Ensuring Timely Access to Care for People With HIV Infection: A Public Health Imperative

The continuing importance to public health of the HIV epidemic is reflected in the number of HIV-related articles published in the Journal. Our focus on HIV this month reflects the editors' ongoing desire to publish new research and commentary on the key challenges associated with addressing HIV as a public health problem. As the range of articles in this issue suggests, there are few if any areas of public health that have not been affected by the HIV epidemic. Just over 20 years into the epidemic, we have learned much about HIV, how it is transmitted, who is potentially at risk, and how HIV infection might be treated. This progress has been made even as our knowledge base has shifted and expanded. We have learned to define (if not always adopt) sound public health strategies and policies based on the science as we know it. And we have not been afraid to adapt our approaches as our scientific knowledge evolves—for example, attitudes toward early HIV testing and early HIV treatment have changed as our understanding of behavioral and treatment interventions has changed. That said, hubris would be inappropriate. As we begin the third decade of the epidemic, we still have far to go. In some respects, as much as we have learned about HIV, we have not succeeded on some very basic fronts—most important, in the core public health functions of ensuring that people learn their HIV status, reduce their risky behaviors, and have access to new treatments that might prolong life.