HIV Prevention, Testing, and Treatment

Last updated 3 weeks ago. Our resources are updated regularly but please keep in mind that links, programs, policies, and contact information do change.

HIV has transformed from a terminal diagnosis into a manageable chronic condition thanks to remarkable medical advances.

With proper care, people with HIV can live long, healthy lives and prevent transmitting the virus to others.

This guide brings together the latest information from the CDC, NIH, and other federal health agencies to provide clear, actionable guidance on HIV prevention, testing, and treatment.

Understanding HIV

HIV (human immunodeficiency virus) is a retrovirus that targets the body’s immune system, specifically attacking CD4 cells—crucial white blood cells that coordinate immune responses.

When HIV infects a CD4 cell, it uses the cell’s machinery to replicate itself, ultimately destroying the host cell. New virus copies then infect other healthy CD4 cells. Over time, this cycle progressively weakens the immune system, leaving people vulnerable to opportunistic infections and certain cancers that healthy immune systems normally defeat.

HIV vs AIDS

HIV and AIDS are related but not the same. AIDS (Acquired Immunodeficiency Syndrome) is the final, most severe stage of untreated HIV infection.

A person receives an AIDS diagnosis when their CD4 count drops below 200 cells per cubic millimeter of blood or when they develop specific opportunistic infections, regardless of CD4 count. These AIDS-defining illnesses include severe pneumonia, tuberculosis, and certain cancers like Kaposi’s sarcoma.

Important fact: Not everyone with HIV develops AIDS. With modern treatment, most people diagnosed with HIV and starting treatment early never progress to AIDS. Effective treatment stops the virus from damaging the immune system.

The Three Stages of HIV

Without treatment, HIV typically progresses through three distinct stages:

Stage 1: Acute HIV Infection (2-4 weeks after infection)

HIV multiplies rapidly, creating very high viral loads that make people extremely contagious. Many experience flu-like symptoms including fever, chills, rash, night sweats, muscle aches, sore throat, fatigue, and swollen lymph nodes. However, some people have no symptoms at all.

The highly contagious nature of this often asymptomatic stage explains why routine HIV screening is so important—people are most likely to transmit the virus unknowingly during this period.

Stage 2: Chronic HIV Infection (Clinical Latency)

The virus continues reproducing at lower levels. Many people feel well and have no HIV-related symptoms during this stage, which can last a decade or longer without treatment. Despite feeling healthy, people can still transmit HIV to others.

Stage 3: AIDS

The most advanced stage occurs when CD4 counts fall below 200 cells/mm³ or AIDS-defining illnesses develop. People have severely damaged immune systems and high viral loads, making them highly infectious. Without treatment, life expectancy is typically about three years.

The contrast between this progression and the reality for people on treatment is stark—those who start medication may never reach Stage 3, transforming HIV from an inevitable decline into a manageable condition.

Breaking Down HIV Stigma

Despite scientific advances, HIV stigma remains a major barrier to prevention, testing, and treatment. Fear and discrimination prevent people from accessing care and living openly.

The Origins of Stigma

HIV stigma stems from the epidemic’s early history when it was associated with marginalized communities and was often fatal. Media coverage, religious messaging, and political responses in the 1980s created lasting fear and discrimination that persist today.

Common Misconceptions:

• HIV is a “death sentence” (it’s not with treatment)
• Only certain types of people get HIV (anyone can be infected)
• HIV is highly contagious through casual contact (it’s not)
• People with HIV are promiscuous or immoral (infection doesn’t reflect character)

The Real Impact of Stigma

Healthcare Barriers: Fear of judgment prevents people from getting tested, seeking treatment, or being honest with providers about sexual health and risk behaviors.

Mental Health Effects: Internalized stigma leads to depression, anxiety, and social isolation among people with HIV. Fear of disclosure strains relationships and employment.

Public Health Consequences: Stigma drives the epidemic underground, preventing effective prevention and treatment efforts. When people fear testing or treatment, infections spread.

Combating Stigma Through Education

Scientific Facts Combat Fear: Understanding how HIV is and isn’t transmitted reduces irrational fears. Knowing that people with undetectable viral loads can’t transmit HIV sexually revolutionizes relationships and intimacy.

