Coinciding with World AIDS Day, the International Antiviral Society–USA released updated guidelines on the use of antiretroviral therapy for HIV treatment and pre-exposure prophylaxis (PrEP).

The guidelines recommend starting treatment as soon as possible after an HIV diagnosis, since early treatment leads to better outcomes. For most people, integrase inhibitor regimens “remain the mainstay of initial therapy.” For people with viral suppression on a daily oral regimen, switching to long-acting injectable Cabenuva (cabotegravir plus rilpivirine) is now an option. Current PrEP options include tenofovir disoproxil fumarate/emtricitabine (Truvada and generic equivalents), tenofovir alafenamide/emtricitabine (Descovy) and long-acting Apretude (cabotegravir) injections.

The guidelines address barriers to care, treatment simplification and adherence support as well as screening for and management of other health conditions, including substance use disorders and weight gain (see next item). Finally, they discuss how recent global health emergencies, including COVID-19 and monkeypox (mpox), affect people living with HIV (see item on here).

“Ending the HIV epidemic will require an equity approach that focuses resources on addressing societal disparities (for example, tackling poverty as an HIV prevention strategy), addressing stigma as a root cause of HIV risk, eliminating laws that target people with HIV and ensuring access to care for all,” the authors wrote.