The present of aging with HIV: sociodemographic, psychosocial, and health-related differences between people living with HIV and people without HIV in an aging population in Houston, Texas

With the success of antiretroviral therapy (ART), people living with HIV (PLWH) are increasingly aging into older adulthood, where disparities in physical and mental health persist relative to those living without HIV. While correlates of aging with HIV are well described, fewer studies directly compare PLWH with HIV-negative peers from the same clinical setting. This cross-sectional study examined sociodemographic, psychosocial, and health-related differences between PLWH (n = 132) and individuals without HIV (n = 142) aged ≥50 years who were receiving care at a single academic general medicine practice in Houston, Texas. Data collected prospectively (July 2024-August 2025) included demographics, lifestyle factors, sexual behaviors, frailty (FRAIL scale), depression (PHQ-9), anxiety (GAD-7), self-reported happiness, and anthropometrics. Compared with those without HIV, PLWH were younger (median 60 vs 66 years, p < .001), more likely to be male (75.0% vs 30.3%, p < .001), identify as Black (53.0% vs 35.2%, p = .020), and identify as homosexual (55.3% vs 9.9%, p < .001). PLWH also had higher waist-to-hip ratios, greater frailty prevalence, higher depression scores, and lower happiness, with no differences in anxiety. These findings underscore the need for integrated, multidisciplinary care models addressing frailty and mental health.