Antiretroviral therapy (ART) has turned HIV into a manageable chronic condition, and people with HIV are now living well into older age. But longevity comes with complexity. Adults aging with HIV face a higher burden of cardiovascular disease, kidney disease, cognitive decline, and metabolic disorders — partly driven by chronic inflammation tied to the virus itself, a phenomenon researchers call "inflammaging." By 2030, an estimated 70%+ of people with HIV in highly developed countries will be aged 50 or older.

New qualitative research from Sweden and the US sheds light on what these patients actually experience. Participants valued specialized HIV clinics as "safe places" offering personalized, stigma-free care — but flagged frustrating gaps in coordination between specialty and primary care. Many struggled to distinguish HIV-related symptoms from normal aging, and some feared cognitive decline could eventually compromise their ability to manage medications independently. Confidentiality concerns, particularly in small communities, sometimes deterred patients from seeking necessary care.

Key Takeaways:

• Clinicians should be trained on mental models of aging with chronic illness to better support shared decision-making
• Proactive screening and comorbidity management should be integrated into HIV care plans early
• Care coordination between specialized HIV clinics and primary care remains a critical gap to address
• Stigma — though improved — has not been eliminated and continues to affect care-seeking behavior

Why it matters: As the HIV-positive population ages, healthcare systems face mounting pressure to deliver holistic, coordinated, and stigma-free care. Closing the gap between specialized HIV care and broader geriatric medicine isn't just good practice — it's becoming a public health imperative.