The public health challenges of the HIV epidemic [editorial]

This theme issue on HIV/AIDS outlines some of the public health challenges of the HIV epidemic. It has been timed to coincide with the XIII International AIDS Conference where it is hoped to contribute to the discussion and debates surrounding these conferences thereby offering a public health voice and perspective to scientific discussions. Over the first 2 decades of the epidemic success and failures in a wide range of public health arenas have been experienced. Some of its success include the implementation of the AIDS surveillance system decrease in the rate of new infections dramatic progress in HIV treatment and a broader understanding of the communities affected by HIV. However this success is countered by failures. In the context of challenges the critical matters identified are: 1) challenges in monitoring; 2) challenges in designing testing and prevention programs; and 3) challenges in ensuring access to care. Other topics that need to be addressed include the economic and social impact of HIV in the US and around the world international issues prevention and service needs of an HIV-infected and HIV-affected population the need to integrate public health issues into the biomedical research agenda public health consequences of stigmatization and models for promoting treatment adherence among persons infected with HIV.