AIDS at a Crossroads How Antiretrovirals and Community Transformed the HIV Response

by Zuniga, José M.; Amico, K. Rivet; Prachniak, Corey

• ISBN13: 9780198837015
• ISBN10: 0198837011
• eBook ISBN(s): 9780192573926
• Format: Paperback
• Copyright: 2026-09-26
• Publisher: Oxford University Press
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Summary

AIDS at a Crossroads: How Antiretrovirals and Community Transformed the HIV Response chronicles the global HIV response through 2023, and the remarkable progress achieved toward epidemic control through innovation in biomedicine, the resolve of political leadership, and the steadfast commitment of communities on the frontlines of the HIV response. In this sequel to A Decade of HAART: The Development and Global Impact of Highly Active Antiretroviral Therapy (2008), leading voices in HIV medicine and global health chronicle how innovation in biomedicine, political will, and community leadership together transformed the trajectory of the HIV pandemic.

This timely volume captures the extraordinary progress toward epidemic control achieved through antiretroviral therapy, pre-exposure prophylaxis, and the validation of treatment as prevention, while candidly assessing the stigma, inequities, and policy failures that persist. Written during the COVID-19 pandemic, the book includes initial insights into the colliding pandemic's shock on health systems and how this novel public health threat tested the resilience of HIV responses everywhere. New political and fiscal shocks in 2025 - precipitated by the Trump administration's HIV and global health policy reversals and funding cuts - now threaten this progress in the United States and beyond.

Divided into three sections spanning biomedical innovation, country case studies, and strategies for achieving the goal of ending AIDS as a public health threat, AIDS at a Crossroads offers historical reflection on a public health success yet to be attained and an urgent warning that controlling, eliminating, and ultimately eradicating the HIV pandemic will depend as much on scientific breakthroughs as on sustained political will and community leadership.

Author Biography

José M. Zuniga, President/CEO, International Association of Providers of AIDS Care (IAPAC), President/CEO, Fast-Track Cities Institute, and Fast-Track Health, Washington, DC, USA,K. Rivet Amico, Professor, Department of Health Behavior and Health Equity, School of Public Health, University of Michigan, Ann Arbor, MI, USA,Corey Prachniak, Former Senior Advisor on Public Health, International Association of Providers of AIDS Care (IAPAC), Washington, DC, USA

Dr. José M. Zuniga is President/CEO of the International Association of Providers of AIDS Care (IAPAC), Fast-Track Cities Institute, and Fast-Track Health. He is the former Chair of the Joint United Nations Programme on HIV/AIDS (UNAIDS) Task Force on Urban Health, and the Lancet-HIV Commission on the Future of Urban HIV Responses. He is Editor Emeritus of the Journal of the International Association of Providers of AIDS Care and serves on the Editorial Advisory Board of the International Journal of HIV/AIDS Prevention, Education, and Behavioural Science. Dr. Zuniga routinely advises United Nations health agencies, including the World Health Organization (WHO) and its regional offices, as well as bilateral institutions such as the US President's Emergency Plan for AIDS Relief (PEPFAR). He is a member of the American Public Health Association (USA), the National Hispanic Medical Association (USA), and Senior Associate Member of the Royal Society of Medicine (UK).

Dr. K. Rivet Amico is a Professor in the Department of Health Behavior and Health Equity at the University of Michigan's School of Public Health. She is an active contributor in the areas of HIV prevention and treatment, social-behavioural theory development, intervention implementation, and intervention evaluation and measurement. Her research includes work with engagement in HIV care, pre-exposure prophylaxis (PrEP), and social structural factors influencing health and well-being in communities affected by the HIV epidemic. She uses mixed methods, implementation science, and program development principles in her work to advance the reach and quality of care and prevention services. Dr. Amico has strong interests in research design, implementation science, program evaluation and community capacity sharing with youth, pregnant and breast-feeding women, and LGBTQI+ communities in the United States and sub-Saharan Africa.