Personal Stories Matter: When people share their HIV experiences openly, it humanizes the condition and shows that individuals with HIV live full, successful lives.

Language Matters: Using person-first language (“person with HIV” not “HIV-positive person”) and avoiding terms like “victim” or “sufferer” reduces stigma.

Legal Protections

The Americans with Disabilities Act protects people with HIV from discrimination in employment, housing, and public accommodations. HIV criminalization laws in some states, however, create additional barriers and don’t reflect current scientific understanding.

How HIV Spreads

HIV can only be transmitted through specific activities involving direct contact with certain body fluids from someone with detectable HIV levels. These fluids include blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, and breast milk.

Most Common Transmission Routes in the US

Sexual Transmission: Anal or vaginal sex without condoms with someone who has HIV is the most common transmission route. Anal sex carries higher risk than vaginal sex due to tissue differences.

Injection Drug Use: Sharing needles, syringes, or other injection equipment is extremely high-risk because it can directly introduce infected blood.

Mother-to-Child Transmission: HIV can pass from mothers to babies during pregnancy, childbirth, or breastfeeding. However, modern medical care reduces this risk to less than 1%.

How HIV Does NOT Spread

Understanding what doesn’t transmit HIV is crucial for reducing stigma:

• Air, water, or surfaces
• Insects including mosquitoes
• Saliva, sweat, or tears
• Casual contact like hugging or shaking hands
• Sharing toilets, food, or drinks
• Closed-mouth kissing

HIV is a fragile virus that can’t survive long outside the human body and can’t reproduce outside living hosts.

HIV Testing: Taking Control

Testing is the only way to know your HIV status for certain. Early detection enables immediate treatment and prevention of transmission to others.

Who Should Get Tested

Universal Recommendation: The CDC recommends everyone ages 13-64 get tested at least once as routine medical care.

Annual Testing for Higher Risk: People with certain risk factors should test at least yearly:

• Men who have sex with men
• People with HIV-positive partners
• Multiple sexual partners since last test
• Sharing injection drug equipment
• Diagnosed with other STIs, hepatitis, or tuberculosis

More Frequent Testing: Sexually active gay and bisexual men may benefit from testing every 3-6 months.

Pregnancy Testing: All pregnant people should test during each pregnancy for early intervention.

Types of HIV Tests

Understanding Window Periods

No test can detect HIV immediately after infection. The window period varies by test type:

• NAT: 10-33 days after exposure
• Lab antigen/antibody: 18-45 days
• Rapid antigen/antibody: 18-90 days
• Antibody tests: 23-90 days

If someone tests negative after recent potential exposure, they should retest after the window period to confirm their status.

HIV Self-Testing

The OraQuick In-Home HIV Test allows private testing with results in 20 minutes. These oral fluid antibody tests are available at pharmacies and online. Some health departments offer them free.

The CDC’s Together Take Me Home program mails free self-test kits to eligible individuals. While convenient, self-tests have longer window periods and require confirmatory testing if positive.

Finding Testing Services

HIV testing is widely available and covered by most insurance without copays under the Affordable Care Act.

Finding Free/Low-Cost Testing:

• CDC’s testing locator
• Local health departments
• Community health centers
• Planned Parenthood clinics
• LGBTQ+ community centers

Understanding Results

Negative Results: No evidence of HIV was found at the time of testing. If tested after the window period with no new risks, you can be confident you don’t have HIV.

Positive Results: Rapid and self-tests showing positive results need confirmation with laboratory tests. If confirmed positive, the next step is connecting with HIV care immediately.

Modern HIV Prevention

Today’s prevention toolkit offers multiple powerful options that can be combined based on individual circumstances and risk levels.

Pre-Exposure Prophylaxis (PrEP)

PrEP is medication that HIV-negative people at risk can take to prevent infection from sex or injection drug use.

How PrEP Works: It builds protective medicine levels in the body. If HIV exposure occurs, the medication is already present to stop the virus from establishing infection.

