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HIV Care in 2025
HIV Care in 2025: From Daily Pills to Personalized, Long-Acting Care

Released: November 21, 2025

Jean-Michel Molina
Jean-Michel Molina, MD, PhD
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Key Takeaways
  • The era of long-acting ART and PrEP is here and demands new infrastructure to realize their full potential.
  • Viral suppression is the foundation for lifelong health for people living with HIV.

As a healthcare professional (HCP) who has practiced through every phase of antiretroviral therapy (ART) evolution, the 2025 fall conference season—EACS  in Paris, and IDWeek in Atlanta—felt distinctively transformative. The conversation has shifted from “Can we maintain viral suppression?” to “How can we make HIV care simpler, more durable, and more equitable?”

The Era of Long-Acting ART and PrEP Is Here
Data with long-acting (LA) and extended-interval regimens dominated both meetings. The 96-week results for the investigational once-weekly oral combination of lenacapavir and islatravir demonstrated sustained viral suppression with no emergent resistance, making this regimen a potential game-changer for people who are ready to move beyond daily dosing but who do not wish to use injectable ART. After decades of daily therapy defining adherence, the idea of taking medication once a week feels almost radical, yet it perfectly aligns with how people want to live.

Similarly, real-world studies of injectable cabotegravir plus rilpivirine reaffirmed their effectiveness outside controlled clinical trials. Persistence and patient satisfaction remained high, and efficacy was excellent even among older adults with multiple comorbidities, including those with significant renal impairment. These findings reassure those of us in daily practice that LA therapy can succeed across diverse, real-world populations.

Beyond existing options, the combination of investigational broadly neutralizing antibodies (bNAbs) with LA agents such as cabotegravir or lenacapavir may soon extend dosing intervals even further, potentially enabling twice- or thrice-yearly intravenous administration for people whose viruses remain susceptible to these bNAbs. If realized, this approach could redefine what “maintenance therapy” looks like in the years ahead.

Prevention research has also advanced dramatically. Cost modeling suggested that generic production of LA lenacapavir for PrEP could lower annual costs to as little as $25 per person, or roughly 1000 times less than current US list prices. If achieved, this would revolutionize global HIV prevention, especially in resource-limited settings where access and sustainability remain key barriers.

Yet amid this scientific excitement, both meetings reminded us that simpler pharmacology does not automatically translate to simpler care. LA regimens demand new infrastructure, including reliable injection scheduling, robust follow-up systems, and redefined models of adherence. For HCPs, this means greater coordination among patients, pharmacists, nurses, and care teams. Proper implementation of patient education, flexible delivery systems, and ongoing engagement will determine whether LA therapies can truly fulfill their promise.

Viral Suppression as the Foundation for Lifelong Health
The updated EACS Guidelines version 13.0, October 2025, reflect the continued evolution of HIV medicine. We now recognize that aging, polypharmacy, cardiovascular risk, mental health, and sexual wellness are integral elements of comprehensive HIV care. For many people living with HIV, viral suppression is no longer the end goal, but rather the foundation for lifelong health and well-being. 

Across both meetings, equity in HIV care emerged as a central theme. Ultimately, bringing the advances in HIV care and treatment to key populations at increased risk of HIV acquisition remains a key priority. From the EACS–ECDC “Standards of Care” initiative to global pricing debates, speakers underscored that innovation without equitable implementation risks deepening disparities.

As a practicing HCP, I left these meetings feeling both inspired and pragmatic. We now possess the science to deliver truly individualized HIV care—whether weekly, monthly, or twice yearly—but our healthcare systems must evolve to support it. The challenge ahead is not whether we can suppress HIV, but whether we can deliver these advances consistently, affordably, and compassionately to everyone who needs them.

In 2025, HIV care is no longer just about controlling a virus. It is about restoring health, dignity, and choice—the true hallmarks of progress in modern medicine.

Your Thoughts
In your opinion, what recent research has been the most transformative or impactful for HIV care and prevention? Which technologies or agents have had the most impact on your clinical practice? Leave a comment to join the discussion!

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