Fast Facts: HIV and Transgender People

At a glance

Nearly 1 million people (.3%) identify as transgender in the United States (US), and transgender people made up 2% (671) of new HIV diagnoses in the US and dependent areas in 2019. Get the latest data on HIV among transgender people.

Group of transgender people.

Fast facts

HIV affects some groups more than others. Social and structural issues—such as HIV stigma, homophobia, discrimination, poverty, and limited access to high-quality health care—influence health outcomes and continue to drive inequities. 

HIV Diagnoses

HIV diagnoses refers to the number of people who received an HIV diagnosis during a given year.

HIV diagnoses among transgender people in the US and dependent areas, 2019

Of the 36,801 new HIV diagnoses in the US and dependent areas in 2019, 2 percent (671) were among transgender people. The Ending the HIV Epidemic overall goal is to decrease the number of new HIV diagnoses to 9,588 by 2025 and 3,000 by 2030.
Learn more about HIV diagnoses among transgender people.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2019. HIV Surveillance Report 2021;32.

HIV diagnoses among transgender people by race/ethnicity in the US and dependent areas, 2019

Most new HIV diagnoses among transgender people were among Black/African American people. Among transgender women, Black/African American people had the most new HIV diagnoses, followed by Hispanic/Latino, White, multiracial, Asian, American Indian/Alaska Native, and Native Hawaiian/other Pacific Islander people, respectively. Among transgender men, Black/African American people had the most new HIV diagnoses, followed by Hispanic/Latino, White, multiracial, and Asian people, respectively.
Learn more about HIV diagnoses among transgender people by race and ethnicity.

*Black refers to people having origins in any of the Black racial groups of Africa. African American is a term often used for people of African descent with ancestry in North America.

Hispanic/Latino people can be of any race.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2019. HIV Surveillance Report 2021;32.

HIV diagnoses among transgender people by age in the US and dependent areas, 2019

Among transgender people, most new HIV diagnoses were among people aged 25 to 34, followed by people aged 13 to 24, 35 to 44, 45 to 54, and 55 and older, respectively.
Learn more about HIV diagnoses among transgender people by age.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2019. HIV Surveillance Report 2021;32.

HIV diagnoses among transgender people by region in the US and dependent areas, 2019*

The highest number of new HIV diagnoses among transgender people were in the South, followed by transgender people in the West, Northeast, Midwest, and US Dependent Areas, respectively.
Learn more about HIV diagnoses among transgender people by region.

*Regions used in CDC's National HIV Surveillance System: Northeast: CT, ME, MA, NH, NJ, NY, PA, RI, VT Midwest: IL, IN, IA, KS, MI, MN, MO, NE, ND, OH, SD, WI South: AL, AR, DE, DC, FL, GA, KY, LA, MD, MS, NC, OK, SC, TN, TX, VA, WV West: AK, AZ, CA, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2019. HIV Surveillance Report 2021;32.

HIV diagnoses among transgender people in the US and dependent areas, 2015-2019*

Trends in HIV diagnoses among transgender people varied by age. People 55 and older saw the largest increase in diagnoses, followed by people aged 25 to 34 and 35 to 44, respectively. People aged 45 to 54 saw the largest decrease in diagnoses, followed by people aged 13 to 24.
Learn more about trends in HIV diagnoses among transgender people.

*Changes in subpopulations with fewer HIV diagnoses can lead to a large percentage increase or decrease.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2019. HIV Surveillance Report 2021;32.

HIV testing

HIV testing is the gateway to care for people who have HIV and to prevention services for people who don't have HIV. CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care. People with certain risk factors should get tested at least once a year. A recent study found that transgender women have high rates of recent and lifetime HIV testing.

HIV testing among transgender women in 7 US cities, 2019-2020*

Getting test for HIV is the only way for people to learn their status. 96 percent of transgender women had ever tested for HIV. 82 percent of transgender women were tested for HIV in the past 12 months.
Learn more about HIV testing among transgender women.

*Among people aged 18 and older.

Source: 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 2021.

HIV prevention

There are many HIV prevention strategies available, including condoms; pre-exposure prophylaxis (PrEP); post-exposure prophylaxis (PEP); as well as interventions focused on risk reduction; adherence to HIV medicine; linkage to, retention in, and re-engagement in care; structural approaches; and engagement in PrEP care. Additionally, for people with HIV, treatment provides substantial benefits for personal health and reduces HIV transmission to others. This is sometimes called HIV treatment as prevention.

HIV prevention interventions among transgender women in 7 US cities, 2019-2020*

HIV prevention interventions can reduce risk behaviors. 61 percent of transgender women who do not have HIV participated in an individual or group level HIV prevention intervention.
Learn more about HIV prevention interventions among transgender women.

*Among people aged 18 and older.

Source: 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 2021.

PrEP awareness and use among transgender women in 7 US cities, 2019-2020*

PrEP is highly effective for preventing HIV from sex or injection drug use. 92 percent of transgender women without HIV were aware of PrEP. 32 percent of transgender women without HIV used PrEP.
Learn more about PrEP awareness and use among transgender women.

