Houston’s HIV Crisis: Downtown, Montrose at Epicenter

A new wave of public health data has spotlighted Houston’s Downtown and Montrose neighborhoods as the city’s leading HIV hotspots, with both areas experiencing the highest rates of new diagnoses and people living with HIV in recent years.

Alarming Numbers in Central Houston

According to an April 2025 report from Harris County Public Health, the HIV and sexually transmitted infection (STI) rates in Houston and Harris County have surged beyond statewide averages, prompting concern among health officials and community leaders. The report, which analyzed data from 2015 to 2022, found that:

• Downtown Houston (ZIP code 77002) recorded the highest number of people living with HIV, with 5,614 cases.
• Montrose (ZIP code 77006) posted the highest rate of new HIV diagnoses, with 81 new cases during the same period..
• Other neighborhoods, including the Second Ward and Settegast, also reported elevated rates, but Downtown and Montrose remain the epicenters.

Disproportionate Impact on Communities of Color and Young Adults

The data further reveals that Black and multiracial residents are disproportionately affected. In 2019, Black residents had 58 new HIV cases per 100,000 people, while multiracial residents had 92 per 100,000-significantly higher than the rates among Hispanic (23 per 100,000) and white residents (10 per 100,000). Young adults, especially those aged 25–34, continue to represent the highest share of new diagnoses, while the greatest overall prevalence is among those aged 45–64.

Factors Driving the Surge

Health experts point to a combination of factors fueling the rise in HIV and STI rates in these neighborhoods:

• Central location and population density: Downtown and Montrose attract younger populations and have a high concentration of nightlife and social venues, which can increase risk factors.
• Healthcare disparities: Limited access to healthcare and prevention services in some communities has contributed to higher rates among racial and ethnic minorities.
• Stigma and confidentiality concerns: The historic stigma surrounding HIV and AIDS, particularly in Montrose’s LGBTQ+ community, has long hindered testing and treatment efforts.

Community and Public Health Response

In response to the surge, Harris County Public Health and local clinics are expanding prevention, testing, and treatment initiatives:

• Free and low-cost testing: Mobile and clinic-based testing is now available to all residents, regardless of insurance status..
• Community education campaigns: Efforts are underway to raise awareness, reduce stigma, and promote safer practices.
• Youth-focused services: New clinics, such as the Baylor Teen Health Clinic, are providing confidential services for adolescents and young adults, aiming to curb the spread among high-risk age groups.

A Legacy of Advocacy and Care

Montrose, historically the heart of Houston’s LGBTQ+ community, has played a pivotal role in the city’s HIV/AIDS response. The Legacy Community Health (formerly Montrose Clinic) has been at the forefront of confidential testing, treatment, and education since the early days of the epidemic, helping to break down barriers to care and support at-risk populations.

Looking Ahead

The latest data underscores the urgent need for targeted interventions and sustained public health efforts in Houston’s central neighborhoods. By expanding access to care, addressing disparities, and fostering community engagement, health officials hope to slow the spread of HIV and improve outcomes for those most affected.

As the city confronts this new phase of the epidemic, Downtown and Montrose remain both the focus of concern and the center of hope for effective prevention and care.

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