The HIV/AIDS epidemic continues to grow relentlessly. Traditional prevention efforts have been only partially able to curb the growth of the epidemic. Neither a cure nor a fully protective vaccine are available or likely within the foreseeable future. In contrast, antiretroviral therapy has dramatically changed the prognosis of HIV/AIDS. New evidence has clearly demonstrated that in addition to decreasing HIV- and AIDS-related morbidity and mortality, HIV treatment can be remarkably effective in decreasing HIV transmission. At the same time, there has been an increased recognition of the inflammatory consequences of HIV infection, which has led to the recommendation of earlier initiation of HIV treatment in recent therapeutic guidelines. Therefore, a unique opportunity has emerged to simultaneously maximize the individual benefit of HIV therapy with a consequent secondary prevention benefit, as a result of the aggressive roll out of HIV therapy. However, over the last decade, there has been an increasing convergence of the HIV and substance-use epidemics. It is clear that the control of HIV will only be feasible with the implementation of a comprehensive combination therapy approach that optimizes HIV and addiction outcomes in this particularly hard-to-reach population. This symposium will discuss the current understanding of the optimal combined management of addiction and HIV infection as a means to curb HIV/AIDS morbidity and mortality as well as HIV transmission.