The introduction of highly active antiretroviral therapy (HAART or ART) in the mid-1990s, has reduced the number of deaths from AIDS, and increased overall survival. People living with HIV (PLWH) are living much longer and the number of older individuals living with HIV is increasing. In 2019, an estimated 45% of Americans living with HIV were aged 55 and older, 27% were aged 60 and older, and 6% were aged 70 and older. 1 Though ART lowered the risks of developing AIDS-defining cancers, including Kaposi's sarcoma and non-Hodgkin lymphoma (NHL), the incidence of non-AIDS-defining cancers (NADCs) rose by more than threefold. 2,3 Clinical epidemiologic research also suggests a higher prevalence of other age-associated comorbidities in PLWH. These include earlier onset cardiovascular disease, bone fractures, osteoporosis, kidney and liver disease, cognitive decline, and frailty. [4][5][6] ART therapy targets several aspects of HIV replication. As these therapies have evolved, ART treatment can be