ART is not curative meaning that a young adult who acquires HIV will need to take expensive and potentially toxic drugs for several decades—a daunting task for both the individual and the health-care system. In this Review, we argue that although AIDS as a syndrome will diminish in frequency in people identifi ed early and properly treated, solutions to three seemingly disparate issues—HIV-associated infl am mation, an overburdened health-care system, and HIV persistence— are needed to further trans form HIV disease.