AIDS at a Crossroads: How Antiretrovirals and Community Transformed the HIV Response chronicles the global HIV response through 2023, and the remarkable progress achieved toward epidemic control through innovation in biomedicine, the resolve of political leadership, and the steadfast commitment of communities on the frontlines of the HIV response. In this sequel to A Decade of HAART: The Development and Global Impact of Highly Active Antiretroviral Therapy (2008), leading voices in HIV medicine and global health chronicle how innovation in biomedicine, political will, and community leadership together transformed the trajectory of the HIV pandemic. This timely volume captures the extraordinary progress toward epidemic control achieved through antiretroviral therapy, pre-exposure prophylaxis, and the validation of treatment as prevention, while candidly assessing the stigma, inequities, and policy failures that persist. Written during the COVID-19 pandemic, the book includes initial insights into the colliding pandemic's shock on health systems and how this novel public health threat tested the resilience of HIV responses everywhere. New political and fiscal shocks in 2025 - precipitated by the Trump administration's HIV and global health policy reversals and funding cuts - now threaten this progress in the United States and beyond. Divided into three sections spanning biomedical innovation, country case studies, and strategies for achieving the goal of ending AIDS as a public health threat, AIDS at a Crossroads offers historical reflection on a public health success yet to be attained and an urgent warning that controlling, eliminating, and ultimately eradicating the HIV pandemic will depend as much on scientific breakthroughs as on sustained political will and community leadership.