Human immunodeficiency virus, or HIV, is a virus that weakens a person’s immune system by attacking cells that fight off infection, specifically a person’s CD4 cells. HIV is spread through body fluids such as blood. If HIV goes untreated and advances, it can lead to acquired immunodeficiency syndrome or AIDS. Unlike most other viruses, when a person contracts HIV, they have it for life because the human body cannot fight off the virus entirely. HIV, however, can be controlled and its progression can be slowed significantly. There are three stages of HIV: acute HIV infection, clinical latency (HIV inactivity or dormancy), and AIDS.
HIV Around the World
According to the World Health Organization, there are about 37.9 million people in the world living with HIV in 2018. The prevalence of HIV in adults ages 15 to 29 is estimated at about 0.8% of the world’s population. HIV is believed to have come from a type of chimpanzee in Central Africa, where the chimpanzee version of the virus, simian immunodeficiency virus or SIV, was transmitted to humans when they hunted the animal and came into contact with the blood. Once the virus was transmitted to humans, it mutated into HIV. It is believed that HIV was first transmitted in the 1800s and spread slowly across Africa and later into the rest of the world, reaching the United States around the mid to late 1970s. Unfortunately, because it is the origin of HIV, Africa has the highest prevalence of the virus at an estimated 3.9%.
Although HIV cannot be cured, it can be controlled and treated through viral load suppression, also known as antiretroviral therapy (ART). ART reduces the viral load (amount of the virus) in the body’s blood and fluids. ART can not only slow the progression of HIV but also reduces the chances of transmitting the virus to other people. ART is recommended for all people diagnosed with HIV and should be started as soon as possible after diagnosis.
Of the 37.9 million people living with HIV around the world, 23.3 million are receiving ART, which means about 62% of those diagnosed with HIV are controlling their virus. While accessibility to testing and treatment has significantly improved around the world, poverty, gender equality, and HIV stigma and discrimination are major barriers to HIV prevention and treatment in many countries.
UNAIDS, the Joint United Nations Program on HIV/AIDS, is the world’s leading advocate for the comprehensive and coordinated global action against the HIV/AIDS pandemic. In 2014, UNAIDS established the 90-90-90 goals, which called for countries around the world to get 90% of people living with HIV diagnosed; 90% of those diagnosed accessing treatment, and 90% of people on treatment to have suppressed viral loads by 2020.
HIV in the United States
Based on the most recent information from the Centers for Disease Control and Prevention (CDC), about 1.14 million Americans had HIV at the end of 2016. About 1 in 7 of those with the virus are unaware that they have it.
In 2018, 37,832 people received an HIV diagnosis, according to the CDC. Among those, 42% were black or African American, 27% were Hispanic or Latino, and 25% were white. Also among the new diagnoses, 69% were among gay, bisexual, and other men who have sex with men (sometimes referred to as MSM); 24% were among heterosexuals, and 7% were among people who inject drugs.
In the United States, there are five categories of laws pertaining to HIV and other STDs. As of 2018, 26 states have HIV-specific laws that criminalize behaviors that can potentially expose another person to HIV.
States with the Highest Rates of HIV
These numbers are based on the CDC’s HIV Surveillance Report.
California has the highest number of people living with HIV of 128,153, a rate of 389.7 people with HIV per 100,000 residents. Of those living with HIV in California, the largest group is White with 48,155 people and the second-largest is Hispanic/Latino with 48,029.
New York has the second-highest number of people living with HIV of 126,495, a rate of 760.2 per 100,000. This rate is more than double that of California’s. The largest group living with HIV in New York is Black/African American with 47,164 people living with the virus.
Florida has 110,034 people living with HIV, the third-highest number in the United States. Florida’s HIV rate is 612.3 per 100,000. The group with the highest number of people living with HIV is Black/African American with 49,943.
Texas has the fourth-highest number of people living with HIV in the United States of 88,099, translating to a rate of 382.9 per 100,000 people. The largest group living with the virus is Black/African American with 31,915 people, followed by Hispanic/Latino with 29,758.
Georgia has 52,528 people living with HIV, a rate of 608.8 per 100,000. This is the fifth-highest in the country. A majority of those infected with the virus are Black/African American, totaling 35,974.