HIV declines among young people and drives overall decrease in new HIV infections

May 25, 2023
Increased investments, innovation, and focus on equity are vitally needed to end the HIV epidemic.

Estimated annual new HIV infections were 12% lower in 2021 compared to 2017—dropping from about 36,500 infections to about 32,100—according to new CDC data published. The decline was driven by a 34% decrease in new infections among 13- to 24-year-olds, mostly among gay and bisexual males. HIV prevention efforts must go further and progress must be faster, however, for gains to reach populations equitably and for national goals to end the HIV epidemic to be reached.

According to CDC’s latest estimates, annual HIV infections dropped from 9,300 in 2017 to 6,100 in 2021 among 13- to 24-year-olds. Declines among young gay and bisexual males (who account for roughly 80% of new infections in this age group) drove the trend, falling from an estimated 7,400 infections to about 4,900 during the timeframe.

Data suggest that improved reach of HIV testing, treatment, and pre-exposure prophylaxis (PrEP) has contributed to progress in HIV prevention among young gay and bisexual males.

HIV PrEP and treatment outcomes improve, though longstanding factors limit gains among Black people and Hispanic/Latino people.

The decline in annual HIV infections among young gay and bisexual males was not even across all racial and ethnic groups. Declines were lower among young Black/African American (subsequently, Black) and 13- to 24-year-old Hispanic/Latino gay and bisexual males than young White gay and bisexual males, suggesting that HIV prevention and treatment are not reaching everyone in this group equitably—and reflecting broader disparities that hinder HIV prevention.

Among key HIV prevention indicators, the greatest improvement was in the number of people taking PrEP to prevent HIV. In 2021, about 30% of the 1.2 million people who could benefit from PrEP were prescribed it—a notable improvement compared to about 13% prescribed PrEP in 2017. However, although most people who could benefit from PrEP are Black or Hispanic/Latino people, estimates suggest relatively few Black people or Hispanic/Latino people were prescribed PrEP in 2021.

There were also small increases in other key prevention measures, but not at the pace needed to reach national goals. More people with HIV were aware of their status in 2021 than 2017, with an uptick from 86% to 87%. Though data aren’t directly comparable due to reporting differences, the portion of people with diagnosed HIV who were virally suppressed due to effective treatment was slightly higher in 2021 than in 2017, up from 63% to 66%. Viral suppression was lower among Black people and Hispanic/Latino people than White people.

Deeply entrenched social determinants of health continue to drive these disparities and their outcomes. Most new HIV infections in 2021 were among gay and bisexual men, the majority of whom were Black or Hispanic/Latino. About one-fifth of new HIV infections in 2021 were among women, and over half of those were among Black women.

Full CDC data