Mx. Corey Prachniak is a lawyer who serves as Director of Health Equity at CenterLink, where they direct HealthLink, a program that supports LGBTQI+ community centers worldwide. They have a strong background in LGBTQI+ health and public health advocacy, including in their prior role as Senior Advisor on Public Health at the International Association of Providers of AIDS Care (IAPAC), leading research initiatives on urban HIV epidemics and LGBTQI+ health equity. Mx. Prachniak has also held positions at the Commonwealth of Massachusetts, Harvard University, Deloitte Consulting LLP, and other organizations, contributing to research and advocacy efforts in the fields of healthcare technology, human rights, and reproductive rights. They were admitted to the bar in the State of Maryland in 2013 and the Commonwealth of Massachusetts in 2015.

Table of Contents

Part 1: ART, PrEP, and the Continuum from Despair to a Decade of Action1. How Antiretroviral Therapy Turned the Tide of the HIV Pandemic, José M. Zuniga2. HPTN 052, the PARTNER Study, and the Dawn of Treatment as Prevention, Myron S. Cohen, Theresa R. Gamble, and Marybeth McCauley3. The Impact of Option B+ PMTCT Implementation on Mothers Living with HIV, Lee Fairlie, Faeezah Patel, and James McIntyre4. Challenges and Successes from a Decade and a Half of HIV Antiretroviral Therapy, Christopher Duncombe5. Pre-Exposure Prophylaxis for the Biomedical Prevention of HIV Infection, Lao-Tzu Allan-Blitz and Kenneth H. Mayer6. Molecular Genetics: Using Phylogenetics to Enhance the HIV Response, Angela McLaughlin, Julio S.G. Montaner, and Jeffrey B. Joy7. From Elimination to Eradication: The Role of an HIV Vaccine and/or Cure, Caroline Passaes and Asier Sáez-CiriónPart 2: Action to Impact: Country Experiences with ART and PrEP Scale-Up8. Country Review: Kenya, Irene Mukui, Francesca Odhiambo, Maurice Aluda, and Elizabeth Anne Bukusi9. Country Review: South Africa, Yogan Pillay10. Country Review: Uganda, Andrew D. Kambugu and Elly Tebasoboke Katabira11. Country Review: Australia, Jillian S.Y. Lau, David W.J. Griffin, Mihiri P. Weerasuria, James H. McMahon, and Jennifer F. Hoy12. Country Review: China Case Study, Zunyou Wu, Yan Zhao, and Jennifer M. McGoogan13. Country Review: Thailand, Praphan Phanuphak and Nittaya Phanuphak14. Country Review: Brazil, Ana Roberta Pati Pascom, Nazle Mendonça Collaço Véras, Grace Perpétuo, Eduardo Malheiros, Gerson Fernando Pereira, and Adele S. Benzaken15. Country Review: Haiti, J. Deas Van Onacker, E.G. Robin, K. François, V. Rouzier, N. Segaren, D. Jean François, M.M. Zevallos, S. Laguerre, N. Lamothe, F. Moise, M.M. Deschamps, B. Liautaud, J.W. Pape, P. Cremieux, F. Léandre, and S. Koenig16. Country Review: Argentina, Leandro Cahn and Pedro Cahn17. Country Review: United States, Taraz Samandari, Stacy Cohen, Kristen L. Hess, Steven R. Young, Janet Cleveland, Antigone Dempsey, and David W. Purcell18. Country Review: The Netherlands, Peter Reiss19. Country Review: Spain, Matilde Sánchez-Conde, Maria J. Vivancos-Gallego, Javier Martínez-Sanz, and Santiago MorenoPart 3: Challenges and Opportunities for Ending AIDS as a Public Health Threat20. A Revitalised Human Rights and Legal Framework for Ending AIDS, Matthew Weait21. Financing the AIDS Response: Bilateral, Multilateral, and National Investments, Alan Whiteside22. Political Leadership for HIV Control: It Is Time to Unite for Action, Artur Acelino Francisco Luz Nunes Queiroz, Ricardo Baptista Leite, and Amish Laxmidas23. Urbanizing Global Goals by Accelerating HIV Responses in Fast-Track Cities, José M. Zuniga, Sindhu Ravishankar, and Christopher Duncombe24. Leveraging the HIV Response for the Achievement of Universal Health Coverage, Helena Nygren-Krug25. Conclusion, José M. Zuniga