Recent Advances in HIV/AIDS Prevention: Focusing on Antiretroviral Therapy

Although the global HIV incidence has declined over the past decade, Republic of Korea (ROK) continues to report approximately 1,000 new cases annually, with an increasing proportion among foreign nationals, highlighting the need to strengthen prevention strategies. This review aimed to synthesize current scientific evidence on Treatment as Prevention (TasP) and the Undetectable=Untransmittable (U=U) concept, with a particular focus on prevention strategies utilizing antiretroviral therapy, and to discuss their public health implications. This review also examined the history and key evidence of pre-exposure prophylaxis (PrEP) and outlined its current role in ROK.

A narrative literature review was conducted to evaluate the evidence base and implications of TasP and U=U, summarizing the development, efficacy, and implementation of PrEP in both global and Korean contexts.

TasP markedly reduced HIV transmission, confirming its role as a cornerstone prevention strategy. The establishment of the U=U concept helps alleviate stigma and fosters a virtuous cycle that supports the prevention of secondary transmission. PrEP has demonstrated high effectiveness in preventing HIV infection. Notably, recent clinical trials found that long-acting injectable PrEP offers greater convenience, potentially improving adherence and broadening access. In ROK, the nationwide expansion of a government-supported PrEP program in 2025 is expected to lower barriers to testing, care, and medication, thereby facilitating higher uptake in at-risk populations.

An integrated prevention framework that combines TasP/U=U with both oral and long-acting PrEP is anticipated to substantially reduce new HIV infections and contribute to achieving the 2030 HIV elimination goals in ROK.