Highlights & Basics
- HIV infection is believed to have peaked in the late 1990s and to have stabilized recently. Globally, an estimated 38.4 million people were living with HIV at the end of 2021, with 1.5 million people newly infected.
- Most people are infected through sexual contact, before birth or during delivery, during breast-feeding, or when sharing contaminated needles and syringes.
- Diagnosis is established using an HIV antibody test and confirmed using a more specific test. Patients should be clinically staged according to World Health Organization or Centers for Disease Control and Prevention criteria.
- Guidelines recommend that all patients infected with HIV, regardless of CD4 cell count, should start antiretroviral therapy (ART) as soon as possible.
- Pre-exposure prophylaxis with daily oral antiretroviral therapy or long-acting intramuscular cabotegravir reduces the risk of HIV infection and is recommended in sexually active adults and people who inject drugs and who are at substantial ongoing risk of HIV exposure and acquisition.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Sep 2015 [internet publication].[Full Text]
US Department of Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. Feb 2024 [internet publication].[Full Text]
World Health Organization. WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children. Geneva, Switzerland: WHO Press; 2007 [internet publication].[Full Text]
World Health Organization. Update of recommendations on first- and second-line antiretroviral regimens. Jul 2019 [internet publication].[Full Text]
- UNAIDS global AIDS update 2022
- Prevention Access Campaign: consensus statement
- CDC: HIV self-testing
- BMJ practice article: two-drug antiretroviral regimens for HIV
- University of Liverpool: HIV drug interactions
- AIDSinfo: antiretroviral agents in HIV-1-infected adults and adolescents
- FDA: HIV treatment information for adults
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43. Sullivan AK, Saunders J, Desai M, et al. HIV pre-exposure prophylaxis and its implementation in the PrEP impact trial in England: a pragmatic health technology assessment. Lancet HIV. 2023 Dec;10(12):e790-806.[Abstract][Full Text]
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45. World Health Organization. Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for HIV. Sep 2015 [internet publication].[Full Text]
46. Centers for Disease Control and Prevention. Preexposure prophylaxis for the prevention of HIV infection in the United States - 2021 update: a clinical practice guideline. Dec 2021 [internet publication]. [Full Text]
47. American College of Obstetricians and Gynecologists. Practice advisory to committee opinion no. 595: preexposure prophylaxis for the prevention of human immunodeficiency virus. Jun 2022 [internet publication].[Full Text]
48. US Preventive Services Task Force. Recommendation: prevention of acquisition of HIV: preexposure prophylaxis. Aug 2023 [internet publication].[Full Text]
49. Holt M, Lea T, Mao L, et al. Community-level changes in condom use and uptake of HIV pre-exposure prophylaxis by gay and bisexual men in Melbourne and Sydney, Australia: results of repeated behavioural surveillance in 2013-17. Lancet HIV. 2018 Aug;5(8):e448-56.[Abstract]
50. Hart TA, Noor SW, Berlin GW, et al. Pre-exposure prophylaxis and bacterial sexually transmitted infections (STIs) among gay and bisexual men. Sex Transm Infect. 2023 May;99(3):167-72.[Abstract][Full Text]
51. Cohen SE, Sachdev D, Lee SA, et al. Acquisition of tenofovir-susceptible, emtricitabine-resistant HIV despite high adherence to daily pre-exposure prophylaxis: a case report. Lancet HIV. 2018 Nov 29 [Epub ahead of print].[Abstract]
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53. US Food and Drug Administration. FDA approves first injectable treatment for HIV pre-exposure prevention. Dec 2021 [internet publication].[Full Text]
54. Marshall BDL, Goedel WC, King MRF, et al. Potential effectiveness of long-acting injectable pre-exposure prophylaxis for HIV prevention in men who have sex with men: a modelling study. Lancet HIV. 2018 Sep;5(9):e498-505.[Abstract][Full Text]
55. Landovitz RJ, Hanscom BS, Clement ME, et al. Efficacy and safety of long-acting cabotegravir compared with daily oral tenofovir disoproxil fumarate plus emtricitabine to prevent HIV infection in cisgender men and transgender women who have sex with men 1 year after study unblinding: a secondary analysis of the phase 2b and 3 HPTN 083 randomised controlled trial. Lancet HIV. 2023 Dec;10(12):e767-78.[Abstract][Full Text]
56. World Health Organization. Guidelines on long-acting injectable cabotegravir for HIV prevention. Jul 2022 [internet publication].[Full Text]
57. Antoni G, Tremblay C, Delaugerre C, et al. On-demand pre-exposure prophylaxis with tenofovir disoproxil fumarate plus emtricitabine among men who have sex with men with less frequent sexual intercourse: a post-hoc analysis of the ANRS IPERGAY trial. Lancet HIV. 2020 Feb;7(2):e113-20.[Abstract]
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65. Rodger AJ, Cambiano V, Bruun T, et al; PARTNER Study Group. Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy. JAMA. 2016 Jul 12;316(2):171-81.[Abstract][Full Text]
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124. World Health Organization. Guidelines on the public health response to pretreatment HIV drug resistance. Jul 2017 [internet publication].[Full Text]
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129. Segarra-Newnham M. Osteoporosis and vitamin D deficiency in HIV-positive patients. J Pharm Technol. 2011;27:251-7.
130. National Institute for Health and Care Excellence. Cabotegravir with rilpivirine for treating HIV-1. Jan 2022 [internet publication].[Full Text]
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