Who Should Consider PrEP:

• People with HIV-positive partners
• Those not consistently using condoms
• People who inject drugs
• Anyone diagnosed with STIs in the past 6 months
• People in high-prevalence areas or networks

Types of PrEP:

Daily Pills:

• Truvada and generics: Approved for all people at risk through sex or injection drug use
• Descovy: Approved for sexually active men and transgender women

Injectable PrEP:

• Apretude: Long-acting injection given every two months by healthcare providers for people weighing at least 77 pounds

Effectiveness: When taken as prescribed, PrEP reduces HIV risk from sex by about 99% and from injection drug use by at least 74%. It’s much less effective without consistent use.

Getting PrEP: Any licensed healthcare provider can prescribe PrEP. Before starting, you need HIV testing to confirm negative status. Regular follow-up includes HIV testing every 3 months for pills or every 2 months for injections.

Cost: Under the Affordable Care Act, PrEP and associated clinic visits and lab tests are free under most health insurance plans.

Post-Exposure Prophylaxis (PEP)

PEP is emergency HIV prevention taken after potential exposure.

When to Use PEP: After high-risk events like condomless sex with someone whose HIV status is unknown or positive, or sharing injection equipment.

The 72-Hour Window: PEP must start within 72 hours of exposure to be effective. The sooner it starts, the better the chance of success. Anyone who thinks they may have been exposed should immediately go to an emergency room or contact a healthcare provider.

How PEP Works: It’s a 28-day course of antiretroviral medicines that can stop HIV from establishing infection after the virus enters the body.

Condoms and Safer Sex

Consistent, correct condom use during anal or vaginal sex remains highly effective for preventing HIV and other STIs.

Proper Condom Use:

• Use new latex or polyurethane condoms for every sexual act
• Put condoms on before any genital contact
• Use water-based or silicone-based lubricants only
• Check expiration dates and package integrity
• Hold the base while withdrawing to prevent spillage

Safer Sex Strategies:

• Choosing lower-risk activities like oral sex
• Having honest conversations about HIV status and testing
• Regular STI testing for all partners
• Mutual monogamy with confirmed negative partners

Harm Reduction for Injection Drug Use

For people who inject drugs, the only completely effective HIV prevention is stopping injection. For those who continue injecting, harm reduction saves lives:

Never Share Equipment: This includes needles, syringes, cookers, cotton, and water used for injection.

Use New, Sterile Equipment: Syringe Services Programs provide clean needles and safe disposal. Find programs at the CDC’s SSP locator.

Cleaning as Last Resort: If new equipment isn’t available, cleaning used syringes with bleach before reuse can reduce risk, though it’s not as safe as new equipment.

Additional Harm Reduction:

• Medication-assisted treatment for opioid use disorder
• Testing for HIV and hepatitis regularly
• Access to overdose reversal medication (naloxone)

Preventing Mother-to-Child Transmission

Preventing mother-to-child HIV transmission represents one of the epidemic’s greatest successes.

Treatment During Pregnancy: When people with HIV take antiretroviral therapy throughout pregnancy, labor, and delivery, and give their babies HIV medicine for weeks after birth, transmission risk drops to 1% or less.

Prevention for HIV-Negative Partners: If someone is HIV-negative but has an HIV-positive partner and wants to become pregnant, PrEP can provide protection during conception and pregnancy.

Feeding Decisions: In the United States, formula feeding is recommended over breastfeeding for babies born to mothers with HIV to eliminate transmission risk through breast milk.

Advanced Prevention Strategies

Treatment as Prevention (U=U)

One of the most revolutionary HIV prevention discoveries is that people with HIV who achieve and maintain undetectable viral loads cannot sexually transmit the virus.

The Science: Years of rigorous research, including major international studies, conclusively prove that undetectable equals untransmittable (U=U). When viral loads are so low they can’t be detected by standard tests, there’s not enough virus present to transmit sexually.

Personal Impact: U=U transforms intimate relationships for people with HIV, eliminating the fear of transmission to partners and allowing for normal sexual relationships.

Public Health Impact: U=U is one of the most powerful prevention tools available. When people with HIV are on effective treatment, they become part of the prevention solution.

