Outline: Strategies to reduce HIV transmission can radically reduce HIV transmission, including pre-exposure prophylaxis (PrEP), with the use of one daily pill. Clinical trials have demonstrated its efficacy in reducing HIV transmission from 92-96% for people at the highest risk for HIV acquisition. Objectives AND COMPONENT PARTS: We propose to discuss how the epidemiological profile of HIV/AIDS in the South and in the North, as well as the country responses and new prevention technologies adopted by countries such as Brazil, the USA, Spain, and Portugal, taking into consideration that the epidemic was driven by different key population and under extremely disparate political, social and cultural conditions in the four contrasting countries. Key Questions: 1- While access to PrEP has improved since its regulatory approval in 2012, access for populations at the highest risk for HIV acquisition is suboptimal and uneven. 2-While these factors vary by country and population, global trends suggest that disparities in access to PrEP and retention in PrEP care, and access to other HIV prevention strategies can be observed in many different global settings. 3- We will discuss several upper and middle-income countries’ efforts to eliminate HIV transmission by expanding access to PrEP, other HIV prevention strategies, and the epidemiological and health system challenges in a variety of different contexts. This includes efforts to eliminate HIV by expanding access to prevention measures in the United States Deep South among African Americans; through Brazil, Portugal, and Spain HIV/AIDS Programs of the National Health System of these countries. We present several programs that have successfully expanded access to PrEP and other HIV prevention strategies among populations at high risk for HIV acquisition. 4- Participants will learn about comparative health systems as well as trends in scaling up PrEP and other prevention method for vulnerable populations in real-world settings outside of clinical trials. 5- The response to the HIV/AIDS epidemic indicates the stabilization of the incidence of cases in some regions of the country and in some populations. However, there are regional inequalities in epidemic surveillance indicators and a worrying increasing trend among adolescents and youth. 6- People living with HIV/AIDS face challenges in maintaining good health, including those related to economic well-being and ongoing health needs. 7- Discuss the countries response to HIV/AIDS and the goal of EHE (ending the HIV epidemic), based on the various innovative prevention, treatment, and care strategies, and the challenges of taking into account the issues of social determinants, inequalities, discrimination, and stigma.