HIV, Race, and Injection Drug Use

1. Total Number of People in the US Living with HIV

"The first cases of Pneumocystis carinii(jirovecii) pneumonia among young men, which were subsequently linked to HIV infection, were reported in the MMWR on June 5, 1981 (1). At year-end 2019, an estimated 1.2 million persons in the United States were living with HIV infection (2)."

Bosh, K. A., Hall, H. I., Eastham, L., Daskalakis, D. C., & Mermin, J. H. (2021). Estimated Annual Number of HIV Infections ─ United States, 1981-2019. MMWR. Morbidity and mortality weekly report, 70(22), 801–806.

2. Total Number of People Living with HIV in the US

"From 2014 through 2018 in the United States and 6 dependent areas, the number and rate of persons living with diagnosed HIV infection increased (Table 14b). At year-end 2018 in the United States and 6 dependent areas, 1,040,352 adults and adolescents were living with diagnosed HIV infection (Figure 9). The prevalence of diagnosed HIV infection was 374.6 per 100,000 population. From 2014 through 2018, by region, the rates of persons living with HIV in the Midwest, South, and West increased (Tables 14a and 14b). The rate in the Northeast remained stable. The largest percentage increase in the rate (11%) was in the Midwest (from 162.7 in 2014 to 179.8 in 2018). At year-end 2018, the rate was highest in the Northeast at 420.5, followed by 371.6 in the South, 260.7 in the West, and 179.8 in the Midwest (Tables 14a and 14b). Data for the year 2018 are preliminary and based on deaths reported to CDC through December 2019."

Centers for Disease Control and Prevention. HIV Surveillance Report, 2018 (Updated); vol. 31. Published May 2020. Last accessed June 8, 2020.

3. Total Number of People Living with HIV in the US, by Age, Gender, and Race/Ethnicity

"• Gender: From 2014 through 2018 in the United States and 6 dependent areas, the largest percentage increase (24%) in the number of persons living with diagnosed HIV infection was among transgender MTF (Table 14b). At year-end 2018, the largest percentage (75%) of persons living with diagnosed HIV infection were male, followed by females (24%) (Table 14b). Transgender MTF, transgender FTM, and AGI each accounted for less than 1%.

"• Age group: From 2014 through 2018 in the United States and 6 dependent areas, the largest percentage increase (51%) in the rate of persons living with diagnosed HIV infection was among persons aged 65 years and older (from 130.0 in 2014 to 196.6 in 2018) (Table 14b). At year-end 2018, persons aged 50–54 years made up the largest percentage (15%) of persons living with diagnosed HIV (Table 14b). The highest rate (762.6) was among persons aged 50–54 years, followed by those aged 55–59 years (704.3), and those aged 45–49 years (600.0).

"• Race/ethnicity: At year-end 2018 in the United States, the highest rate (1,034.2) and the largest percentage (41%) were those for blacks/African Americans (Table 14a). Among the remaining race/ethnicity groups, the rates were 665.7 for persons of multiple races, 386.4 for Hispanics/Latinos, 154.0 for whites, 150.3 for Native Hawaiians/other Pacific Islanders, 129.6 for American Indians/Alaska Natives, and 80.9 for Asians.

"At the end of 2018, 1,040,352 adults and adolescents were living with diagnosed HIV infection in the United States and 6 dependent areas (Figure 10). Among 795,198 males living with diagnosed HIV infection, 35% were black/African American, 33% were white, 25% were Hispanic/Latino, 5% were males of multiple races, and 2% were Asian. Less than 1% each were American Indian/Alaska Native and Native Hawaiian/other Pacific Islander. Among 245,154 females living with diagnosed HIV infection, 58% were black/African American, 20% were Hispanic/Latino, 16% were white, 5% were females of multiple races, and 1% were Asian. Less than 1% each were American Indian/Alaska Native and Native Hawaiian/other Pacific Islander."

Centers for Disease Control and Prevention. HIV Surveillance Report, 2018 (Updated); vol. 31. Published May 2020. Last accessed June 8, 2020.

4. People Who Use Drugs Living with HIV in the US, by Region and Race/Ethnicity

"Region and race/ethnicity: In 2018 in the United States and 6 dependent areas, 2,492 diagnosed HIV infections were among PWID. Of these, the largest number of HIV infection diagnoses were in the South (976), followed by the Northeast (595) (Figure 19). In all regions, the largest percentage of diagnosed HIV infections among PWID was among whites. In the South, whites accounted for 436 diagnosed HIV infections among PWID (45%), blacks/African Americans accounted for 359 (37%), and Hispanics/Latinos accounted for 143 (15%) (Table 6b). In the Northeast, whites accounted for 212 diagnosed HIV infections among PWID (36%), blacks/African Americans accounted for 206 (35%), and Hispanics/Latinos accounted for 152 (26%). Please use caution when interpreting data for American Indian/Alaska Native, Asian, and Native Hawaiian/other Pacific Islander PWID, and persons of multiple races who inject drugs: the numbers are small."

Centers for Disease Control and Prevention. HIV Surveillance Report, 2018 (Updated); vol. 31. Published May 2020. Last accessed June 8, 2020.

5. HIV as a Leading Cause of Death among Black People in the US

According to the CDC, Human Immunodeficiency Virus (HIV) disease was the eighth leading cause of death among Black people in the US aged 20-24, the sixth leading cause among Black people aged 35-44, and the eighth among Black people aged 45-54.

