Sadlier C, et al. - Performing this cohort study of human immunodeficiency virus (HIV)-positive patients attending an ambulatory HIV care centre in Dublin, Ireland over a 10-year period 2006–2015, researchers measured temporal trends in incidence and risk factors for invasive pneumococcal diseases (IPDs: defined as culture of Streptococcus pneumoniae from blood, cerebrospinal fluid or both). They undertook a nested case–control study (four controls per case) to assess risk factors for IPD. Findings revealed decreased incidence of IPD per 100,000 person-years from 728 (95% CI, 455–1002), to 242 (95% CI, 120–365) to 82 (95% CI, 40–154) in calendar periods 2006–2008, 2009–2012 and 2013–2015, respectively. IPD was noted in correlation with older age, male gender, detectable HIV viral load and non-receipt of the pneumococcal vaccine while injecting drug user (IDU) as risk of acquisition of HIV was of borderline significance. Compared to the general population, HIV-positive individuals remained at higher risk of IPD. They recommend considering pneumococcal vaccine as a priority to ensure optimal protection for HIV-positive patients.