Means to an end

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Science  17 Jul 2015:
Vol. 349, Issue 6245, pp. 226-231
DOI: 10.1126/science.349.6245.226

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Recent advances in HIV/AIDS treatment and prevention have convinced an increasing number of scientists, politicians, and advocates that the tools now exist to end AIDS epidemics locally and, by 2030, around the world. Chief among the new findings that have driven this optimism is that antiretroviral (ARV) drugs both ward off disease in an infected person and, if the virus is suppressed to undetectable levels, powerfully reduce the risk of transmission. ARVs given to uninfected people as prophylaxis, a strategy dubbed pre-exposure prophylaxis, also can prevent transmissions, further changing the trajectory of epidemics. San Francisco, New York state, and British Columbia, Canada, all are at the vanguard of the movement to end AIDS epidemics, and each locale is tailor-making a response based on their demographics, politics, and scientific convictions of what is needed most. They also have different definitions of what it means to "end AIDS." But each locale has set the goal line at 2020—and each faces complex challenges.