African Americans are worse affected across all key population groups. Increasing levels of injecting drug use, linked to an epidemic of opioid misuse, are threatening the gains made on reducing HIV among people who use drugs. A huge contributing factor to this is prescription opioid misuse, which has seen an increasing number of people turn to injecting drug use, particularly in non-urban areas where previously injecting drugs had not been a significant issue. Nearly one in seven of these people are unaware they have HIV. The latest data from this survey suggests the number of men who have sex with men having anal sex without a condom is increasing, with This was updated in , to run until , and is structured around four core aims: These key affected populations can be grouped by transmission category for example, men who have sex with men but also by race and ethnicity, with people of colour having significantly higher rates of HIV infection over white Americans. Of these 3, were in the later stages of infection and had been diagnosed with AIDS. Despite condoms being widely available, their use is falling, even among people who are at heightened risk of acquiring HIV. Language, cultural factors and fear of being deported are all key barriers. Eighty percent of those diagnoses occurred in people aged 20 to
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