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Racial and geographical disparities exist in HIV infections in the USA. The highest burden of HIV diagnoses remains among Black/African American persons and is concentrated in the Southern region. This paper describes within-race changes in HIV diagnoses among heterosexually active Black/African American persons in seven states with the highest rates/100,000 population of HIV diagnoses in the South, during 2014-2018. The total number of diagnoses among Black males and females with infection attributed to heterosexual contact decreased i