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Race and HIV: Who Is Most Affected?

Medically reviewed by Barry S. Zingman, M.D.
Updated on July 10, 2024

HIV infection affects millions of people around the world, including in the United States. According to the United Nations, there has been a 32 percent decrease in the annual rate of new HIV infections worldwide since 2010. Even though the number of new HIV infections has gone down, it's important to know that they’re still occurring. HIV is a lifelong condition, and it affects different groups of people in different ways. Two groups who are disproportionately affected by HIV are Black people and Latino people.

Understanding how race and identity are connected to HIV rates is crucial for stopping the spread of the virus and ensuring that everyone who is affected can get the right care. In this article, we’ll discuss HIV prevalence (how common HIV is), how HIV affects different communities, and the barriers that prevent people from getting the care they need.

Understanding HIV Prevalence

In 2019, around 1.2 million people aged 13 and older in the U.S. were estimated to be living with HIV infection. However, HIV infection does not affect all groups of people equally. A few of the groups that are more impacted by HIV include Black and Latino people, those who identify as transgender, people who inject drugs, and men who have sex with men.

Black and Latino Communities

Black and Latino communities in the U.S. have higher rates of HIV infection compared to other groups. More people from these communities get infected with HIV and experience HIV-related health problems than those in other communities.

HIV rates are higher in Black and Latino communities due to economic challenges, limited access to health care, and factors that affect how people seek help and learn about HIV prevention.

From 2017 to 2021, the Centers for Disease Control and Prevention (CDC) reported the rate of HIV diagnosis in Black/African American people decreased by 10 percent, while the rate of HIV diagnosis among Hispanic/Latino people remained stable. Despite this finding, Black/African American and Hispanic/Latino people together still made up the majority of new HIV diagnoses in 2021.

There are several reasons why HIV infection rates are higher in Black and Latino communities. Some factors include economic challenges, like poverty and limited access to health care, as well as cultural and social factors that affect how people seek help and learn about HIV prevention. Bigger issues like homophobia, racism, and discrimination make the impact of HIV worse in these communities. They can also make it harder for people to access health care, education, and stable jobs, which are all important for preventing and treating HIV.

Transgender People

Another group that is disproportionately affected by HIV are people who identify as transgender or as a gender other than male or female. Transgender individuals are those whose gender identity is different from the gender they were assigned at birth. From 2017 to 2021, the CDC reported an increase in the number of transgender people who were diagnosed with HIV. The prevalence of HIV infection tends to be higher for transgender women than for transgender men. On the other hand, the number of cisgender people (those whose gender matches the one they were assigned at birth) diagnosed with HIV has decreased.

Transgender people face unique challenges when it comes to preventing HIV and getting proper care. Factors like stigma, discrimination, difficulties in accessing health care, and a lack of gender-affirming medical support can make people who identify as transgender more vulnerable to HIV.

White people made up the largest portion (49 percent) of new HIV diagnoses associated with injected drug use in 2021.

People Who Inject Drugs

People who use needles to inject drugs have a higher risk of getting HIV. The CDC reported that in 2021 in the U.S., more than 2,500 people were diagnosed with HIV due to injected drug use. While white people made up the largest portion (49 percent) of new HIV diagnoses associated with injected drug use in 2021, Black/African American and Hispanic/Latino people made up the majority of all people living with HIV due to injection drug use (44 percent and 27 percent, respectively).

Gay and Bisexual Men

Gay men, bisexual men, and other men who have sex with men are also more likely to be affected by HIV. In 2021, 67 percent of new HIV diagnoses were among men who reported having sexual contact with other men. There are more than 620,000 men who have sex with other men and live with HIV in the U.S., and this group makes up almost half of the total number of people living with HIV in the U.S.

People With Overlapping Identities

You’ve probably noticed that a lot of the people diagnosed with HIV belong to more than one of these groups. This overlap in identity is called intersectionality. People who belong to multiple marginalized communities may face discrimination or social disadvantages for various reasons and may have a higher risk of contracting HIV compared to those who don't have these overlapping identities. For example, Black gay and bisexual men face a higher risk of getting HIV. Similarly, transgender individuals within Black and Latinx communities may face unique challenges that increase their vulnerability to HIV.

Key Factors for Controlling the Spread of HIV

Several factors can help limit the spread of HIV and reduce its impact on people and communities.

Knowing Your HIV Status

In 2019, the CDC estimated that about 13 percent of the total number of people with HIV in the U.S. did not know their HIV status. The CDC recommends that everyone between the ages of 13 and 64 be tested for HIV at least once, and more often if they fall into a higher-risk group. Testing allows you to know your HIV status, so you can receive the treatment and care you need if you test positive. Additionally, knowing your HIV status is important so you can prevent the spread of the virus to other people.

The Centers for Disease Control and Prevention recommends that everyone between the ages of 13 and 64 be tested for HIV.

Preventing the Spread of HIV

Several things can reduce the risk of getting or spreading HIV. These strategies include:

  • Condom use — Using condoms during sexual activity can reduce your risk of HIV. Condoms also help to lower the risk of other sexually transmitted infections (STIs) that can increase the risk of HIV transmission.
  • Preexposure prophylaxis (PrEP) — PrEP involves taking medication that can prevent HIV infection for individuals who are at risk.
  • Harm reduction programs — Harm reduction approaches, such as needle and syringe exchange programs, help reduce the risk of HIV transmission among people who inject drugs by providing clean needles and encouraging safe injection practices.
  • Education and awareness — Raising awareness about how HIV is spread, promoting comprehensive sex education, and fighting HIV-related stigma are important for preventing new HIV infections.
  • Treating STIs — Having an STI such as syphilis, chlamydia, gonorrhea, or herpes makes it easier to get and transmit HIV. Being tested and treated for STIs is an effective way to help reduce the risk of HIV infection.

