On Sept. 18, National HIV/AIDS and Aging Awareness Day, we pause to honor the resilience of older adults who are aging with HIV—and to confront what remains undone in care, policy and public awareness.
More than half of people living with HIV in the United States are older than age 50. By 2030, that number is expected to grow to nearly 70%. This is not a small segment of our community—it is a generation that fought through the earliest, most devastating years of the epidemic who now face the everyday realities of growing older while managing a lifelong chronic condition.
Yet too often, they remain invisible. Older adults with HIV are left out of aging policy discussions and overlooked in HIV funding priorities. They face stigma, not only for their HIV status, but also for their age. They navigate systems that were never designed for their realities: fragmented care between HIV specialists and geriatricians, housing programs that don’t account for both aging and HIV, and service providers untrained to offer trauma-informed, stigma-free support.
This year’s U.S. Conference on HIV/AIDS (USCHA 2025), with its theme “Aging with HIV,” spotlighted these issues. Attending the conference on behalf of ASA as part of our partnership with the Gilead HIV Age Positively-sponsored Center of Excellence for Healthy Aging with HIV, led by Ribbon, I gleaned several key takeaways that must shape our work moving forward.
Key Takeaways from USCHA 2025
- Older Adults with HIV Are Finally Center Stage
USCHA 2025 elevated older people with HIV not just as beneficiaries of programs, but as leaders, storytellers and experts in their own lived experience. Workshops, plenaries and institutes featured long-term survivors, the pre- and post-protease inhibitor generations, “dandelions” (those born with HIV), and their caregivers and champions. All emphasized that aging with HIV is not a homogeneous experience. - Clusters of Need Around Comorbidities, Behavioral Health and Systems Gaps
USCHA sessions underscored that aging with HIV means more than managing the virus. Attendees heard about mental health burdens (anxiety, depression, grief, trauma), neurocognitive decline, increased risk of cardiovascular disease, bone and kidney disease, obesity and other chronic conditions emerging earlier or more severely among people with HIV. There is a necessity for integrated systems of care that knit together HIV specialists, geriatric care, mental health and primary care. - Policy, Legal and Structural Barriers Still Constrain Well-Being
Political determinants of health—funding allocations, laws, policy enforcement—are not abstract concerns; they deeply affect outcomes: access to housing, social supports, care navigation, social connection and everyday survival. USCHA revealed gaps in criminalization laws, ageism in policy, and uneven investment in programs tailored for older adults with HIV, especially those who are women, transgender, or from communities of color. - The Power of Community, Voice and Representation
As USCHA illustrated, when people aging with HIV are centered in designing and delivering programs, outcomes improve. Peer support, storytelling, intergenerational conversations, and models led by people with lived experience are not “nice add-ons”—they are central. Visibility—being “seen and heard”—matters, especially for those who came through the earliest years of the epidemic or who have lived with HIV since birth. - Opportunities for Innovation
USCHA showcased emerging models and areas advocates in the aging-with-HIV space must lean into:- Long-acting injectable therapies and alternative antiretroviral therapy (ART) delivery for older adults.
- Expanded HIV prevention and care via pharmacies, telehealth, mobile clinics, senior centers, and other community-based settings beyond standard medical centers.
- Holistic wellness models that address physical and emotional intimacy, stigma, identity, intersectionality, caregiving and end-of-life care.
How Aging Networks Can Show Up: A Call to Action
From the insights gained at USCHA 2025, to truly honor older adults aging with HIV, we must:
- Integrate aging and HIV care in policy, funding and practice. This means ensuring geriatric competencies in HIV treatment settings and HIV-aware practices in aging services to ensure older adults are not bounced between systems.
- Advance equity: ensure that older adults with HIV—disproportionately Black, Brown, and LGBTQ+—are fully included in the nation’s vision for healthy longevity.
- Confront stigma and ageism explicitly in both the HIV and aging sectors: in clinical guidelines, in social services and in public messaging. This also requires addressing the racism, homophobia, transphobia and HIV-related stigma that continue to compound health disparities.
- Center lived experience in program design, evaluation, and leadership roles. Elevate the voices of older adults aging with HIV as co-designers of programs and policy solutions.
- Mobilize policy change: ensure older adults living with HIV are included in all relevant legislation (e.g., housing, health equity, aging services, caregiving), push for adequate funding in aging-HIV programs, and support legal reforms (e.g., around criminalization, rights protections, access to long-term care).
- Harness innovations: adopt new modes of care delivery (telehealth, pharmacies, community-based), expand wellness and quality of life beyond viral suppression, including pleasure, mental health, mobility and autonomy.
The good news is that we know what works. When aging services, health systems and community-based organizations collaborate, older adults with HIV can thrive. When we invest in culturally responsive training for providers, stigma decreases, and health outcomes improve. When policymakers strengthen the Older Americans Act, Medicare, Medicaid and the Ryan White HIV/AIDS Program with older adults aging with HIV in mind, we can ensure that HIV does not mean isolation, poverty or shortened lives.
Aging with HIV is not just a medical matter—it’s about justice, choice and community. At the American Society on Aging, we believe that every person deserves to age with health, dignity and belonging. On this National HIV/AIDS and Aging Awareness Day, ASA reaffirms our commitment to building systems that see, serve, and celebrate older adults with HIV—not as an afterthought, but as central to the American story of resilience and longevity.
To learn more about ASA’s work at the intersection of HIV+Aging, we have a website devoted to our initiative with Gilead Sciences to help professionals in aging to better support and engage with older adults aging with HIV. You can listen to the Beyond Generations podcasts in the Aging with HIV: Navigating the Future series, and read Generations Today articles in the Aging and Thriving with HIV issue.
Patrice L. Dickerson, PhD, is ASA’s Senior Equity Strategy Director.
Photo illustration: Patrice L. Dickerson
