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Yes. According to the Centers for Disease Control and Prevention (CDC), adolescents (13 to 19 years of age) and young adults (20 to 24 years of age) made up 28,087 (3%) of all people living with HIV in the United States.
In addition, adolescents and young adults accounted for 7,099 (19%) of the 37,981 new HIV diagnoses in the United States and dependent areas in 2022. This means that about one in every five new HIV diagnoses was someone between 13 and 24 years old.
Some AYA with HIV in the United States previously acquired the virus as infants through perinatal transmission. However, most adolescents and young adults with HIV acquired it through sexual transmission.
Most male adolescents and young adults diagnosed with HIV acquired HIV through male-to-male sexual contact, whereas most female AYA diagnosed with HIV acquired it through heterosexual contact.
Several factors increase the likelihood that AYA may acquire HIV:
About 44 percent of AYA with HIV do not know they have it, and about 34 percent of AYA diagnosed with HIV are not virally suppressed. Together, these factors create unique challenges for preventing HIV transmission among AYA.
Adolescents who are at risk for acquiring HIV can benefit from pre-exposure prophylaxis (PrEP). The word “prophylaxis” means to prevent or control the spread of an infection or disease. PrEP is used by people without HIV who are at high risk of being exposed to HIV through sex or injection drug use. PrEP medicines are not for people who already have HIV.
In 2018, the FDA first approved an HIV PrEP medicine to include adolescents weighing at least 77 lb (35 kg) who are at risk of acquiring HIV. Although PrEP use increased from 8 percent in 2017 to 20 percent in 2021 among all applicable AYA, increasing use could help to further reduce the risk of HIV transmission in this group. Notably, Black and Hispanic individuals were less likely than White individuals to use PrEP.
Three HIV medicines are currently FDA-approved for HIV PrEP. To learn more, read the HIVinfo fact sheet Pre-Exposure Prophylaxis.
PrEP medications can be prescribed by a pediatrician and are also available through many local health departments and community health clinics. PrEP medications are usually covered by most insurance companies, but uninsured individuals can find free or affordable PrEP through the CDC’s Paying for PrEP webpage.
Legal issues about consent for clinical care, status as a legal minor, and confidentiality are important considerations for providing PrEP medications to adolescents under 18 years old. The legal rules and regulations vary considerably by state.
For detailed information about the use of PrEP in adolescents, see the CDC’s Preexposure Prophylaxis for Prevention of HIV Acquisition Among Adolescents: Clinical Considerations, 2020.
Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone with HIV, including AYA. HIV medicines help people with HIV live long, healthy lives and reduce the risk of HIV transmission.
Several factors, including growth and development, affect HIV treatment among AYA. For example, because adolescents grow at different rates, dosing of an HIV medicine may depend on their weight rather than their age.
Issues that make it difficult to take HIV medicines regularly and exactly as prescribed (called medication adherence) can affect HIV treatment in adolescents. Effective HIV treatment depends on good medication adherence.
Several factors can make medication adherence difficult for AYA with HIV. Negative beliefs and attitudes about HIV (called stigma) can make adherence especially difficult for AYA with HIV. To avoid stigma or judgment from peers, they may skip medicine doses to hide their HIV status.
The following factors can also affect medication adherence:
The HIVinfo fact sheets HIV Treatment Adherence and Following an HIV Treatment Regimen: Steps to Take Before and After Starting HIV Medicines include tips on adherence. Some of these tips may be useful to AYA with HIV and their parents or caregivers.
This fact sheet is based on information from the following sources:
From CDC:
From the HIV Clinical Practice Guidelines at Clinicalinfo.HIV.gov:
Also see the HIV Source collection of HIV links and resources.
Yes, HIV affects children. According to the Centers for Disease Control and Prevention (CDC), 170 children younger than 13 years old were diagnosed with HIV in the United States and Puerto Rico from 2018 to 2021.
With modern HIV treatment, people with HIV live long, healthy lives. As of 2022, nearly 13,000 youth and adults in the United States were living with HIV acquired through perinatal transmission. People who acquired HIV at birth or shortly after are referred to as lifetime survivors or Dandelions.
HIV can pass to a baby during pregnancy, childbirth, or breastfeeding. In the United States, while very rare, it is the most common way children under 13 get HIV. Perinatal transmission of HIV is sometimes called mother-to-child or vertical transmission.
When taken as prescribed, HIV medicines (called antiretroviral therapy or ART) can lower the amount of HIV in the blood to an undetectable level, a state called viral suppression. When HIV stays suppressed during pregnancy, any type of childbirth (including vaginal delivery), and breastfeeding, the chance of perinatal transmission is less than 1%.
Some options for reducing the chance of perinatal transmission for those who are not virally suppressed include planning a cesarean delivery (also called a C-section) and using formula instead of breastfeeding.
All babies exposed to HIV during birth should receive HIV medicines, preferably within six hours of delivery.
To learn more, read the HIVinfo fact sheets Preventing Perinatal Transmission of HIV During Pregnancy and Childbirth and Preventing Perinatal Transmission of HIV After Birth.
