High Risk Groups

Disproportionate impact on certain populations and geographic locations. Men who have sex with men (MSM), blacks/African Americans, and Hispanic/Latinos are the groups most affected by HIV infection. Geographically, urban areas are the most heavily impacted.MSM represent 2% of the population; however, their HIV diagnosis rate is more than 44 times that of other men and more than 40 times that of women (7). MSM account for more than half of all new infections in the United States each year (5).
Blacks/African Americans are the racial/ethnic group most affected by HIV. They represent about 14% of the population but but accounted for 44% of new HIV infections in 2009. (6). Over the course of their life, 1 in 16 black/African American men will receive a diagnosis of HIV, as will 1 in 30 black women (7). HIV infection rates are higher among black MSM compared to other MSM. More new HIV infections occurred among young black MSM (aged 13–29) than among any other age and racial group of MSM (6).
Hispanics/Latinos represent 16% of the population (8) but account for an estimated 20% of new HIV infections in 2009 (6).
Women of color continue to be disproportionately affected by HIV infection. The rate of new HIV infection for black/African American women is nearly 15 times the rate for white women. The rate of new HIV infection among Hispanic/Latina women is over four times that of white women (6).
Specific locations are more affected, although HIV and AIDS have had a severe impact on all regions of the country. AIDS remains mainly an urban disease, with most individuals diagnosed in 2009 living in cities with more than 500,000 people. Areas hardest hit based on ranking of AIDS cases include Miami and Jacksonville, Florida; Baton Rouge, Louisiana; New York City, New York; and Washington, D.C.

Communities at Risk Headquarters-CDC

ACCORDING TO THE UNITED STATES CENTERS FOR DISEASE CONTROL NATIONAL PREVENTION

Learn More About Populations Affected By HIV:

Men Who Have Sex with Men (MSM): CDC

Blacks/African Americans: CDC | NPIN

Hispanics/Latinos: CDC | NPIN

Women: CDC | NPIN

http://www.cdcnpin.org/scripts/hiv/hiv.asp

http://www.cdc.gov/hiv/topics/aa/index.htm

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 HIV infections at all stages of disease—from new infections to deaths.

The Numbers

New HIV Infections

African Americans accounted for an estimated 44% of all new HIV infections among adults and adolescents (aged 13 years or older) in in 2009, despite representing only 12% to14% of the US population.
In 2009, black men accounted for 70% (14,700) of the estimated 20,900 new HIV infections among all adult and adolescent blacks. The estimated rate of new HIV infection for black men (103.6/100,000 population) was seven times as high as that of white men, twice as high as that of Latino men, and nearly three times as high as among black women.
In 2009, black gay, bisexual, and other men who have sex with men (MSM)a represented an estimated 72% (10,600) of new infections among all black men and 36% of an estimated 29,800 new HIV infections among all MSM. More new HIV infections (4,800) occurred among young black MSM (aged 13-24) than any other age or racial group of MSM.
In 2009, black women accounted for 6,100 (29%) of the estimated new HIV infections among all adult and adolescent blacks. This number represents a decrease of 21% since 2008. Most HIV infections among black women (87%; 5,300) are attributed to heterosexual sex. The estimated rate of new HIV infections for black women (38.1/100,000 population) was 20 times as high as the rate for white women, and almost five times as high as that of Latinas.

Estimates of New HIV Infections in the United States for the Most-Affected Subpopulations, 2009

Source: CDC. Estimated HIV incidence among adults and adolescents in the United States, 2007–2009. HIV Surveillance Supplemental Report 2012;17(4). Subpopulations representing 2% or less of the overall US epidemic are not reflected in this chart. Abbreviations: MSM, men who have sex with men; IDU, injection drug user.

HIV and AIDS Diagnoses^b and Deaths

At some point in their lifetimes, an estimated 1 in 16 black men and 1 in 32 black women will be diagnosed with HIV infection.
In 2009, an estimated 16,188 blacks were diagnosed with AIDS in the US, a number that has slowly decreased since 2007.
By the end of 2009, an estimated 250,745 blacks with an AIDS diagnosis had died in the US.

Prevention Challenges

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.

The poverty rate is higher among African Americans—28%—than for any other race. 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 infection.

Lack of awareness of HIV status can affect HIV rates in communities. Almost 100,000 people in the African American community in 2009 were unaware of their HIV status. Late diagnosis of HIV infection is common, which results in missed opportunities to get early medical care and prevent transmission to others.

Stigma, fear, discrimination, homophobia, and negative perceptions about HIV testing can also place too many African Americans at higher risk. Many at risk for infection fear stigma more than infection and may choose instead to hide their high-risk behavior rather than seek counseling and testing.

What CDC Is Doing

CDC and its partners are pursuing a High-Impact Preventionapproach to advance the goals of the National HIV/AIDS Strategy and maximize the effectiveness of current HIV prevention methods. Activities include:

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 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.
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 US epidemic.
A second 3-year expanded HIV testing program to increase HIV testing among African Americans. The Expanded Testing Initiative includes 30 health departments and focuses on increasing HIV testing among African Americans and Latinos as well as MSM and injection drug users of all races and ethnicities.
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 asWILLOW, d-up: Defend Yourself!, and Mpowerment.

¹The term men who have sex with men (MSM) is used in CDC surveillance systems. It indicates the behaviors that transmit HIV infection, not how individuals self-identify in terms of their sexuality.

²HIV and AIDS Diagnoses indicates when a person is diagnosed with HIV infection or AIDS but does not indicate when the person was infected.