The advent of highly active antiretroviral therapy means that we now have people living with HIV/AIDS (PLWHA) living longer, many of them surviving into old age. There has been relatively little attention paid to people aging with HIV. This study reports on a group of Australian PLWHA aged 50 years and over. They are compared to younger PLWHA on a range of social dimensions. Older PLWHA were significantly less likely to rate their health and well-being as good or excellent. A significantly larger percentage of older PLWHA reported additional health conditions (47.2% versus 35.5%), of which the most common was cardiovascular disease (12.2% of older PLWHA). There was no significant difference in the percentage of older PLWHA who reported a mental health condition. Younger PLWHA were significantly more likely to have been diagnosed with hepatitis C (15.3% versus 8.1% for older PLWHA). Older PLWHA were markedly less likely to be in contact with services, both those that were HIV related and those that were not. The financial circumstances of older PLWHA were significantly worse than for younger PLWHA, and personal support through a regular sexual relationship was also significantly less. The clinical and community needs of this group of PLWHA are likely to be of increasing concern. The challenges associated with this group will be the consequence both of the effects of long-term therapy, with potentially toxic side effects, and the natural aging process.