HIV disease was the sixth leading cause of death among Black males in the US aged 20-24, the sixth leading cause among Black males aged 25-34, the eighth leading cause among Black males aged 35-44, and the eighth leading cause among Black males aged 45-54.

HIV disease was the ninth leading cause of death among Black females in the US aged 25-34, the seventh leading cause among Black females aged 35-44, and the tenth leading cause among Black females aged 45-54.

Heron M. Deaths: Leading causes for 2018. National Vital Statistics Reports; vol 70 no 4. Hyattsville, MD: National Center for Health Statistics. 2021. doi.org/10.15620/cdc:104186.

6. HIV Diagnoses Attributed to Injection Drug Use by Race and Ethnicity

"From 2014 through 2018 in the United States and 6 dependent areas, the percentage of diagnoses of HIV infection attributed to injection drug use increased. In 2018, among 1,434 male adult and adolescent PWID with diagnosed HIV infection, approximately 41% were white, 30% were black/African American, and 24% were Hispanic/Latino (Figure 18). Among 1,058 female adult and adolescent PWID with diagnosed HIV infection, 50% were white, 30% black/African American, and 15% Hispanic/Latino. Please use caution when interpreting data for American Indian/Alaska Native, Asian, and Native Hawaiian/other Pacific Islander PWID, and persons of multiple races who inject drugs: the numbers are small."

Centers for Disease Control and Prevention. HIV Surveillance Report, 2018 (Updated); vol. 31. Published May 2020. Last accessed June 8, 2020.

7. HIV Diagnoses Associated With Injection Drug Use by Region and Race/Ethnicity

"In 2018 in the United States and 6 dependent areas, 2,492 diagnosed HIV infections were among PWID. Of these, the largest number of HIV infection diagnoses were in the South (976), followed by the Northeast (595) (Figure 19). In all regions, the largest percentage of diagnosed HIV infections among PWID was among whites. In the South, whites accounted for 436 diagnosed HIV infections among PWID (45%), blacks/African Americans accounted for 359 (37%), and Hispanics/Latinos accounted for 143 (15%) (Table 6b). In the Northeast, whites accounted for 212 diagnosed HIV infections among PWID (36%), blacks/African Americans accounted for 206 (35%), and Hispanics/Latinos accounted for 152 (26%). Please use caution when interpreting data for American Indian/Alaska Native, Asian, and Native Hawaiian/other Pacific Islander PWID, and persons of multiple races who inject drugs: the numbers are small."

Centers for Disease Control and Prevention. HIV Surveillance Report, 2018 (Updated); vol. 31. Published May 2020. Last accessed June 8, 2020.

8. AIDS-Related Deaths Among State Prison Inmates 2008-2010 By Race/Ethnicity

"AIDS-related deaths among all state and federal prison inmates declined an average 16% per year between 2001 and 2010, from 24 deaths per 100,000 inmates in 2001 to 5 per 100,000 in 2010.

"Among state and federal inmates with HIV/AIDS, the rate of AIDS-related deaths dropped significantly, from 134 deaths per 10,000 inmates with HIV/AIDS in 2001 to 38 per 10,000 in 2010.

"When grouped by 2010 yearend custody populations, the declining rate of HIV/AIDS in small, medium, and large state prisons had the same 3% average annual decline in the national rate between 2001 and 2010.

"Between 2001 and 2010, the average annual decline of 16% in the national AIDS mortality rate was similar to the decline in small (down 12%), medium (down 17%), and large (down 19%) state prison populations.

"Rate of HIV/AIDS cases and AIDS-related deaths declined across all sizes of prison populations.

"In 2009, the AIDS mortality rate among state prison inmates (6 per 100,000) fell below the rate for the U.S. general population (7 per 100,000).

"AIDS-related deaths in state prisons declined from 89 in 2009 to 69 in 2010 among males, from 70 to 43 among black non-Hispanics, and from 87 to 60 among all state inmates age 35 or older."

Click here for complete datatable of Number of AIDS-Related Deaths Among State Prison Inmates 2008-2010

Maruschak, Laura M. "HIV In Prisons, 2001-2010," (Washington, DC: US Dept. of Justice Bureau of Justice Statistics), NCJ 238877, Sept. 2012.

9. AIDS Deaths in Local Jails in the US

From 2000 through 2014, a total of 569 people died from AIDS-related illnesses while serving time in a local jail in the US. Of those, 98 were white non-Latinx, 395 were black non-Latinx, 73 were Latinx, and 3 were "other."
In 2015, a total of 10 people serving time in local jails in the US died from AIDS-related illnesses.

Noonan, Margaret E., "Mortality in Local Jails, 2000-2014 - Statistical Tables" (Washington, DC: US Dept of Justice Bureau of Justice Statistics, Dec. 2016), NCJ250169.

10. HIV in Jails

"Among jail inmates in 2002 who had ever been tested for HIV, Hispanics (2.9%) were more than 3 times as likely as whites (0.8%) and twice as likely as blacks (1.2%) to report being HIV positive."

Maruschak, Laura M. HIV In Prisons and Jails, 2002. NCJ-205333. Washington, DC: Department of Justice, Bureau of Justice Statistics, Dec. 2004.