Millions are exposed to the human immunodeficiency virus type 1 (HIV-1) every year, but not all acquire the virus, suggesting a potential role for host genetics in the moderation of HIV-1 acquisition. Here, we analyzed summary statistics from the largest genome-wide association study of HIV-1 acquisition todate, consisting of 6,334 infected patients and 7,247 population controls, to advance our understanding of the genetic mechanisms implicated in this trait. We found that HIV-1 acquisition is polygenic and heritable, with SNP heritability estimates explaining 28-42% of the variance in this trait at a population level. Genetic correlations alongside UK Biobank data revealed associations with smoking, prospective memory and socioeconomic traits. Gene-level enrichment analysis identified EF-hand calcium binding domain 14 as a novel susceptibility gene for HIV-1 acquisition. We also observed that susceptibility variants for HIV-1 acquisition were significantly enriched for genes expressed in T-cells, but also in striatal and hippocampal neurons. Finally, we tested how polygenic risk scores for HIV-1 acquisition influence blood levels of 35 inflammatory markers in 406 HIV-1-negative individuals. We found that higher genetic risk for HIV-1 acquisition was associated with lower levels of C-C motif chemokine ligand 17. Our findings corroborate a complex model for HIV-1 acquisition, whereby susceptibility is partly heritable and moderated by specific behavioral, cellular and immunological parameters.Around 38 million people currently live with the human immunodeficiency virus type 1 (HIV-1) worldwide 1 , and millions more are exposed to potential infection every year through sexual contact, vertical transmission, or via the parenteral route 2,3 . First-line prevention strategies against acquisition comprise of the use of condoms and pre-exposure prophylaxis (PrEP), or abstinence from drugs or sex 4 . However, epidemiological studies have identified varying degrees of susceptibility to HIV-1, suggesting that host genetics may play a role in moderating acquisition, which could be explored in the context of preventive strategies. For example, studies conducted prior to the development of antiretroviral therapy observed that less than a third of babies born from HIV-1-positive mothers acquire HIV-1 5 and, similarly, that a proportion of highly exposed individuals are resistant to infection 6 . Supporting this hypothesis, homozygosity of the Δ32 mutation of the C-C chemokine receptor type 5 (CCR5) gene has been shown to protect against HIV-1 infection 7-9 , as the encoded protein is a co-receptor needed for viral entry. However, it remains unknown whether common genetic risk factors are also involved in host susceptibility to acquisition.HIV-1 acquisition is a complex phenotype that consists of behavioral risk parameters and biological factors moderating viral entry and replication. A better understanding of both behavioral and biological factors influencing acquisition has the potential to improve our basic comprehension of ...