Throughout the history of the AIDS epidemic, successes and breakthroughs in the fight against AIDS have come from the leadership and boldness of key individuals willing to take calculated risks, to think differently about prevention and treatment, and to push public health specialists and government leaders to do the same. In the United States, no city better exemplifies this historical trend and leadership in the fight against HIV than San Francisco. In this session, US leaders will discuss what San Francisco got right and the best parts that can be replicated for similar effect around the world. From the early days of the epidemic, working to ensure treatment was available to those who needed it in the US, to a global push to ensure treatment was accessible and affordable to all who needed it no matter where they live, these have been major milestones in the evolution of our response to the disease. In San Francisco still today, the bold move of offering treatment as prevention to those at high risk, while controversial, has made a big difference in the way we perceive our options in the response. The same leadership and boldness is needed in other parts of the world, where in some regions young women and adolescent girls are vastly more vulnerable to infection.