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Understanding Who Is Most At Risk

HIV INFECTION RATES VARY REGIONALLY1

Highest Risk
Lowest Risk

Select risk level to view corresponding states

State
One in every (n)
District of Columbia
13
Maryland
49
Georgia
51
Florida
54
Louisiana
56
New York
69
Texas
81
New Jersey
84
Mississippi
85
South Carolina
86
North Carolina
93
Delaware
96
Alabama
97
Nevada
98
Illinois
101
California
102
Tennessee
103
Pennsylvania
115
Virginia
115
Massachusetts
121
Arizona
138
Connecticut
139
Rhode Island
143
Ohio
150
Missouri
155
Arkansas
159
Michigan
167
Oklahoma
168
Kentucky
173
Indiana
183
Washington
185
Colorado
191
New Mexico
196
Hawaii
202
Oregon
214
Minnesota
216
Kansas
262
Nebraska
264
West Virginia
302
Wisconsin
307
Iowa
342
Utah
366
Maine
373
Alaska
384
South Dakota
402
New Hampshire
411
Wyoming
481
Vermont
527
Idaho
547
Montana
578
North Dakota
670
United States HIV Infection Rate Regional Map
United States HIV Infection Rate Regional Map – Highest Risk
United States HIV Infection Rate Regional Map – High Risk
United States HIV Infection Rate Regional Map – Medium Risk
United States HIV Infection Rate Regional –Low Risk
United States HIV Infection Rate Regional Map
United States HIV Infection Rate Regional Map – Highest Risk
United States HIV Infection Rate Regional Map – High Risk
United States HIV Infection Rate Regional Map – Medium Risk
United States HIV Infection Rate Regional –Low Risk
Highest Risk
Lowest Risk

Select risk level to view corresponding states

State
One in every (n)
District of Columbia
13
Maryland
49
Georgia
51
Florida
54
Louisiana
56
New York
69
Texas
81
New Jersey
84
Mississippi
85
South Carolina
86
North Carolina
93
Delaware
96
Alabama
97
Nevada
98
Illinois
101
California
102
Tennessee
103
Pennsylvania
115
Virginia
115
Massachusetts
121
Arizona
138
Connecticut
139
Rhode Island
143
Ohio
150
Missouri
155
Arkansas
159
Michigan
167
Oklahoma
168
Kentucky
173
Indiana
183
Washington
185
Colorado
191
New Mexico
196
Hawaii
202
Oregon
214
Minnesota
216
Kansas
262
Nebraska
264
West Virginia
302
Wisconsin
307
Iowa
342
Utah
366
Maine
373
Alaska
384
South Dakota
402
New Hampshire
411
Wyoming
481
Vermont
527
Idaho
547
Montana
578
North Dakota
670

Although some areas may have a higher prevalence of HIV, it is critical to encourage prevention in all regions. States in the southern part of the United States are most affected by HIV. People in the South have a 34% greater chance of receiving an HIV diagnosis than people in the rest of the United States.2

HIV INFECTION RATES VARY BY PATIENT POPULATION

The Centers for Disease Control and Prevention report these statistics estimating the number of people in the United States who will contract HIV in their lifetime1,3:

MEN WHO HAVE SEX WITH MEN (MSM)
  • Overall
  • African American
  • Hispanic/Latino
  • Caucasian
  • 1 in 6
  • 1 in 2
  • 1 in 4
  • 1 in 11
HETEROSEXUAL
  • Overall
MEN
  • 1 in 473
WOMEN
  • 1 in 241
OVERALL
  • Overall
  • African American
  • Hispanic/Latino
  • Caucasian
  • Injection drug users
MEN
  • 1 in 64
  • 1 in 20
  • 1 in 48
  • 1 in 132
  • 1 in 36
WOMEN
  • 1 in 227
  • 1 in 48
  • 1 in 227
  • 1 in 880
  • 1 in 23

The transgender community in the United States is one of the highest-risk groups for HIV infection

22% of transgender women are HIV positive

OF TRANSGENDER WOMEN ARE HIV POSITIVE4

HIV prevalence in transgender women was estimated at nearly 50 times higher than in all adults of reproductive age.5

HOW CAN YOU BEST EVALUATE YOUR PATIENTS’ risK?

The first step in HIV prevention is identifying who is at risk. Do this by starting a candid conversation with your patients about their sexual preferences, recent sexual encounters, and safer sexual practices.

It is important to consider social determinants of health (access to food and housing, financial security, social exclusion, etc) as risk factors. These factors should be addressed when evaluating HIV risk and coordinating care.6,7

If your patient is HIV-positive, have a conversation about treatment as prevention (TasP). Treatment can help achieve viral suppression in those who are HIV-positive, and can help prevent transmission to an HIV-negative partner.8

"Clinicians should consider the epidemiologic context of the sexual practices reported by the patient. The risk of HIV acquisition is determined by both the frequency of specific sexual practices (e.g., unprotected anal intercourse) and the likelihood that a sex partner has HIV infection. The same behaviors when reported as occurring in communities and demographic populations with high HIV prevalence or occurring with partners known to have HIV infection, are more likely to result in exposure to HIV and so will indicate greater need for intensive risk reduction methods (PrEP, multisession behavioral counseling) than when they occur in a community or population with low HIV prevalence."
—Centers for Disease Control and Prevention9

References: 1. Centers for Disease Control and Prevention. 2016 Conference on retroviruses and opportunistic infections. http://www.cdc.gov/nchhstp/newsroom/2016/croi-2016.html. Published 2016. Accessed April 22, 2016. 2. Centers for Disease Control and Prevention. HIV prevention in the United States: new opportunities, new expectations. http://www.cdc.gov/hiv/pdf/policies/cdc-hiv-prevention-bluebook.pdf. Published December 2015. Accessed May 16, 2016. 3. Highleyman L. Major disparities persist in lifetime risk of HIV diagnosis in the US. http://www.aidsmap.com/Major-disparities-persist-in-lifetime-risk-of-HIV-diagnosis-in-the-US/page/3038645/. Published February 25, 2016. Accessed June 1, 2016. 4. Centers for Disease Control and Prevention. HIV among transgender people. https://www.cdc.gov/hiv/pdf/group/gender/transgender/cdc-hiv-transgender.pdf. Published 2016. Accessed May 18, 2016. 5. Joint United Nations Programme on HIV/AIDS (UNAIDS). The gap report: transgender people. http://www.unaids.org/sites/default/files/media_asset/08_Transgenderpeople.pdf. Published 2014. Accessed May 18, 2016. 6. Dean HD, Fenton KA. Addressing social determinants of health in the prevention and control of HIV/AIDS, viral hepatitis, sexually transmitted infections, and tuberculosis. Public Health Rep. 2010;125 (suppl 4):1-5. 7. White House Office of National AIDS Policy. National HIV/AIDS Strategy for the United States: updated to 2020. https://www.aids.gov/federal-resources/national-hiv-aids-strategy/nhas-update.pdf. Published July 2015. Accessed May 9, 2016. 8. Centers for Disease Control and Prevention. HIV risk reduction tool: what are the best ways to decrease my chances of getting or transmitting HIV? https://wwwn.cdc.gov/hivrisk/best-actions/. Accessed April 15, 2016. 9. Centers for Disease Control and Prevention. Preexposure prophylaxis for the prevention of HIV infection in the United States–2014: a clinical practice guideline. http://www.cdc.gov/hiv/pdf/prepguidelines2014.pdf. Published 2014. Accessed May 4, 2016.