More than half of people living with HIV in the United States are now age 50 or older.

Many in this age group carry the trauma of surviving while peers did not, alongside limited financial resources tied to early retirement or disability with the expectation of a shorter life, attenuated social support systems, and the physiological cost of decades of stress. Providers, in turn, are managing an increasingly medically complex HIV population that presents with geriatric needs earlier than the general population, against a backdrop of shrinking organizational resources. Understanding what people aging with HIV need, and what the systems and providers who serve them are working with, is essential to improving operations and the health outcomes of people aging with HIV, both for this generation and for those growing older alongside them.

To this end, HealthHIV fielded the fifth State of Aging with HIV™ Survey in February 2026. The survey revealed an HIV care system that delivers clinical wins. Over 98% of consumers reported being virally suppressed, and nearly 100% are taking antiretrovirals, the highest rates across five waves of the survey. The same data, however, show that the broader clinical reality of aging with HIV, multimorbidity, frailty risk, mental health burden, and the structural conditions of daily life, is not being managed with the same consistency.

This report details the findings from the survey and their implications across five domains: HIV and Geriatric Care, Comorbidities, Behavioral Health, Access and Payment, and Workforce.