Blacks/African Americans* have the most severe burden of HIV of all racial/ethnic groups in the United States. Compared with other races and ethnicities, African Americans account for a higher proportion of new HIV infections, those living with HIV, and those ever diagnosed with AIDS.
New HIV Infections1
- African Americans accounted for an estimated 44% of all new HIV infections among adults and adolescents (aged 13 years or older) in 2010, despite representing only 12% of the U.S. population; considering the smaller size of the African American population in the United States, this represents a population rate that is 8 times that of whites overall.
- In 2010, men accounted for 70% (14,700) of the estimated 20,900 new HIV infections among all adult and adolescent African Americans. The estimated rate of new HIV infections for African American men (103.6/100,000 population) was 7 times that of white men, twice that of Latino men, and nearly 3 times that of African American women.
- In 2010, African American gay, bisexual, and other men who have sex with men**2 represented an estimated 72% (10,600) of new infections among all African American men and 36% of an estimated 29,800 new HIV infections among all gay and bisexual men. More new HIV infections (4,800) occurred among young African American gay and bisexual men (aged 13-24) than any other subgroup of gay and bisexual men.
- In 2010, African American women accounted for 6,100 (29%) of the estimated new HIV infections among all adult and adolescent African Americans. This number represents a decrease of 21% since 2008. Most new HIV infections among African American women (87%; 5,300) are attributed to heterosexual contact.3 The estimated rate of new HIV infections for African American women (38.1/100,000 population) was 20 times that of white women and almost 5 times that of Hispanic/Latino women.4
Estimates of New HIV Infections in the United States for the Most-Affected Subpopulations, 2010
Source: CDC. Estimated HIV incidence among adults and adolescents in the United States, 2007-2010. HIV Surveillance Supplemental Report 2012;17(4). Subpopulations representing 2% or less are not reflected in this chart. Abbreviations: MSM, men who have sex with men; IDU, injection drug user.
HIV and AIDS Diagnoses5 and Deaths
- At some point in their lifetimes, an estimated 1 in 16 African American men and 1 in 32 African American women will be diagnosed with HIV infection.
- In 2012, African Americans had the largest percentage (47%) of the estimated 47,989 diagnoses of HIV infection in the United States.
- In 2012, an estimated 14,102 African Americans were diagnosed with HIV infection ever classified as stage 3 (AIDS) in the United States.
- By the end of 2011, an estimated 265,812 African Americans diagnosed with HIV infection ever classified as stage 3 (AIDS) had died in the United States.
African Americans face a number of challenges that contribute to the higher rates of HIV infection. The greater number of people living with HIV (prevalence) in African American communities and the fact that African Americans tend to have sex with partners of the same race/ethnicity means that they face a greater risk of HIV infection with each new sexual encounter.
African American communities continue to experience higher rates of other sexually transmitted infections (STIs) compared with other racial/ethnic communities in the United States. Having an STI can significantly increase the chance of getting or transmitting HIV.
Lack of awareness of HIV status can affect HIV rates in communities. Almost 73,600 HIV-infected people in the African American community in 2011 were unaware of their HIV status. Diagnosis late in the course of HIV infection is common, which results in missed opportunities to get early medical care and prevent transmission to others.
The poverty rate is higher among African Americans than other racial/ethnic groups. The socioeconomic issues associated with poverty -- including limited access to high-quality health care, housing, and HIV prevention education -- directly and indirectly increase the risk for HIV infection, and affect the health of people living with and at risk for HIV. These factors may explain why African Americans have worse outcomes on the HIV continuum of care, including lower rates of linkage to care, retention in care, being prescribed HIV treatment, and viral suppression. New data from 2010 indicate that 75% of HIV-infected African Americans aged 13 or older are linked to care, 48% are retained in care, 46% are prescribed antiretroviral therapy, and only 35% are virally suppressed.
Stigma, fear, discrimination, homophobia, and negative perceptions about HIV testing can also place too many African Americans at higher risk. Many at risk for HIV fear discrimination and rejection more than infection and may choose not to seek testing.
What CDC Is Doing
CDC and its partners are pursuing a High-Impact Prevention approach to advance the goals of the National HIV/AIDS Strategy and maximize the effectiveness of current HIV prevention methods. Activities include:
- Awards to health departments to support the goals of High-Impact Prevention. These awards direct resources to the geographic areas of greatest need and prioritize the HIV prevention strategies that will have the greatest impact on the U.S. epidemic. New funding for National Capacity Building Assistance for High Impact Prevention addresses gaps in each step of the HIV care continuum by providing training and technical assistance for staff of health departments, community-based organizations, and health care organizations. Estimated annual funding will be $22 million.
- Phases of the Act Against AIDS campaign, including Take Charge. Take the Test. to encourage African American women to get tested for HIV; Testing Makes Us Stronger, to increase HIV testing among black gay, bisexual, and other men who have sex with men; and Let's Stop HIV Together, to address stigma and raises awareness.
- The Act Against AIDS Leadership Initiative, a partnership between CDC and 19 national African American and Hispanic/Latino civil rights and social justice organizations, strengthens HIV prevention efforts in the populations hardest hit by HIV and AIDS.
- The Care and Prevention in the United States (CAPUS) Demonstration Project that supports increased testing and optimizes linkage to, retention in, and re-engagement with care and prevention services for newly diagnosed and previously diagnosed racial and ethnic minorities with HIV.
- HIV prevention projects for community-based organizations to provide effective HIV prevention services over 5 years to gay, bisexual, and transgender youth of color and their partners.
- The MSM Testing Initiative to establish and evaluate an HIV testing and linkage-to-care program that will identify MSM with HIV who were previously unaware of their infection and link them to HIV medical care.
- Support and technical assistance to health departments and community-based organizations to deliver effective prevention interventions for African Americans, such as WILLOW, d-up: Defend Yourself!, and Mpowerment.
* Referred to as African Americans in this fact sheet.
** Referred to as gay and bisexual men in this fact sheet.