Investigating Which States Have Made the Most Progress Against HIV/AIDS

It’s been nearly three decades since NBA legend Magic Johnson announced to the world that he was HIV-positive. Johnson’s announcement in November 1991 was assumed by many to be a death sentence for the Basketball Hall-of-Famer, and there was widespread false belief that only gay or bisexual men could contract HIV through sex.

The world has changed a lot in the 28 intervening years. Public understanding of HIV and AIDS has grown, and enormous strides in the treatment and prevention of both the virus and the disease it causes have meant that thousands of people, Magic Johnson included, are living normal, healthy lives despite having contracted HIV.

Medical science has advanced so far that many people assume AIDS and HIV have been more or less cured and that the HIV epidemic is over. This assumption is false, and it is dangerous. At the end of 2018, nearly 40 million people in the world were living with HIV, and about 10% of those people were in the Americas.

Global progress against HIV/AIDS has brought down infection and death rates across the world and here in the United States, but a close examination of federal health data shows that HIV/AIDS remains a huge crisis that’s getting worse in much of the United States.

We wanted to look at where in the United States HIV and AIDS were most common and which states have seen rates of both the virus and the disease it causes increase as well as which states lag behind in medical treatment of both. What we found was that the 10 states where HIV/AIDS is most critical are largely in the South — seven of the top 10 are in that region.

Where in the U.S. Are HIV and AIDS Most Serious?

You can jump to the bottom of the page to see our detailed methodology, but we compared every state across four broad areas related to prevalence, death rates and medical treatment of HIV and AIDS. Each state was ranked from best to worst and their rankings were added together to create an overall ranking where higher numbers equate to a more serious HIV problem.

The lowest-scoring state, Alaska, has an HIV-risk score that’s only about 16% of the score put up by the highest-scoring states, Ohio and Nevada, which tied for the worst score. But aside from those two states, the rest of the 10 highest-scoring states are all in the South, the region with the highest average score.

In addition to dominating the top 10, only two Southern states placed outside the top half of the list, and only one Northeastern state was among the 25 highest-scoring states.

Top 10 State Breakdown

Let’s dig a little deeper into the stats of each of the top 10 states on our list. For comparison’s sake, here’s a look at the national rates or averages in each category (in each category, the most recent available data was used):

Best & Worst Rates by Category

Here are the best and worst states in each of the categories used in our rankings:

Who is at the Greatest Risk?

For the average American, the risk of contracting HIV is falling, as new-diagnosis rates have dropped by more than one-quarter over the past decade. But many groups have far higher rates, and some are even seeing HIV rates go up.

African-Americans have by far the highest HIV diagnosis rate of any racial or ethnic group, but there’s another group that’s actually seeing rates increase, sadly bucking the national trend.

In addition to differences along racial and ethnic lines, gender plays a large role as well, with men being far more likely to contract HIV.

Men have a much higher risk of contracting HIV, and while their diagnosis rate has declined, the rate for women has fallen faster. The rate for men has fallen by 21.7%, while the rate for women declined 42.2%.

Those between 25 and 34 are most likely to be diagnosed with HIV, followed by the 35-to-44 age group.

All of those age groups have seen diagnosis rates fall over the past decade, but some have seen much more dramatic decreases than others, with the rate for 25-to-34-year-olds declining the slowest at 4.9% and the rate for 35- to 44-year-olds falling fastest, 40.9%.

Along with demographic differences, behavior plays a role in a person’s likelihood of contracting HIV, as sex, whether gay or straight sex, continues to be the predominant method of transmission.

Conclusion

The prevalence of antiretroviral (ARV) drugs and pre-exposure prophylaxis (PrEP) have combined to dramatically reduce the rates of both new HIV transmissions as well as deaths resulting from AIDS. But that is no reason to believe AIDS or HIV are cured. There’s no doubt that the past 10 years have seen HIV rates fall, but more recent years have seen far less progress being made, which illustrates that vigilance is still required if we want to completely eradicate this virus and the deadly disease it causes.

The American public needs to make prevention a priority by remaining vigilant regarding precautions to stop the spread of HIV and other sexually transmitted diseases. Using protection and getting tested for STDs is critical to your health and that of your partners. At Health Testing Centers we make ordering STD and other medical tests easy and affordable so you can stay safe.

Methodology

To quantify which states’ HIV/AIDS data present the best and worst overall picture, we examined state-level health data across a range of categories related to HIV and AIDS. In each category, we ranked the states from best to worst such that the state with the best rate or percentage in each category was No. 1 and so on. We added each state’s rank in each category to create that state’s overall score; for our purposes, lower scores equate to better health results when it comes to prevalence and treatment of HIV and AIDS.

All data used in this report came from the federal Centers for Disease Control and Prevention, utilizing the agency’s Atlas Plus tool, which allows users to build custom tables related to a host of health outcomes. While we’ve discussed other data in portions of this report, the categories used to develop our rankings were:

HIV diagnosis rates: We used the overall population-adjusted rate of new diagnoses of HIV in each state and the percentage change between 2008 and 2017 (the most recent year).

AIDS death rates:We used the overall population-adjusted rate of deaths attributed to AIDS in each state and the rate of change between 2008 and 2016 (the most recent year).

HIV viral suppression and treatment levels: We used the percentage of HIV patients in each state who have achieved viral suppression, meaning their viral load is so low that the virus no longer can be transmitted to sexual partners through unprotected sex. We also used data covering the percentage of HIV-positive individuals in each state who are receiving medical treatment for HIV. In both cases, data for several states (Arizona, Arkansas, Idaho, Kansas, Kentucky, Nevada, New Jersey, Pennsylvania and Vermont) was unavailable, so for the purposes of ranking the states, in both of those categories, the national average was substituted for those states.

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