Combination Prevention

The most effective prevention strategies combine multiple approaches:

Individual Level:

• Regular HIV testing
• PrEP for those at risk
• Consistent condom use
• Reducing number of sexual partners
• Avoiding injection drug use or using harm reduction

Community Level:

• Widespread testing and treatment
• Needle exchange programs
• Comprehensive sex education
• Stigma reduction campaigns
• Healthcare access expansion

Structural Level:

• Anti-discrimination laws
• Healthcare system improvements
• Social service integration
• Economic opportunity expansion
• Criminal justice reform

HIV Treatment Revolution

Modern HIV treatment has transformed the condition from a fatal disease into a manageable chronic illness.

Antiretroviral Therapy (ART)

ART involves taking HIV medicines daily to control the virus. Current guidelines recommend starting treatment immediately upon diagnosis, regardless of CD4 count or symptoms.

How ART Works: HIV medicines stop the virus from replicating, reducing viral load and allowing the immune system to recover. The goal is achieving and maintaining an undetectable viral load.

Modern Treatment Advantages:

• Fewer pills (often just one daily pill)
• Fewer side effects than older medications
• High effectiveness with proper adherence
• Long-acting injection options for some people

Treatment Timeline: Most people who start ART and take it as prescribed achieve viral suppression within six months.

Types of HIV Medicines

HIV medicines are grouped into classes based on how they fight the virus:

Entry/Fusion Inhibitors: Prevent HIV from entering CD4 cells Reverse Transcriptase Inhibitors: Block an enzyme HIV needs to replicate Integrase Inhibitors: Block another enzyme HIV uses to replicate Protease Inhibitors: Prevent assembly of new virus particles

Modern treatment regimens typically combine medicines from different classes for maximum effectiveness.

The Importance of Adherence

Taking HIV medicine exactly as prescribed is crucial for:

Viral Suppression: Consistent medication levels keep the virus controlled Preventing Resistance: Missing doses allows the virus to mutate and become resistant to treatment Maintaining Health: Good adherence prevents immune system damage Preventing Transmission: Only consistent treatment maintains undetectable viral loads

Adherence Strategies:

• Setting daily alarms or reminders
• Using pill organizers
• Connecting medication to daily routines
• Getting support from healthcare teams
• Addressing barriers like side effects or cost

Managing Side Effects

While modern HIV medicines have fewer side effects than older drugs, some people still experience them:

Common Initial Side Effects:

• Nausea or stomach upset
• Headaches
• Fatigue
• Dizziness

Most side effects improve within weeks as the body adjusts. If side effects persist or are severe, healthcare providers can adjust treatment regimens.

Long-term Monitoring: Regular lab work monitors for potential long-term effects on kidneys, liver, bones, and cardiovascular health.

Long-Acting Treatment Options

Injectable HIV medicines administered every month or every two months offer alternatives to daily pills for some people:

Cabenuva: Monthly or every-two-months injections for people who’ve achieved viral suppression on daily pills

Advantages:

• No daily pill-taking
• Higher privacy
• May improve adherence for some people

Considerations:

• Requires regular clinic visits
• Not suitable for everyone
• May have different side effect profiles

Building Your HIV Care Team

Managing HIV effectively requires coordinated care from multiple healthcare professionals.

Core Team Members

HIV Specialist: Infectious disease doctors or other providers with HIV expertise manage treatment and monitor progress.

Primary Care Provider: Manages overall health including preventive care, vaccinations, and non-HIV conditions.

Pharmacist: Provides medication counseling, monitors drug interactions, and may offer adherence support.

Nurse/Care Coordinator: Helps navigate the healthcare system, coordinates appointments, and provides education.

Case Manager: Assists with accessing services, benefits, transportation, and addressing social needs.

Additional Support Services

Mental Health Professionals: Address depression, anxiety, trauma, and adjustment challenges related to HIV diagnosis and management.

Nutritionist: Provides guidance on healthy eating to support immune function and overall health.

Substance Use Counselors: Help address alcohol or drug use that might interfere with treatment adherence.

Peer Support Specialists: People with HIV who provide emotional support and practical guidance based on lived experience.

