To understand whether HIV is on the rise, you need a regional lens, because the curve points in different directions around the world. Global new infections have dropped roughly 40 percent since the late 1990s, yet progress has flattened since about 2015, and several regions now show clear increases. In the United States, federal surveillance shows uneven movement, with diagnoses ticking upward in some communities while holding steady in others.
You will find current HIV statistics here, the populations driving new infections, and the prevention tools available to you today.
The Global Picture Has Quietly Shifted
An estimated 1.3 million people acquired HIV in 2023, a figure UNAIDS released in its annual surveillance update. That number reflects a dramatic long-term decline from the late-1990s peak, when annual infections ran several times higher. The pace of improvement, however, has slowed almost to a crawl in recent years, and the curve that once bent sharply downward now bends barely at all.
Where the burden concentrates today
Sub-Saharan Africa still carries about two-thirds of all people living with HIV globally, even as access to antiretroviral therapy (ART) has expanded across the region. Within that region, southern Africa remains the epicenter of new diagnoses, particularly among adolescent girls and young women, a pattern that has held for more than a decade despite broad prevention campaigns.
| Region | Approximate share of new global infections (2023) | Direction of trend |
|---|---|---|
| Sub-Saharan Africa | ~55–60% | Slow decline or plateau |
| Asia and the Pacific | ~15% | Mixed; some countries rising |
| Eastern Europe and Central Asia | ~5–7% | Sharp rise |
| Latin America | ~7% | Slow decline |
| North America and Western/Central Europe | ~5% | Plateau with local increases |
Where Diagnoses Are Actually Climbing
The places posting the steepest increases share common features: stigma, criminalization of key populations, and shrinking harm-reduction infrastructure. Eastern Europe and Central Asia have seen new HIV infections climb for more than a decade, driven largely by injection drug use and the absence of widespread needle exchange or opioid substitution programs in several countries.
US hot spots that buck the national trend
Inside the United States, federal CDC data show renewed upticks in the South and in specific demographic groups. Diagnoses among Black and Latino men who have sex with men (MSM) have not declined at the pace seen among white MSM, and several southern states report rising case counts in rural counties where testing infrastructure is thin. Adolescents and young adults also accounted for a growing share of new domestic infections in recent surveillance years.
Heading east tells a different story. Russia, Ukraine, and several Central Asian republics are reporting record-high new infection rates, with outbreaks concentrated among people who inject drugs and their sexual partners.
Why the Numbers Move in Unexpected Directions
A diagnosis spike does not always equal a transmission spike, and the post-COVID rebound in routine testing caught a backlog of undiagnosed cases that had quietly accumulated during pandemic-era clinic closures. Those caught infections now appear as a sudden surge in the surveillance data even when true incidence barely budged, which is why you should read year-over-year changes with care.
The opioid and methamphetamine redraw
Fentanyl-laced opioids and surging methamphetamine use have reshaped sexual and injection networks across entire regions in this third wave of the US crisis. Outbreaks now appear in areas that once posted steady declines, including rural Appalachia, the Ozarks, and parts of the Mountain West. Sharing injection equipment transmits HIV far more efficiently than sexual contact, so a single contaminated syringe can seed dozens of new infections in a short window.
Funding cuts and criminalization as silent drivers
Reduced global funding for prevention programs suppresses both testing and honest reporting, and the criminalization of key populations pushes cases underground. When sex workers, people who inject drugs, or MSM fear arrest or violence, they avoid clinics, so the surveillance system records fewer diagnoses, which then looks like progress until a delayed data release reveals the truth.
Those data blind spots are precisely what makes interpreting prevention coverage so complicated across regions.
PrEP, PEP, and Treatment as Prevention Compared
Three modern tools have reshaped HIV prevention, and choosing the right one depends on the situation in front of you. Pre-exposure prophylaxis (PrEP) is a daily or on-demand pill for people who are HIV-negative and at ongoing risk, and it cuts transmission by more than 99 percent when taken as prescribed.
Post-exposure prophylaxis (PEP) is an emergency 28-day course started within 72 hours of a possible exposure and is intended for one-off incidents such as a condom break or a needlestick injury.
| Tool | Who it is for | When it is used | Key requirement |
|---|---|---|---|
| PrEP | HIV-negative adults at ongoing risk | Daily or on-demand before exposure | Confirmed HIV-negative status; prescription |
| PEP | Anyone with a recent possible exposure | Within 72 hours, lasting 28 days | Rapid access to a clinic or emergency department |
| Treatment as Prevention (U=U) | People already living with HIV | Continuous ART | Sustained undetectable viral load for 6+ months |
Treatment as prevention rests on a finding so consistent it earned its own slogan: Undetectable equals Untransmittable. People living with HIV who stay on ART and maintain an undetectable viral load cannot sexually transmit the virus to partners, a conclusion supported by multiple large-scale studies.
