How HIV Testing Powers Prevention, Treatment and Hope

By Karen Harrington PhD, HCLD (ABB), Head of Scientific Affairs, Diagnostics at Hologic

Unique to HIV is the disproportionate burden of disease in resource constrained countries and the historical response by the U.S. and European governments to provide billions in funding annually for care and treatment. Despite a 39% decline in new HIV infections since 2010, an estimated 1.3 million people acquired HIV in 2024, far exceeding the current target of fewer than 370,000.¹ Knowing one’s status remains the single most powerful tool to stop new infections and ensure that those living with HIV receive lifesaving treatment.

Testing: the first step toward ending HIV

HIV testing is the cornerstone of prevention and the gateway to the care continuum. In the U.S., the Centers for Disease Control and Prevention (CDC) recommends annual opt-out screening for ages 13–64 in healthcare settings and more frequently for key populations.² Those who test negative can explore preventive options such as pre-exposure prophylaxis (PrEP), reducing acquisition risk by over 95% with optimal adherence.³ While those who test positive can begin antiretroviral therapy (ART) immediately, achieving viral suppression that keeps them healthy and prevents transmission. In fact, people who are virally suppressed cannot transmit HIV to their partners, a concept widely known as U = U: undetectable equals untransmittable.⁴ Yet only 76% of people living with HIV in the U.S. received care in 2023, and 67% achieved viral suppression, underscoring gaps in diagnosis and retention.⁵

While innovation has helped testing become faster, easier and more widely available, screening gaps persist, particularly in rural areas, among marginalized populations and in places where stigma still discourages people from seeking care.¹

The link between testing and prevention innovation

Testing does more than diagnose; it connects people to prevention. The last few years have brought exciting breakthroughs in long-acting PrEP, reshaping how we think about HIV prevention and adherence.

Cabotegravir, a long-acting injectable PrEP formulation, is given every two months and has proven more effective than daily oral PrEP in major studies.³ It eliminates the burden of daily pill-taking, which has been a major barrier for many individuals at risk. More recently, lenacapavir, a twice-yearly injectable capsid inhibitor, has emerged as another powerful option⁶, extending protection intervals and improving convenience for people who face structural or social barriers to regular medication.⁷

Both cabotegravir and lenacapavir represent the future of HIV prevention: discreet, durable and empowering. But these options depend on routine and accurate HIV testing. Before anyone can start PrEP — and before each subsequent injection — clinicians must confirm that the individual is and remains HIV-negative. This ensures the medications are used safely and effectively, supporting long-term protection and detecting breakthrough infections should they occur. In this way, HIV testing isn’t just an entry point; it’s the foundation of every prevention advance we have today.

Monitoring: sustaining health and preventing transmission

For people living with HIV, testing doesn’t stop at diagnosis. Ongoing viral load monitoring is essential to assess treatment success and maintain long-term health.8 Regular monitoring confirms that antiretroviral therapy is working to keep the virus suppressed, and by doing so, prevents transmission to others.

Today’s diagnostic technologies allow viral load testing to be faster and more precise than ever. These advances empower clinicians to tailor care, address adherence challenges and reinforce the goal of viral suppression for every person on therapy. The message is simple: testing saves lives, not just once, but repeatedly through continuous engagement in care.⁹

Confronting barriers and building equity

Despite medical progress, social and structural barriers continue to limit access to testing and care. Stigma, fear and misinformation still discourage people from seeking testing. In many communities, disparities in healthcare access, particularly among racial and ethnic minorities, LGBTQ+ individuals, and people in low-income settings, widen the gap between those who can access preventive tools and those who cannot.¹⁰

Public health programs and clinicians play a critical role in changing this narrative. Expanding culturally competent outreach, integrating HIV testing into routine healthcare, and normalizing conversations about sexual health are essential to reducing stigma and increasing uptake. Testing must be framed not as a judgment but as an act of empowerment and self-care.¹¹

Community engagement is essential. Affected populations must be involved in program design, implementation and evaluation. Collaboration with community-based organizations is vital for reaching the most vulnerable and ensuring interventions are both accessible and effective.

The path forward

The 95-95-95 global goal set by UNAIDS aims for 95% of people living with HIV to know their status, 95% of those diagnosed to be on treatment and 95% of those on treatment to achieve viral suppression.¹² Current global estimates for all ages are 87-89-94%.¹³ UNAIDS efforts continue with a focus on promoting quality HIV care in support of achieving the 95-95-95 target and ending the AIDS epidemic by 2030.¹² Achieving these goals will require a sustained focus on testing, innovation and equity. 

Scientific progress continues to give us reason for hope: faster diagnostics, long-acting prevention like cabotegravir and lenacapavir and highly effective antiretroviral therapies that make viral suppression achievable for nearly everyone. Every breakthrough depends on one simple, powerful act — getting tested.

A call to action

At Hologic, we honor those we’ve lost and celebrate how far we’ve come but understand that our work is far from done. Whether you’re a clinician, a public health advocate or someone who simply cares about community health, you have a role to play. Get tested, encourage others to get tested and seek treatment, and support equitable access to care. 

When everyone knows their status and has the tools to act on it, we bring the end of the HIV epidemic within reach.