CROI 2017: HIV Epidemic Trends and Advances in Prevention

At the 2017 Conference on Retroviruses and Opportunistic Infections (CROI), trends in the HIV epidemic were highlighted, with decreasing HIV incidence reported across several countries, although key groups remain underdiagnosed and undertreated. In the United States, men who have sex with men (MSM) continue to comprise the largest number of new and undiagnosed HIV infections, with rising incidence in MSM 25 to 34 years old and Latino MSM. Phylogenetics are being used to identify rapidly growing HIV transmission clusters, which can inform prevention efforts. HIV testing is a crucial first step for accessing HIV prevention and treatment, and several innovative strategies to increase HIV testing show promise. Sexually transmitted infections (STIs) have been on the rise but predate widespread use of HIV preexposure prophylaxis (PrEP); enhanced STI screening and treatment coupled with PrEP could substantially reduce STI incidence in the United States. Several studies indicate increasing PrEP awareness and use, although disparities exist in vulnerable populations. PrEP persistence remains a challenge, and practitioner adherence to prescribing guidelines is suboptimal. Novel PrEP delivery models are being developed to increase PrEP knowledge, access, and support.