Highly active antiretroviral therapy is not sufficient to fully control HIV replication and problems of side effects and escape mutation have emerged. Current prophylactic and therapeutic vaccine strategies appear to be unable to confer full protection. However, given the rapid recent progress made in RNA interference and lentivirus technologies, it may soon be possible to develop effective gene therapies against HIV infection. We describe here the recent progress made in the lentivirus-based HIV-1-targeting RNAi system and the possibility that this system can be used to generate an anti-HIV-1 gene therapy. We speculate that this system would be most useful if it would be used in a coordinated manner with vaccines that can initiate and maintain potent anti-HIV immunity.