Although highly active antiretroviral therapy suppresses HIV replication resulting in extraordinary clinical benefits, toxicity, adherence difficulties, and the monetary cost of medications limit the long-term effectiveness and availability of therapy for many HIV-infected individuals. Strategies to interrupt therapy have been proposed as a means to enhance the sustainability of antiretroviral treatment. Widely different approaches with varied patient populations, theoretical concepts, and clinical designs are frequently lumped together as "structured treatment interruptions." This review summarizes the approaches and risks of treatment interruptions in HIV infection. Currently, none of these strategies can be recommended in standard clinical practice.