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HIV, a slowly progressive, almost uniformly fatal, sexually transmitted infection, remains one of the most significant global health concerns, affecting individuals across all ages, genders, and social groups. Since the pandemic was recognized in the 1980s, 44.1 million people have died of the advanced form of HIV, known as AIDS. This course reviews the remarkable progress with antiretroviral therapy (ART) that has transformed HIV into a manageable chronic condition, as well as the burden of new infections and AIDS-related deaths that persists worldwide despite these advancements. Although new diagnoses have declined since the 1980s, progress has plateaued; therefore, participants will also gain an understanding of the need for improved prevention, testing, treatment, and retention in care to achieve target goals. While a cure is out of reach and vaccines have remained elusive, HIV infection is now regarded as a chronic illness due to the effectiveness of antiretroviral therapy. This course explores biomedical HIV prevention strategies, modes of transmission, and implementation considerations across diverse populations. The integration of prevention and treatment approaches such as preexposure prophylaxis (PrEP), postexposure prophylaxis (PEP), and treatment as prevention (TasP) into patient-centered care is also reviewed. This activity for healthcare professionals is designed to enhance the learner's competence in identifying individuals at high-risk for HIV, counseling patients on effective HIV prevention measures, improving linkage to and retention in care, and collaborating across interprofessional teams to reduce inequities, enhance patient outcomes, and advance both national and global HIV prevention goals. Objectives: Identify populations at greatest risk for HIV infection contributing to ongoing transmission. Develop patient-centered strategies to improve adherence to antiretroviral therapy and prevention interventions. Implement tailored interventions to address inequities, improving outcomes in high-risk and underserved populations. Collaborate with interprofessional teams to promote awareness of HIV prevention and testing strategies, including overcoming barriers related to stigma and socioeconomic factors and supporting people living with or at risk of HIV. Access free multiple choice questions on this topic.

HIV Overview HIV can infect individuals of any age, gender, race, or social class. Due to the effectiveness of antiretroviral therapy, HIV infection is now seen as a manageable chronic disease. However, despite significant advancements in controlling the virus, the disease remains a major global health concern fed by and contributing to inequities. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that 630,000 individuals died from AIDS-related causes in 2024.[UNAIDS.Global AIDS Update.2025] Forty million people are living with HIV, of whom 60% live in Africa, and 1.4 million of whom are children. In addition, 1.3 million individuals acquire HIV each year, most commonly through heterosexual contact. The Centers for Disease Control and Prevention (CDC) estimated that 1.2 million people in the United States (US) were living with HIV at the end of 2022, of which 13% were unaware of their status.[HIVGov.US HIV Statistics.2025] Male-to-male sexual (MSM) contact accounts for 66% of all new HIV diagnoses in the US, with heterosexual contact accounting for 24% and intravenous drug use for 3%.[CDC.HIV Surveillance Report.2025] High-risk groups included MSM, transgender individuals, those with multiple partners or who do not use condoms, individuals who trade sex for money, goods, or services, those living in locations where the incidence is 3% or greater, and individuals who have had sexually transmitted infections (STIs) or who share injection drug needles, syringes, or other equipment.[1] While new HIV diagnoses have declined significantly from their peak in the 1980s, progress on further reducing them has stalled in recent years, with an estimated 38,000 new diagnoses each year.[HIVGov.EHE Overview.2025] An analysis of US data from 2009 showed that 91.5% of HIV transmissions were from People Living With HIV (PLWH) who are undiagnosed and PLWH who are diagnosed but not in care.[2] Such analyses strengthen the case for systematically improving the HIV care continuum for better HIV prevention.[HIVGov.HIV Care Continuum.2025] HIV Target Goals

While new HIV diagnoses have declined significantly from their peak in the 1980s, progress on further reducing them has stalled in recent years, with an estimated 38,000 new diagnoses each year.[HIVGov.EHE Overview.2025] An analysis of US data from 2009 showed that 91.5% of HIV transmissions were from People Living With HIV (PLWH) who are undiagnosed and PLWH who are diagnosed but not in care.[2] Such analyses strengthen the case for systematically improving the HIV care continuum for better HIV prevention.[HIVGov.HIV Care Continuum.2025] HIV Target Goals Targets and initiatives set by the United Nations (UN), the World Health Organization (WHO), and public health agencies of individual countries have fostered significant progress in scaling up testing and implementing antiretroviral therapy. However, knowledge of HIV status, use of preventive services, and access to retention in care for PLWH remain suboptimal in the United States and worldwide, with significant inequities between populations. UNAIDS has set the following "95-95-95" goals for 2025: Where 95% of all individuals with HIV know their status When 95% of all those who have HIV receive antiretroviral therapy With 95% of all individuals on antiretroviral therapy achieving viral suppression Global progress has been made, with 26.9 million lives saved; however, the international community was not on track to achieve these ambitious goals, and by 2025, this progress became less likely due to major disruptions in global aid.[UNAIDS.Global AIDS Update.2025][3] (Please refer to the Monitoring, Surveillance, and Reporting and the Enhancing Healthcare Team Outcomes sections for more information on the 95-95-95 goals). Understanding the biomedical HIV prevention approaches for clinicians is an essential part of an overall public health strategy to achieve global and national targets and reduce the global burden of this disease, as well as the modes of transmission of HIV, biomedical strategies for at-risk populations, implementation considerations for select populations, and public health measures of relevance across an interprofessional team. Please see StatPearls' companion resource, "HIV and AIDS," "HIV Testing,” and "HIV Antiretroviral Therapy," for further information on these HIV topics.

HIV remains a leading public health challenge despite advances that transformed it into a manageable chronic disease with antiretroviral therapy. Globally, more than 40 million people live with HIV, with 1.3 million new infections and over 600,000 AIDS-related deaths annually. In the US, an estimated 1.2 million people are living with HIV, yet 13% remain undiagnosed, fueling ongoing transmission. Biomedical prevention strategies, including PrEP, PEP, and TasP, offer highly effective means to reduce new infections; however, gaps in implementation and retention in care hinder progress toward UNAIDS’ 95-95-95 targets. Optimizing patient-centered HIV prevention and care requires coordinated interprofessional collaboration to support individuals with HIV or at high risk of HIV and to ensure factors within organizational, community, and policy environments support the prevention of HIV. Physicians, general practitioners, and advanced practitioners must screen at-risk individuals, initiate ART promptly, and integrate PrEP and PEP into care. Nurses support adherence, provide education, and monitor treatment outcomes, while pharmacists ensure safe medication use and reinforce adherence strategies. Effective communication across the care team and with patients helps address inequities, reduce stigma, and promote engagement in care. Coordinated strategies that emphasize prevention, early diagnosis, and long-term retention improve patient safety, health outcomes, and overall team performance in combating HIV.