HIV Viral Suppression

HIV viral suppression refers to decreasing the viral load (the amount of HIV in the body) to undetectable levels using antiretroviral therapy (ART). This helps to maintain the health of the person living with HIV and prevent HIV from spreading. In fact, the CDC reports that there is no risk of spreading HIV to sexual partners if a person’s HIV viral load is undetectable for at least six months straight and they are taking ART.

Barriers To Accessing Care and Preventing the Spread of HIV

For some people, getting the necessary care and support for HIV can be difficult, especially if they come from marginalized groups. It’s important to understand the barriers that prevent people from accessing the care they deserve. A few of the common obstacles include less access to health care, a lack of HIV awareness, and social stigma.

Difficulty in Finding Health Care

It’s not always easy to find health care services for HIV. Here are a few reasons why:

  • Money concerns — Health care can be expensive, including the cost of HIV medications and doctor visits. It’s important to know there are resources available to help pay for your HIV prevention or treatment.
  • Limited health care options — In certain areas, there may not be enough health care facilities that provide HIV treatment and prevention services, or you may not know how to find a health care provider. The Ryan White HIV/AIDS Program is a useful resource for finding health care providers that can treat HIV. Many primary care providers, infectious diseases specialists, sexual health clinics, and gynecologists offer HIV prevention care.
  • Stigma — Fear of being judged or treated badly by health care providers can make it hard to seek HIV services. The stigma, or negative attitudes and beliefs, surrounding HIV can make you less likely to share your HIV status or get the care you need.

Lack of HIV Awareness

Not having enough knowledge about HIV can create barriers to care. Some important factors include:

  • A lack of information — Many people don’t have accurate knowledge about HIV prevention, testing, and treatment options. This can lead to stigma, delays in care, and behaviors that increase the risk of spreading the virus.
  • Language barriers — Communication can be challenging when there are language barriers between patients and health care providers. This can make it harder for individuals to understand HIV-related information.

Social Challenges

Several social factors can make it challenging to access HIV care. These include stigma, lack of support from loved ones and the community, and discrimination based on factors like race, gender, or sexual orientation.

We Can Make a Difference

By acknowledging the differences in how HIV affects groups of people and taking action, we can work toward achieving fairness and better health for everyone affected by HIV.

Everyone, especially those who may be at higher risk for HIV, should prioritize their health by getting tested. Remember, receiving a proper diagnosis is an important first step toward accessing the care and support you need. Don’t hesitate to reach out for help, especially if you belong to a community that may have a greater risk for HIV.

By working together and educating ourselves, we can create a future where everyone, regardless of their race or background, has equal opportunities for HIV prevention, testing, and care.

Talk With Others Who Understand

On myHIVteam, the social network for people with HIV and their loved ones, more than 41,000 members come together to ask questions, give advice, and share their stories with others who understand life with HIV.

Have you been diagnosed with HIV? Did you know that some people of different races and backgrounds have a higher risk for HIV? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. The Global HIV and AIDS Epidemic — HIV.gov
  2. Global HIV & Aids Statistics — Fact Sheet — UNAIDS
  3. About HIV — Centers for Disease Control and Prevention
  4. Fast Facts: HIV in the United States — Centers for Disease Control and Prevention
  5. HIV in the United States by Race and Ethnicity — Centers for Disease Control and Prevention
  6. Transgender Facts — Mayo Clinic
  7. Issue Brief: HIV and Transgender Communities — Centers for Disease Control and Prevention
  8. Diagnoses of HIV Infection in the United States and Dependent Areas 2021: Special Focus Profiles — Centers for Disease Control and Prevention
  9. Intersectionality Part One: Intersectionality Defined — National Institutes of Health Office of Equity, Diversity, and Inclusion
  10. Fast Facts: HIV and Gay and Bisexual Men — Centers for Disease Control and Prevention
  11. HIV Testing — Centers for Disease Control and Prevention
  12. HIV Risk Reduction Tool: What Can Decrease HIV Risk? — U.S. Department of Health and Human Services
  13. Harm Reduction To Lessen HIV Risks — National Institute of Allergy and Infectious Diseases
  14. Let's Stop HIV Together: HIV Stigma — Centers for Disease Control and Prevention
  15. HIV Treatment as Prevention — Centers for Disease Control and Prevention
  16. Estimated Lifetime HIV-Related Medical Costs in the United States — Sexually Transmitted Diseases
  17. Paying for HIV Care and Treatment — HIV.gov
  18. Available Care & Services — HRSA Ryan White HIV/AIDS Program
  19. Ways To Stop HIV Stigma and Discrimination — Centers for Disease Control and Prevention
  20. Stigma Scenarios: Support in Action — Centers for Disease Control and Prevention
    Updated on July 10, 2024

    A myHIVteam Subscriber

    It seems perfect to me that they help the population with their talks about HIV

    Me parece perfecto que ayuden a la población con sus charlas sobre VIH

    posted March 18
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    Barry S. Zingman, M.D. specializes in HIV/AIDS medicine and general infectious disease. Review provided by VeriMed Healthcare Network. Learn more about him here.
    Catherine Leasure, Ph.D. is a Ph.D. candidate currently studying at Vanderbilt University in Nashville, Tennessee. Learn more about her here.

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