Friedman said, We know from our studies that about 50 percent of HIV infections are not seen as the result of unsafe sexual behavior or transmission directly between partners.

The decline is consistent with reduced HIV numbers worldwide and the effectiveness of current treatment regimens.

Antiretroviral therapy is used to slow the progression of HIV from someone with a proven history of viral load to someone who is not yet infected (called antiretroviral (ARV)-negative). If people are using ART because they are HIV-positive, they often avoid the risky use of expensive (prescription) drugs that can be withdrawn in the event of a positive test. In addition, research shows most HIV infections in Africa are not caused by infected patients and those in the US are not infected by those infected here

For the rest of America, it is estimated that at least 27 percent use ART to reduce the risk of contracting HIV.

The US National Institutes of Health estimates that nearly 10 million adults in the United States are infected with HIV and more than 10 million others are estimated to be living with the virus.

For about 40 percent of those who are infected with HIV, they choose not to use ART and the virus continues to grow unchecked; approximately 55 percent have no idea there is an infection in their bodies. In the United States, 70 to 80 percent of people with HIV are unaware they are infected.

More than 25 percent of all Americans with a diagnosed HIV infection have failed at least four HIV tests (or more than twice the average in developed countries).

“While most HIV infections in the US are acquired through sexual transmission, an increasing share comes from non-sexual exposures,” said Dr. Michael J. Friedman, chief medical officer for the US Centers for Disease Control and Prevention, and a professor of medical epidemiology at the University of Washington , in a release. Friedman said, “We know from our studies that about 50 percent of HIV infections are not seen as the result of unsafe sexual behavior or transmission directly between partners. A third are acquired through the spread of HIV-laced blood from infected people to people with whom they have no close relationship.”

In other words, almost half–47 percent –of all HIV infections in the US are a consequence of sharing needles or sharing syringes with an HIV-seropositive partner.

Friedman said the rise in the number of undiagnosed infections is linked to two trends: a “staggering increase in HIV-associated diagnoses,” which is driven by increased testing (an average of 1,600 per year in the US, compared with 700 per year in 1983), as well as an increase in infection rates among younger people and those with “understanding of their HIV situation.” However, while overall numbers are trending upward, in some states they have been on the downturn in recent years.

“We need to continue efforts to educate people about who they are and the dangers of HIV-related disease, to implement HIV prevention efforts with active needle exchange, to expand the testing capacity of health care providers and law enforcement, and to expand access to ART,” Friedman said. “And we all have a shared responsibility to provide care, access, and treatment to those most at risk.”

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