Kerala has a low HIV rate of 0.07%, much below India's 0.20%. Yet, new HIV infections are rising among the 15-24 age group. The state recorded 1,213 new HIV infections in 2024 and has 23,608 people living with HIV. From 2022 to October 2025, Kerala found 4,477 new cases. Most are men (3,393), but 1,065 women (including 90 pregnant) and 19 transgenders also tested positive. A senior official said, "New infections during this three-year period have more or less been steady. However, what is alarming is the steady increase in new HIV infections in the 15-24 year age group in Kerala. In 2022, new infections in the 15-24 year age group was 9%, which increased to 12% in 2023 and 14.2% in 2024." Between April and October 2025, the rate rose to 15.4%. Most infections (62.6%) came from unsafe heterosexual sex with multiple partners. Other cases include 24.6% via homosexual or bisexual contact, 8.1% from needle sharing among drug users, 0.9% from mother-to-child, and 3.7% unknown reasons. The key districts needing focus are Ernakulam, Thiruvananthapuram, Thrissur and Kozhikode. Kerala leads in viral load suppression and service coverage but must boost prevention efforts among youth and mobile groups to control the spread.