First reports of the HIV/AIDS epidemic surfaced in MMWR in 1981 when 5 cases of pneumocystis pneumonia were described in Los Angeles. Within 18-months, epidemiologists had defined the risk factors and issued recommendations around transmission prevention despite not knowing the actual cause. By 1984, US and French investigators determined the aetiology of AIDS, a retrovirus which was eventually renamed HIV. The first antiretroviral, zidovudine (AZT), became available in 1987, but it was not until 1996 when effective treatment was described with the addition of a new class of drug, protease inhibitors.
The simplicity of single-tablet regimens and world-wide availability of medications has transformed the landscape of HIV management. Now 20 years after the advent of effective therapy, HIV can be considered a chronic disease. The development of newer generation testing makes diagnosis far simpler, with enhanced monitoring available to Australian clinicians to maintain engagement and retention in care. Cure remains, unfortunately, elusive and the epidemic persists: controversies exist today in HIV management. This session will focus on 3 areas: (1) point of care diagnostic testing; (2) prevention strategies to halt ongoing transmission; and (3) managing an ageing population with a chronic illness.