The future of HIV diagnostics: an exemplar in infectious diseases

Over the past 40 years, diagnostics have become the backbone of HIV prevention, treatment, and retention in care, and are central to the achievement of UNAIDS 95-95-95 targets. Over the next decade, the global HIV response will face difficult challenges. In addition to sustaining gains achieved in prevention and treatment, substantial gaps in care need to be addressed for underserved populations. Diagnostics will play an important role in control and prevention of HIV infection through novel technologies, digital solutions, and integrated service delivery innovations. The integration of diagnostics with digital health, machine learning, and generative artificial intelligence provides opportunities for more effective individual and public health disease control. These diagnostics and other futuristic innovations such as wearable technologies, omics, metaverse-based solutions, and quantum diagnostics could enable the achievement of the UNAIDS 95-95-95 targets; however, their use will face barriers related to health-care system financing, infrastructure, technological readiness and skills, and long-term sustainability. This Review highlights diagnostic strategies and innovations that could catalyse a new era in the management of the HIV pandemic.