ART is recommended for everyone with HIV, including children. These medicines help people with HIV live long, healthy lives and reduce the risk of HIV transmission.
Healthcare providers consider several factors when prescribing HIV treatment in children, including a child’s growth and development. For example, because children grow at different rates, the recommended dose of an HIV medicine may depend on a child’s weight rather than their age. Children who are unable to swallow a pill may take HIV medicines that come in liquid or powder form.
HIV treatment must be taken exactly as prescribed and, while the treatment regimen may change, it must be continued for life to control the virus. For many children, taking HIV medicines exactly as prescribed (called medication adherence) can be difficult.
Several factors can make medication adherence difficult for children with HIV. Examples of factors that can affect medication adherence in children include—
The HIVinfo fact sheet Following an HIV Treatment Regimen: Steps to Take Before and After Starting HIV Medicines includes tips on adherence. Some of the tips may be useful to children with HIV and their parents or caregivers.
Children with HIV may face challenges beyond taking their medicines, including:
With modern HIV treatment, children can look forward to long, healthy lives. Strong support systems and community resources can help them overcome certain challenges related to HIV. See the HIVinfo Community Resources for People With HIV fact sheet for more information on available resources.
This fact sheet is based on information from the following sources:
From CDC:
From the HIV Clinical Practice Guidelines at Clinicalinfo.HIV.gov:
Also see the HIV Source collection of HIV information and resources.
*NOTE: Males who do not identify as gay or bisexual but engage in male-to-male sexual contact are included in this group.
In the United States, gay and bisexual men are the population most affected by HIV. According to the Centers for Disease Control and Prevention (CDC), in 2022, adolescent and adult gay, bisexual, and other men who reported male-to-male sexual contact accounted for 67% of the new HIV diagnoses in the United States and dependent areas.
In addition, gay and bisexual men may be less likely to start or continue HIV treatment. For example, only about 68% of all gay and bisexual men with HIV were virally suppressed in 2022. When a person is not virally suppressed, it is harder to stay healthy and can increase the chance of passing HIV to others.
Factors that put gay and bisexual men at risk for HIV infection:
Men can take the following steps to reduce the likelihood of HIV infection:
Know the risks.
The risk of HIV transmission varies by sexual activity, with oral sex posing much lower risk than vaginal or anal sex. However, it is hard to know the exact risk because a lot of people who have oral sex also have anal or vaginal sex. Other sexually transmitted infections (STIs), such as syphilis, herpes, gonorrhea, and chlamydia, can be transmitted during oral sex.
Make sure partners with HIV are receiving treatment.
HIV medicines can lower the amount of virus in the body to an undetectable level when taken as prescribed. People with an undetectable viral load have effectively no risk of transmitting HIV through sex, a concept known as Undetectable = Untransmittable (or U=U).
Limit the number of sex partners.
Multiple or concurrent sex partners can increase exposure to HIV and STIs. STIs can create inflammation or open sores that make it easier for HIV to enter the body.
Use condoms correctly with every sexual encounter.
Condoms can reduce the chances of transmitting HIV or other STIs when used correctly. For example, condoms are estimated to reduce HIV risk by as much as 80%. Read this CDC fact sheet on how to use a condom.
Consider HIV prophylaxis.
Pre-exposure prophylaxis (PrEP) is HIV medicine taken before a potential exposure to prevent infection. PrEP is best for people who are more likely to be exposed to HIV. To learn more, read the HIVinfo fact sheet on Pre-Exposure Prophylaxis (PrEP).
In contrast, post-exposure prophylaxis (PEP) is HIV medicine taken after a possible exposure to HIV to help prevent infection. PEP is for emergencies and does not replace PrEP or other prevention methods. To learn more, read the HIVinfo fact sheet on Post-Exposure Prophylaxis (PEP).
Get tested for HIV.
Regular HIV testing helps people make informed decisions about preventing or treating HIV. Identifying HIV early supports effective treatment and lowers the chance of passing HIV to others.
The CDC recommends that all men who have male-to-male sexual contact get tested for HIV at least once a year. However, some sexually active men may benefit from getting tested more often (every 3 to 6 months).
A health care provider can help determine an appropriate HIV testing schedule based on each person’s HIV risk factors. Visit the Let’s Stop HIV Together webpage to learn more about HIV testing and to find a local testing location.
This fact sheet is based on information from the following sources:
From CDC:
Also see the HIV Source collection of HIV links and resources.
Yes. Because modern HIV medicines (called antiretroviral therapy or ART) are highly effective, many people with HIV live long, healthy lives. According to the Centers for Disease Control and Prevention (CDC), more than half of people with HIV in the United States were at least 50 years old. This means more people are living–and therefore aging–with HIV.
In 2022, people aged 50 years and older made up 16% of all new HIV diagnoses in the United States, less than half the share among people aged 20 to 29.
Many HIV risk factors are similar for people of all ages. It is important for everyone, including older people, to have knowledge, understanding, and awareness of their HIV risk factors.
HIV is spread mainly by:
Fact: A person living with HIV who is on treatment and maintains an undetectable viral load (meaning they are virally suppressed) has zero risk of transmitting HIV to their sexual partners. This concept is called Undetectable = Untransmittable or U=U.
