The International (HIV) Mycoses Prevention, Research, Implementation, Networks & Training consortium, better known as IMPRINT , is a ground-breaking global health research initiative that is reshaping how we address life-threatening fungal infections among people living with HIV (PLHIV). These infections, particularly cryptococcal meningitis (CM) , continue to cause thousands of deaths every year, especially in sub-Saharan Africa where access to timely diagnostics and antifungal treatments is limited. What Is IMPRINT? Cryptococcal meningitis (CM) alone accounts for approximately 15% of all HIV-related deaths globally , translating to over 112,000 deaths each year , with the vast majority occurring in sub-Saharan Africa. Despite the availability of antiretroviral therapy (ART), CM remains a leading killer of people living with HIV due to late diagnosis, inadequate access to diagnostics and life-saving treatment, and gaps in health system capacity. However, hope lies in the dev...

Globally, the HIV response has seen significant progress. In Botswana, for instance, over 95 per cent of people living with HIV (PLHIV) are aware of their status, receive treatment, and achieve viral suppression. These results reflect sustained investment in public health and strong community engagement. As a result, the country has seen a notable decline in HIV incidence. While this is an encouraging development, it introduces new complexity for HIV prevention researchers. With fewer new infections, widespread access to antiretroviral therapy (ART), and the availability of proven prevention tools like pre-exposure prophylaxis (PrEP), we are faced with a pressing question: How do we design HIV prevention trials in settings where the number of new infections is becoming increasingly low? The Paradox of Success Traditionally, HIV prevention trials have measured the rate of new HIV infections between those who receive an intervention and those who do not. In high-coverage setting...