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July 27, 2022
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Times have changed since AIDS conference last held in Montreal

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The International AIDS Conference, now 37 years old, is the longest standing comprehensive conference addressing the full spectrum of developments in controlling the spread of HIV infection globally.

The conference has been an historic forum confronting the social and political setting of the epidemic, as well as updating us on new developments in treating and preventing the infection and resulting diseases. It has been held in countries heavily affected by HIV, affording an examination of the complexity of the international response and enabling efforts to stimulate a more effective and compassionate response that is informed by the voices of those most affected. The conference has been the primary responsibility of the Geneva-based International AIDS Society, which ensures that the meeting continues its role in including all aspects of the approaches of epidemic control.

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The conference was last held in Montreal in 1989. World events at that time included the death in Iran of the Ayatollah Khomeini, celebrated in the streets by the large Canadian expat community, and the brutal suppression of the Tiananmen Square movement, celebrated by no one. In the AIDS epidemic, it was a period of despair. Although the nature of the infection and disease had been well described, there were no effective treatments and AIDS remained uniformly fatal. Affected persons rose to create activist communities and for the first time took center stage at the International AIDS Conference, demanding answers to loudly voiced demands, galvanizing the previously staid scientific attendees.

Times have changed since 1989, but as we will learn again in Montreal at the 2022 conference, we still have much to do. Global HIV response has been hampered by the COVID-19 pandemic, now in its third year. Although the conference again welcomes an in-person assembly, many will still participate virtually, and international travel disruptions are in full view. Global HIV funding is jeopardized by competing demands, including COVID-19 and now monkeypox, and many scientists have redirected their efforts to these other challenging infections. Still, we expect the 2022 International AIDS Conference to help bring us together and to highlight some very positive stories of continuing progress.

It's always a challenge to guess what we will take away from such a huge and comprehensive conference. We certainly expect to learn of progress in HIV cure research, and in the elusive efforts to create an effective vaccine. Ongoing trials centered on improving PrEP uptake through the application of long-acting oral and injectable drugs will be updated, and we expect to learn the status of the efforts of WHO and UNAIDS to focus epidemic response by the several goal-directed campaigns to increase testing, HIV treatment and PrEP implementation. Less obvious, but equally important, will be the many interactive exchanges of social, behavioral and political scientists with affected persons and communities as they devise implementation strategies.

As always, we are excited to hear of the many developments presented at the conference and know our field will be changed and reinvigorated at the meeting’s conclusion.

For more information:

Paul A. Volberding, MD, is professor emeritus of medicine at the University of California, San Francisco, and Chief Medical Editor of Infectious Disease News.