Navigating Healthcare Systems

Insurance and Benefits: Understanding coverage for HIV treatment, which can be complex but is generally comprehensive under most plans.

Ryan White Program: Federal safety net providing HIV care for uninsured and underinsured individuals. Services include medical care, medications, case management, and support services.

Patient Assistance Programs: Pharmaceutical companies offer programs to help with medication costs for eligible individuals.

Clinical Trials: Opportunities to access new treatments while contributing to HIV research.

Women and HIV

Women face unique challenges related to HIV prevention, testing, and treatment.

HIV Risk Factors for Women

Biological Vulnerability: The vaginal lining is more susceptible to HIV infection than penile skin, making women at higher risk during heterosexual sex.

Gender-Based Violence: Sexual assault and intimate partner violence increase HIV risk through forced unprotected sex and reduced ability to negotiate safer sex.

Economic Dependence: Financial dependence on male partners may limit women’s ability to insist on condom use or leave risky relationships.

Substance Use: Women who inject drugs face HIV risk through sharing equipment and may engage in sex work to support drug use.

Women and HIV Testing

Routine Screening: All women should receive HIV testing as part of routine healthcare, regardless of perceived risk.

Pregnancy Testing: HIV testing is standard during pregnancy, with repeat testing in the third trimester for high-risk women.

Partner Testing: Women should encourage male partners to get tested, as men are less likely to seek healthcare regularly.

Treatment Considerations for Women

Reproductive Health: HIV treatment is safe during pregnancy and doesn’t affect fertility. Family planning counseling helps women make informed decisions about pregnancy.

Menstrual Changes: Some HIV medicines may affect menstrual cycles, which should be discussed with healthcare providers.

Drug Interactions: Hormonal contraceptives may interact with some HIV medicines, requiring alternative contraception or treatment adjustments.

Bone Health: Some HIV medicines can affect bone density, particularly important for postmenopausal women already at risk for osteoporosis.

Women in HIV Clinical Trials

Historically, women were underrepresented in HIV research. Efforts now ensure women’s participation in clinical trials to better understand how treatments work in diverse populations.

Aging with HIV

As HIV treatment has improved, people with HIV are living longer, creating new considerations for aging with the virus.

Unique Challenges

Accelerated Aging: HIV and some medications may accelerate certain aging processes, leading to earlier onset of age-related conditions.

Multiple Medications: Managing HIV treatment alongside medications for other chronic conditions increases complexity and drug interaction risks.

Isolation: Older adults with HIV may face double stigma related to both HIV and aging, leading to social isolation.

Healthcare Navigation: Coordinating HIV care with geriatric care requires providers familiar with both areas.

Common Age-Related Health Issues

Cardiovascular Disease: People with HIV have higher rates of heart disease, requiring careful monitoring and prevention strategies.

Bone Health: HIV and some medications increase osteoporosis risk, making bone density screening and prevention important.

Kidney Disease: Some HIV medicines can affect kidney function, requiring monitoring and potential treatment adjustments as people age.

Cancer: People with HIV have higher rates of certain cancers, making cancer screening crucial.

Cognitive Changes: Some people with HIV experience cognitive changes, though modern treatment has greatly reduced HIV-related dementia.

Successful Aging Strategies

Comprehensive Healthcare: Regular monitoring for age-related conditions alongside HIV care ensures early detection and treatment.

Healthy Lifestyle: Exercise, good nutrition, not smoking, and limiting alcohol support healthy aging.

Social Connections: Maintaining relationships and community connections combats isolation and supports mental health.

Advanced Planning: Legal and healthcare planning ensures wishes are respected and care is coordinated.

Mental Health and HIV

Mental health plays a crucial role in HIV prevention, testing, and treatment outcomes.

Common Mental Health Challenges

Depression: Rates of depression among people with HIV are significantly higher than in the general population, affecting treatment adherence and quality of life.

Anxiety: Worry about health, disclosure, stigma, and the future can create persistent anxiety requiring professional support.

Trauma: Many people with HIV have histories of trauma, including sexual assault, childhood abuse, or discrimination, affecting mental health and risk behaviors.

Substance Use: Alcohol and drug use may be used to cope with HIV-related stress but can interfere with treatment and increase risky behaviors.

