The number of adults aged 50 years and over living with diagnosed HIV is on the increase. This increase is not only due to an aging cohort of HIV-infected individuals experiencing better survival rates as a result of effective antiretroviral therapy, but also as a result of greater numbers of diagnoses among this group, many of whom were infected when aged 50 years and older. Describing the unique challenges HIV presents to both older adults living with HIV and relevant health professionals, we raise the profile of HIV among persons aged 50 years and over, and highlight the importance for age-specific research activities in promoting earlier testing and treatment. © 2011 Future Medicine Ltd.