Four decades after the initial HIV case was reported, strategies for treating and preventing the disease continue to advance. In the United States, the HIV epidemic continues to disproportionately affect people who are Black or Hispanic, men who have sex with men, people who are transgender, and individuals who use illicit drugs. HIV is increasingly diagnosed in older adults, and one-fourth of HIV-positive people will be older than 65 years by 2030.

HIV Prevention

Condom use remains the foundation of HIV prevention. Preexposure prophylaxis (PrEP) is proven to reduce incidence and should be discussed with all sexually active adults and adolescents, especially cisgender men and trans-gender individuals who have sex with men, people with a recent sexually transmitted infection, and those with substance use disorder or who inject nonprescription drugs. PrEP can be started immediately with negative point-of-care HIV testing or negative testing within seven days. Regular laboratory testing is recommended for patients taking PrEP (Table 1).