More than 1.1 million individuals in the United States live with human immunodeficiency virus (HIV) infection.1 Since the mid-1990s, much of the clinical, behavioral, and psychosocial research has rightly focused on how to most effectively use combination antiretroviral therapy, improve adherence to medications, and address the short-term complexities of caring for this population. Success on these fronts has led to improvements in survival and quality of life. Life expectancies for patients newly diagnosed with HIV infection increased from 10.5 to 22.5 years from 1996 to 2005.2 The reality of patients living with HIV infection for decades will require physicians and the health care system to confront 4 critical issues.
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