IAS-USA publishes updated guidelines for HIV treatment and prevention

On the occasion of World AIDS Day on December 1, 2024, the International Antivirus (formerly AIDS) Society-USA (IAS-USA) published new international guidelines for the treatment and prevention of HIV. The updated recommendations were developed by a group of volunteer medical experts, including Professor Clara Lehmann of the University Hospital of Cologne and the German Center for Infection Research (DZIF). They are based on major advances in antiretroviral therapies and new prevention strategies, such as pre-exposure prophylaxis. The 2024 guidelines highlight the significant progress that has been made in the fight against HIV, while recognizing that much remains to be done to ensure equitable access to life-saving interventions.

Thanks to effective antiretroviral therapy, many people living with HIV can achieve a normal or near-normal life expectancy. As new data and new antiretroviral drugs and formulations become available, recommendations for HIV treatment, clinical management, and prevention must be updated regularly so that health professionals can provide the best care for their patients.

An international panel of leading experts in HIV research and clinical care identified and reviewed the latest evidence from literature and peer-reviewed conference presentations published between June 2022 and October 2024, as well as data provided by antiretroviral manufacturers. Expert consensus based on the comprehensive review led to updated guidelines for the treatment and prevention of HIV infection, related sexually transmitted infections, and the development of cardiovascular disease in people living with HIV. Here is an overview of recommendations for HIV treatment, prevention and care.

Tailored antiretroviral therapy

The committee recommends that antiretroviral therapy should be tailored to the individual’s needs, especially for those who cannot tolerate certain HIV medications. Long-acting injectable therapies are highlighted as a valuable option to help patients adhere to their treatment plans.

HIV prevention strategies

For people at increased risk of exposure to HIV, the guidelines emphasize the use of pre-exposure prophylaxis, available as daily oral medication or long-acting injectable options. In addition, doxycycline is recognized as an effective post-exposure prophylaxis for the prevention of sexually transmitted infections.

Integrated care for people living with HIV

The panel emphasizes the importance of a holistic approach to HIV care. This includes preventing cardiovascular disease, managing substance use disorders, and monitoring weight changes that may occur during antiretroviral therapy.

Tackling inequalities in access to care

Recognizing persistent disparities in access to HIV care and prevention, the guidelines propose targeted solutions to address gaps in underserved communities. Proposed interventions include: expanding access to video telemedicine and mobile health units. using smartphone reminders for medications or injections; and providing compliance support through traditional methods such as pill boxes and regular check-ins by phone or text.

While remarkable progress has been made in the fight against HIV, much remains to be done to ensure equitable access to life-saving interventions. These updated guidelines provide a comprehensive framework for health professionals around the world to help us provide better care and move closer to ending the HIV epidemic.”

Prof. Clara Lehmann, Deputy Coordinator of the DZIF research area “HIV”