Who Gets Left Behind in Prevention Access
Black and Latino MSM remain the group with the largest US disparities in PrEP uptake relative to need, despite carrying a disproportionate share of new diagnoses. Rural communities and the US South lack PrEP-prescribing clinicians, pharmacy coverage, and reliable transportation, so even motivated patients struggle to start or stay on a daily pill.
Stigma and the law as barriers
HIV-related stigma, immigration status concerns, and HIV criminalization laws in more than 30 US states keep many at-risk individuals from seeking testing or disclosing status to partners. A person who fears prosecution for not disclosing status may avoid the test that would connect them to care, and the surveillance system never counts what it never sees.
Practical Steps for Testing, Prevention, and Care
Free or low-cost HIV testing is available through the CDC’s GetTested locator, local health departments, and many community-based organizations, often with results in under 20 minutes for rapid tests. Most US insurance plans, including Medicaid expansion programs, now cover PrEP with no out-of-pocket cost, and manufacturer assistance programs cover the uninsured.
Where to turn for help paying for care
The Ryan White Program funds treatment, case management, and support services for people living with HIV who could not otherwise afford care. The Ending the HIV Epidemic initiative channels federal resources into the counties and states with the highest burden, and both programs operate in every state and most US territories.
Those structural resources only reach the people who actually walk through a clinic door.
- Get tested annually: Anyone sexually active or sharing injection equipment benefits from an annual HIV test as part of routine preventive care.
- Ask about PrEP: A primary care provider, community health center, or telehealth service can prescribe daily PrEP after a confirmed negative HIV test.
- Seek PEP fast: A possible exposure calls for a same-day visit to an emergency department, urgent care clinic, or PEP hotline.
- Connect to Ryan White: People diagnosed with HIV can enter care regardless of insurance status through the Ryan White Program.
- Use harm reduction: Needle exchanges and medication-assisted treatment cut transmission risk for people who inject drugs.
The Next Decade Depends on Closing the Gaps
Long-acting injectable PrEP, administered every two months instead of daily, and same-day treatment starts could reset the curve if delivery systems reach the people most at risk. Sustained funding for harm reduction, sex education, and anti-stigma campaigns is the variable that determines whether 2030 elimination targets remain realistic.
What success requires from public health
Several policy shifts would accelerate progress: expanding Medicaid in the remaining non-expansion states, reforming or repealing HIV criminalization laws, and routing prevention funding directly to community organizations rather than large institutions. Without those shifts, the 2030 targets slip further out of reach, and the regional disparities harden.
Bottom Line
HIV is not rising everywhere, but it is clearly rising in specific places and specific populations, and the global decline has stalled. Prevention tools exist, they work, and they are more accessible than at any point in the epidemic, yet the people who need them most often face the steepest barriers. Closing those gaps is the single highest-leverage move left in the fight against HIV.
FAQ
Is HIV on the rise in the United States?
National HIV diagnoses in the United States have edged downward since the late 2010s, yet that downward trend has stalled and reversed in several regions and demographic groups. CDC data show rising or plateauing rates among Black and Latino MSM and in many southern states.
Why are new HIV infections increasing in some regions?
Rising infection rates in Eastern Europe, Central Asia, and parts of the US South trace to stigma, criminalization of key populations, opioid and methamphetamine injection, and shrinking harm-reduction services. Post-pandemic testing rebounds also surface previously undiagnosed infections.
How many new HIV cases are reported each year globally?
UNAIDS estimates roughly 1.3 million new HIV infections occurred worldwide in 2023, down dramatically from the late-1990s peak but with progress slowing since about 2015.
Which populations are most affected by rising HIV rates?
Adolescent girls and young women in southern Africa, people who inject drugs in Eastern Europe and Central Asia, and Black and Latino MSM in the United States carry the heaviest per-capita burden of new HIV diagnoses.
What is the difference between PrEP and PEP?
PrEP is a daily or on-demand pill taken before potential exposure to prevent HIV infection, while PEP is a 28-day emergency course started within 72 hours after a possible exposure.
How effective is HIV treatment at preventing transmission?
Antiretroviral therapy that suppresses viral load to undetectable levels eliminates sexual transmission risk, the foundation of the Undetectable equals Untransmittable consensus backed by multiple large studies.