Some age‑related changes may increase the likelihood of HIV transmission. For example, vaginal dryness and thinning of the vaginal lining after menopause can make the tissue more fragile. Fragile tissue may be more likely to tear during sex, which can increase the chance of HIV entering the body.
Older people may also be less likely to use condoms during sex because they are less concerned about pregnancy. Because of these factors, it can be helpful to talk with a health care provider about your HIV risk factors and ways to reduce them.
The CDC recommends that everyone 13 to 64 years old get tested for HIV at least once as part of routine health care. People with certain HIV risk factors should get tested at least once per year. A health care provider may recommend HIV testing for an adult older than 64 if they have certain risk factors.
For several reasons, older people are less likely to get tested for HIV:
Because these reasons can delay diagnosis, HIV is more likely to be diagnosed at an advanced stage in many older people. For example, the CDC reported that people aged 65 years and older made up more than one-third (33.9%) of all stage 3 HIV (AIDS) diagnoses in 2023.
A late-stage HIV diagnosis can increase the chances of damage to the immune system. A delayed HIV diagnosis delays treatment with HIV medicines. Studies have shown that early treatment is one of the most effective ways to control HIV and prevent other serious illnesses.
Ask a health care provider about the benefits of HIV testing. Use these questions from Health.gov to start the conversation: HIV Testing: Questions for the Doctor.
Treatment with HIV medicines is recommended for everyone with HIV. As for anyone with HIV, the choice of an HIV treatment regimen for an older person is based on their individual needs, daily routine, other medicines, and personal preferences.
However, HIV treatment can be more complicated for older people for reasons like:
Because older people often have other health conditions, routine screening for age-related health concerns may be necessary.
This fact sheet is based on information from the following sources:
From CDC:
From the HIV Clinical Practice Guidelines at Clinicalinfo.HIV.gov:
From the NIH National Institute on Aging:
Also see the HIV Source collection of HIV information and resources.
Yes. According to the Centers for Disease Control and Prevention (CDC), in 2022, 18% of the new HIV diagnoses in the United States and dependent areas were among women. In addition, 56% of women with HIV are Black/African American.
The most common way that women get HIV is through sex with a male partner who has HIV without using condom. Most women who have HIV know that they are HIV positive, but some women are not getting the HIV care and treatment they need.
HIV can be transmitted from one person to another through bodily fluids such as blood, pre-seminal fluids, semen, vaginal fluids, rectal fluids, and breast milk. In the United States, the main risk factors for HIV transmission are the following:
In women, several factors can increase the risk of HIV transmission. For example, during vaginal or anal sex, a woman has a greater risk for getting HIV because, in general, receptive sex is riskier than insertive sex. Age-related thinning and dryness of the vagina may also increase the risk of HIV in older women, because these can cause a tear in the vagina during sex and lead to HIV transmission. A woman’s risk of HIV can also increase if her partner engages in high-risk behaviors, such as injection drug use or having sex with other partners without using condoms.
Treatment with HIV medicines (called antiretroviral therapy or ART) is recommended for everyone with HIV. Treatment with HIV medicines helps people with HIV live long, healthy lives. ART also reduces the risk of HIV transmission.
People should start taking HIV medicines as soon as possible after HIV is diagnosed. However, birth control and pregnancy are two issues that can affect HIV treatment in women.
Birth control
Some HIV medicines may reduce the effectiveness of hormonal contraceptives, such as birth control pills, patches, rings, or implants. Women taking certain HIV medicines may have to use an additional or different form of birth control. For more information, view the HIV and Birth Control infographic from HIVinfo.
Pregnancy
Women with HIV take HIV medicines during pregnancy and childbirth to reduce the risk of perinatal transmission of HIV and to protect their own health. See the Preventing Perinatal Transmission fact sheet for more information.
The choice of an HIV treatment regimen to use during pregnancy depends on several factors, including a woman’s current or past use of HIV medicines, other medical conditions she may have, and the results of drug-resistance testing. In general, pregnant women with HIV can use the same HIV treatment regimens recommended for non-pregnant adults—unless the risk of any known side effects to a pregnant woman or her baby outweighs the benefits of a regimen.
Sometimes a woman’s HIV treatment regimen may change during pregnancy. Women and their health care providers should discuss whether any changes need to be made to an HIV treatment regimen during pregnancy.
PrEP and PEP for women
Pre-exposure prophylaxis (PrEP) is HIV medicine taken to reduce the chances of getting HIV infection. PrEP is used by people who do not have HIV but are at high risk of being exposed to HIV through sex or injection drug use.
There are two PrEP medications approved for use by women:
In emergency situations, people can also take post-exposure prophylaxis (PEP). PEP is HIV medicine taken within 72 hours (3 days) to reduce the chances of getting HIV infection after a possible exposure to HIV.
Women should speak with their health care provider to learn about PrEP and PEP and how to protect themselves from HIV. See the Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) fact sheets for more detailed information about PrEP and PEP.
This fact sheet is based on information from the following sources:
From CDC:
From the Department of Health and Human Services:
Also see the HIV Source collection of HIV links and resources.
