Estimated Annual Number of HIV Infections ─ United States, 1981-2019

Abstract

The first cases of Pneumocystis carinii (jirovecii) pneumonia among young men, which were subsequently linked to HIV infection, were reported in the MMWR on June 5, 1981 (1). At year-end 2019, an estimated 1.2 million persons in the United States were living with HIV infection (2). Using data reported to the National HIV Surveillance System, CDC estimated the annual number of new HIV infections (incidence) among persons aged ≥13 years in the United States during 1981-2019. Estimated annual HIV incidence increased from 20,000 infections in 1981 to a peak of 130,400 infections in 1984 and 1985. Incidence was relatively stable during 1991-2007, with approximately 50,000-58,000 infections annually, and then decreased in recent years to 34,800 infections in 2019. The majority of infections continue to be attributable to male-to-male sexual contact (63% in 1981 and 66% in 2019). Over time, the proportion of HIV infections has increased among Black/African American (Black) persons (from 29% in 1981 to 41% in 2019) and among Hispanic/Latino persons (from 16% in 1981 to 29% in 2019). Despite the lack of a cure or a vaccine, today's HIV prevention tools, including HIV testing, prompt and sustained treatment, preexposure prophylaxis, and comprehensive syringe service programs, provide an opportunity to substantially decrease new HIV infections. Intensifying efforts to implement these strategies equitably could accelerate declines in HIV transmission, morbidity, and mortality and reduce disparities.

FIGURE 1

Estimated HIV incidence among persons aged ≥13 years — United States, 1981–2019 Abbreviations: BCA = back-calculation approach; CD4 = CD4+ T-lymphocyte model; SEA = stratified extrapolation approach. * HIV incidence estimates for 1981–2006 were derived from the extended BCA applied to HIV surveillance data reported to CDC through June 2007. HIV incidence in 2007 was estimated using the SEA applied to HIV surveillance data reported to CDC through June 2011. HIV incidence estimates during 2008–2019 were derived from the CD4 model applied to HIV surveillance data reported to CDC through December 2020.

FIGURE 2

Estimated HIV incidence* among persons aged ≥13 years, by selected race/ethnicity and transmission category — United States, 1981–2019 Abbreviations: BCA = back-calculation approach; CD4 = CD4+ T-lymphocyte model; IDU = injection drug use; MMSC = male-to-male sexual contact; SEA = stratified extrapolation approach. * HIV incidence estimates for 1981–2006 were derived from the extended BCA applied to HIV surveillance data reported to CDC through June 2007. HIV incidence in 2007 was estimated using the SEA applied to HIV surveillance data reported to CDC through June 2011. HIV incidence estimates during 2008–2019 were derived from the CD4 model applied to HIV surveillance data reported to CDC through December 2020. ^† Hispanic/Latino persons can be of any race. ^§ Transmission categories assigned on the basis of sex at birth and include transgender persons. Data by transmission category have been adjusted to account for missing risk-factor information.