Mental Health and Treatment Adherence

The Connection: Depression and other mental health conditions can make it difficult to maintain daily medication routines and keep medical appointments.

Integrated Care: The most effective approach combines HIV treatment with mental health services, addressing both simultaneously.

Peer Support: Connecting with others who have HIV can provide emotional support and practical advice for managing both HIV and mental health.

Disclosure and Relationships

Disclosure Decisions: Deciding whether, when, and how to tell others about HIV status can create significant stress and anxiety.

Relationship Impacts: HIV can affect intimate relationships, friendships, and family relationships, requiring communication skills and sometimes professional support.

Workplace Considerations: While HIV is protected under disability laws, workplace disclosure decisions can be complex and stressful.

Building Resilience

Professional Support: Therapists experienced with HIV can help develop coping strategies and address specific challenges.

Support Groups: Both in-person and online support groups connect people with similar experiences.

Stress Management: Techniques like meditation, exercise, and mindfulness can help manage HIV-related stress.

Purpose and Meaning: Many people find meaning through advocacy, volunteering, or helping others, which can improve mental health outcomes.

HIV in Different Communities

The HIV epidemic affects different communities in unique ways, requiring tailored prevention and treatment approaches.

Gay and Bisexual Men

Gay and bisexual men continue to bear the greatest burden of HIV in the United States, accounting for about two-thirds of new diagnoses.

Risk Factors:

• Higher transmission efficiency through anal sex
• Network effects where infections circulate within connected communities
• Stigma affecting healthcare access and disclosure
• Mental health challenges related to discrimination

Prevention Strategies:

• Widespread PrEP use in high-risk communities
• Regular testing (every 3-6 months for sexually active men)
• Treatment as prevention through viral suppression
• Comprehensive sexual health services
• Community-based prevention programs

Recent Progress: New HIV diagnoses among gay and bisexual men have decreased in recent years, particularly among young men, due to expanded prevention efforts.

Black and Hispanic/Latino Communities

These communities face disproportionately high HIV rates due to complex social, economic, and healthcare factors.

Contributing Factors:

• Healthcare access barriers
• Economic inequality
• Residential segregation
• Medical mistrust due to historical discrimination
• Higher background HIV prevalence increasing transmission risk

Addressing Disparities:

• Community-based prevention programs led by trusted community members
• Culturally competent healthcare services
• Economic support addressing social determinants of health
• Anti-discrimination efforts in healthcare settings
• Faith-based partnerships respecting cultural values

Women

Women account for about 19% of new HIV diagnoses, with significant disparities by race and ethnicity.

Prevention Focus:

• Addressing gender-based violence and economic dependence
• Improving access to PrEP for women at risk
• Partner testing and treatment
• Comprehensive reproductive health services

Young People

Young people ages 13-24 accounted for significant portions of new diagnoses, though rates have decreased in recent years.

Unique Needs:

• Age-appropriate education and services
• Confidential testing and treatment options
• Parental involvement considerations
• Insurance coverage continuity
• Mental health support for diagnosis adjustment

Rural Communities

Rural areas face unique HIV challenges including provider shortages, geographic barriers, and greater stigma.

Solutions:

• Telehealth services expanding access to specialists
• Mobile testing and treatment services
• Training primary care providers in HIV care
• Pharmacy-based services for PrEP and other medications
• Community health worker programs

The Economic Impact of HIV

HIV affects individuals, families, and society economically in significant ways.

Personal Economic Impact

Medical Costs: HIV treatment is expensive, though generally well-covered by insurance. Out-of-pocket costs can still be substantial for some people.

Employment: While illegal, HIV discrimination in employment still occurs. Health issues may also affect work capacity.

Insurance: Maintaining continuous health insurance coverage is crucial for accessing HIV care and medications.

Healthcare System Costs

Treatment Costs: Lifetime HIV treatment costs are estimated at several hundred thousand dollars, though effective treatment prevents more expensive complications.

Prevention Savings: Every HIV infection prevented saves significant healthcare costs over a lifetime.

Cost-Effectiveness: Programs like PrEP and treatment as prevention are highly cost-effective public health interventions.

