; and Seattle, WA.
• b. Took PrEP at any point in the 12 months before interview to reduce the risk of getting HIV.
• c. Participants with a valid negative NHBS HIV test result.
• d. Hispanic/Latina people can be of any race.

Table 8. Receipt of HIV care and treatment among self-reported HIV - Positive transgender women - National HIV behavioral surveillance, 7 U.S. cities, 2019 - 2020^a

Source: Table 7 in CDC. HIV Infection, Risk, Prevention, and Testing Behaviors Among Transgender Women—National HIV Behavioral Surveillance, 7 U.S. Cities, 2019–2020. HIV Surveillance Special Report 27. Published April 2021. Accessed September 2021.

Abbreviations: NHBS, National HIV Behavioral Surveillance; PrEP, pre-exposure prophylaxis.

• a. The seven U.S. cities in this report included Atlanta, GA; Los Angeles, CA; New Orleans, LA; New York City, NY; Philadelphia, PA; San Francisco, CA; and Seattle, WA.
• b. Data include all participants who reported having ever received an HIV-positive test result (which may include those who did not have a valid NHBS result, positive or negative, or who did not consent to the HIV test). "Past six months" refers to the 6 months before interview.
• c. Hispanics/Latina can be of any race.