When the Centers for Disease Control and Prevention first documented AIDS in 1981, women accounted for 8% of diagnoses. By 2001 that figure had climbed to 30%, and today women represent roughly 22% of people living with HIV in the United States. Globally, women account for more than half of all individuals living with the virus.
Those numbers tell a story that the dominant narrative around HIV has consistently failed to center. From the earliest years of the epidemic, public attention and research resources followed a framework built around white gay men. Women, and in particular women of color, were present from the beginning. Their experiences were not.
Where the numbers land
The racial disparities within those figures are stark. Black women account for approximately 50% of new HIV diagnoses among women in the US despite representing just 13% of the female population. Latina women represent about 20% of new diagnoses and experience infection rates nearly six times higher than white women.
In New York the picture sharpens further. Women make up about one in five people living with HIV statewide, with Black and Latina women comprising the majority of those cases. In New York City specifically, Black and Latina women account for 90% of all new AIDS cases among women, and they face higher rates of late diagnosis alongside deeper socioeconomic vulnerabilities that affect their health outcomes at every stage.
Transgender women face some of the most severe exposure of any group. Studies conducted across major US cities found that approximately 42% of transgender women surveyed were living with HIV, with Black and Latina transgender women bearing the heaviest share of that burden.
Prevention tools exist. Access does not
PrEP, the medication used to prevent HIV transmission, reduces the risk of acquiring the virus by up to 99% when taken as prescribed. It is one of the most effective public health tools developed in the history of the epidemic. Women are largely not using it.
Women account for only 7% of those using oral PrEP and 12.5% of those using injectable options. That gap is not a reflection of need. It reflects persistent failures in awareness, outreach and access, particularly in communities where the risk is highest and the resources to address it are thinnest.
Medicaid as infrastructure
In New York, Medicaid functions as the primary access point for antiretroviral therapy, PrEP, HIV testing and reproductive care for low-income women living with or at risk of HIV. Organizations working at the intersection of HIV care and community health have long argued that stable, continuous Medicaid coverage is not a peripheral benefit but a structural requirement for managing the epidemic effectively.
When coverage is interrupted, the consequences are immediate. Missed medications lead to rising viral loads. Gaps in care translate into worsening health outcomes. The women most likely to experience those disruptions are the same women already carrying the greatest burden of the disease. Cuts or restrictions to Medicaid do not land evenly across the population. They concentrate at the point of greatest vulnerability.
HIV‘s unfinished accounting
More than four decades after the CDC first reported racial disparities in HIV diagnoses, the gap has not closed. The persistence of those disparities is not a scientific failure. The tools to prevent transmission, suppress the virus and support people living with HIV exist and work. What has not kept pace is the political and policy commitment to delivering those tools equitably.
National Women and Girls HIV/AIDS Awareness Day each year marks an opportunity to take stock of that gap. The data is not ambiguous. Black and Latina women continue to bear a share of the epidemic’s burden that is entirely out of proportion to their representation in the population, and the systems meant to correct that imbalance remain underfunded, understaffed and under threat.