*Among people aged 18 and older.

Source: 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 2021.

HIV prevalence

HIV prevalence is the number of people with HIV at a given time regardless of the time of infection.

HIV prevalence among transgender women in 7 US cities, 2019-2020*

Racial and ethnic disparities exist among transgender women with HIV. Among transgender women interviewed, 42 percent had HIV. 62 percent of Black/African American transgender women had HIV. 35 percent of Hispanic/Latina transgender women had HIV. 17 percent of White transgender women had HIV.
Learn more about HIV prevalence among transgender women.

*Among people aged 18 and older.

Source: 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 2021.

Viral suppression and barriers to care

Viral suppression refers to the percentage of people with diagnosed HIV who have less than 200 copies of HIV per milliliter of blood.

Transgender people with diagnosed HIV in 44 states and the District of Columbia, 2019

For every 100 transgender women with diagnosed HIV in 2019, 84 received some HIV care, 67 were retained in care, and 67 were virally suppressed. For every 100 transgender men with diagnosed HIV in 2019, 85 received some HIV care, 65 were retained in care, and 68 were virally suppressed. For comparison, for every 100 people overall with diagnosed HIV, 76 received some HIV care, 58 were retained in care, and 66 were virally suppressed.
Learn more about HIV care and viral suppression among transgender people with diagnosed HIV.

*Had 2 viral load or CD4 tests at least 3 months apart in a year.

Had less than 200 copies of HIV per milliliter of blood on most recent viral load test.

Source: CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data—United States and 6 Dependent Areas, 2019. HIV Surveillance Special Report 2021; 26(2).

Many people with HIV experience challenges with achieving and maintaining viral suppression over time. Some of these challenges include missing HIV medical appointments, needing but not receiving other important health care services, or missing doses of HIV treatment.

Missed HIV medical care appointments among transgender people with diagnosed HIV in the US, 2020*

Staying in HIV care is important to achieving and maintaining viral suppression. 20 percent of all people with HIV, compared to 31 percent of transgender people with HIV, missed at least 1 medical appointment in the past 12 months.
Learn more about missed HIV medical care appointments among transgender people with diagnosed HIV.

*Among people aged 18 and older.

Source: CDC. Medical Monitoring Project.

HIV treatment among transgender people with diagnosed HIV in the US, 2020*

Taking HIV medicine consistently and as prescribed is the bast way to achieve and maintain viral suppression. 62 percent of all people with HIV, compared to 35 percent of transgender people with HIV, reported taking all of their doses of HIV medicine over the last 30 days.
Learn more about HIV treatment among transgender people with diagnosed HIV.

*Among people aged 18 and older.

Source: CDC. Medical Monitoring Project.

Needed HIV ancillary services among transgender people with diagnosed HIV in the US, 2020*†

HIV ancillary care services are essential for supporting people in staying in HIV care and maintaining viral suppression. The top service transgender people with HIV reported needing in 2020 was dental care, with 17 percent saying they needed but did not receive it. 41 percent of all people with HIV needed, but did not receive, at least 1 HIV ancillary service in the past 12 months.
Learn more about needed HIV ancillary services among transgender people with diagnosed HIV.

*Among people aged 18 and older.

HIV ancillary services, such as case management and mental health services, are services that support retention in HIV care and viral suppression.

Source: CDC. Medical Monitoring Project.

Homelessness among transgender people with diagnosed HIV in the US, 2020*

People who experience homelessness may find it difficult to get HIV care and treatment. 8 percent of all people with HIV, compared to 29 percent of transgender people with HIV, reported homelessness in the past 12 months.
Learn more about homelessness among transgender people with diagnosed HIV.

*Among people aged 18 and older.

Source: CDC. Medical Monitoring Project.

Depression and anxiety among transgender people with diagnosed HIV in the US, 2020*

Some transgender people with diagnosed HIV may have difficulty getting treatment. 19 percent of all people with HIV, compared to 26 percent of transgender people with HIV, experienced symptoms of depression or anxiety in the past 12 months.
Learn more about depression and anxiety among transgender people with diagnosed HIV.

*Among people aged 18 and older.

Source: CDC. Medical Monitoring Project.

Median HIV stigma score among transgender people with diagnosed HIV in the US, 2020*

Transgender people with HIV experienced HIV stigma. On a scale of 1 to 100, with 100 representing high HIV stigma and 0 representing no HIV stigma, all people with HIV had a score of 28, while transgender people with HIV had a score of 34. The goal is 0 for all populations.
Learn more about HIV stigma experienced by transgender people with diagnosed HIV.

Median HIV stigma scores are presented based on a ten-item scale ranging from 0 (no stigma) to 100 (high stigma) that measures personalized stigma during the past 12 months, current disclosure concerns, current negative self-image, and current perceived public attitudes about people with HIV.

*Among people aged 18 and older.

Source: CDC. Medical Monitoring Project.