Social and Economic Benefits of Treatment

Productivity: Effective HIV treatment allows people to remain productive members of society.

Prevention: Treatment as prevention reduces new infections, saving future healthcare and social costs.

Quality of Life: Good HIV care improves quality of life for individuals, families, and communities.

Research and Future Directions

HIV research continues advancing toward better treatments, prevention methods, and ultimately a cure.

Treatment Advances

Long-Acting Formulations: Monthly and bi-monthly injections reduce pill burden and may improve adherence for some people.

Newer Drug Classes: Research continues on medicines that work in new ways to fight HIV.

Personalized Medicine: Genetic testing may help predict which treatments work best for individual patients.

Prevention Research

Vaccines: Multiple HIV vaccine trials are underway, though an effective vaccine remains elusive.

Microbicides: Topical products that can prevent HIV infection during sex are in development.

Long-Acting PrEP: Longer-lasting PrEP formulations could improve adherence and effectiveness.

Cure Research

Functional Cure: Research focuses on achieving long-term viral suppression without daily medication.

Sterilizing Cure: The ultimate goal of completely eliminating HIV from the body remains challenging but continues being pursued.

HIV Reservoir: Understanding how HIV persists in the body despite treatment is key to developing cure strategies.

Implementation Science

Optimizing Programs: Research on how to best deliver prevention and treatment services in real-world settings.

Health Equity: Studies on reducing disparities and reaching underserved communities more effectively.

Technology Integration: Using digital health tools, artificial intelligence, and other technologies to improve HIV care.

Global Context

While this guide focuses on HIV in the United States, the epidemic is global, affecting millions worldwide.

Global Statistics

Prevalence: About 39 million people worldwide live with HIV, with the majority in sub-Saharan Africa.

New Infections: Approximately 1.3 million people acquired HIV globally in 2022.

Treatment Access: About 76% of people with HIV worldwide have access to treatment, though significant gaps remain.

US Role in Global Response

PEPFAR: The President’s Emergency Plan for AIDS Relief is the largest global health program focused on a single disease.

Research Leadership: US institutions lead much of the world’s HIV research efforts.

Technical Assistance: The US provides expertise and support for HIV programs worldwide.

Lessons from Global Experience

Community Mobilization: Successful programs worldwide emphasize community leadership and engagement.

Integration: Combining HIV services with other healthcare improves outcomes and efficiency.

Human Rights: Protecting the rights of people with HIV and key populations is essential for effective responses.

Current State of HIV in America

Recent surveillance data reveals both progress and persistent challenges in the US HIV epidemic.

2023 HIV Statistics

New Diagnoses: 39,201 new HIV diagnoses among people aged 13 and older

People Living with HIV: An estimated 1,132,739 people living with diagnosed HIV

HIV Deaths: 4,496 deaths attributed to HIV-related causes

New Infections: Approximately 31,800 people acquired HIV in 2022 (most recent data), representing a 12% decrease from 2018

Demographics of New Diagnoses

Progress and Challenges

Encouraging Trends:

• Overall decrease in new infections, particularly among young people (30% decline ages 13-24)
• Increased PrEP use and awareness
• Earlier HIV diagnosis and treatment
• Reduced mother-to-child transmission

Persistent Challenges:

• Significant racial and ethnic disparities
• Geographic concentration in the South
• Higher rates among gay and bisexual men
• Barriers to care in rural and underserved areas

The Path Forward: Future progress depends on equitably implementing existing prevention and treatment tools rather than waiting for new scientific breakthroughs. Success requires addressing systemic barriers like stigma, racism, poverty, and healthcare access that prevent effective interventions from reaching the communities that need them most.

The fight against HIV in America has the tools to succeed—PrEP, treatment as prevention, widespread testing, and effective treatment. The challenge now is ensuring these powerful interventions reach everyone who needs them, particularly communities that have been disproportionately affected by the epidemic. With sustained commitment to equity, evidence-based interventions, and community engagement, ending the HIV epidemic in the United States is an achievable goal.

Our articles make government information more accessible. Please consult a qualified professional for financial, legal, or health advice specific to your circumstances.