A number of presentations at the 15th Conference on Retroviruses and Opportunistic Infections focused on approaches to identify HIV-infected persons for early referral to treatment and prevention. This year's conference also highlighted the challenges we face in developing effective biomedical preventions, with reports on the failure of a candidate HIV vaccine and chronic herpes simplex virus type 2 suppression to prevent HIV acquisition, and the failure of male circumcision for HIV-seropositive men to prevent HIV transmission to their uninfected female partners. On the other hand, there were presentations on progress being made in animal models of microbicides and preexposure prophylaxis and on prevention of HIV transmission through breastfeeding. Several interesting presentations addressed the need to move beyond individual-level interventions into those that target sexual partnerships, communities, and policy changes, as these larger factors are driving the HIV epidemic in the United States and globally.