Introduction

With the introduction of effective antiretroviral therapy (ART), people with HIV are living longer than ever before. Currently, more than half of people living with diagnosed HIV in the United States and dependent areas are 50 years old or older. Many of those individuals have been living with HIV for several years, while others were diagnosed with HIV later in their lives. By 2030, those 50 years or older will make up 70% of Americans with diagnosed HIV.

Aging is a privilege that was denied to tens of thousands of LGBTQ+ people diagnosed with HIV prior to introduction of lifesaving ART. Now as generations of people living with HIV and at risk of HIV enter their later years, new challenges emerge.

Healthy aging means a more holistic approach to health rooted in physical, emotional, social, and sexual well-being. The BRIDGE survey provides insight into the unique experiences of LGBTQ+ people as they grow older. This National HIV/AIDS Aging Awareness Day, HRCF recognizes the importance of Healthy Aging, Healthy Relationships, and Healthy Sex.

About the BRIDGE Survey

The Barriers, Resources, and Inequities in Delivery of HIV Care and Engagement (BRIDGE) Survey is a national survey designed to help the HRC Foundation understand what keeps people from accessing HIV prevention, care, and treatment. It examines issues such as stigma, discrimination, policy and funding barriers, insurance, provider availability, and unmet service needs. This analysis focuses on LGBTQ+ people who are 55 years and older, not currently living with HIV and who indicated that HIV prevention, care, or treatment was relevant to them based on their survey responses.

The Biggest Barriers for Older LGBTQ+ People are Concerns about Privacy, Fear of Judgement, and Navigation

In total, 4.9% of respondents 55 and older said there was a time in the past year when they wanted an HIV test but did not get it. The main barriers were concerns about privacy, fear of provider and peer judgement, and not knowing where to go. While access to medications and treatment have extended the life span for people living with HIV none of that matters if someone does not know their HIV status.

The barriers show that access to HIV testing is more than if the test is available. If an older LGBTQ+ person does not feel comfortable or that their privacy will not be protected they are less likely to seek testing and care. Even when connected to care, several older respondents expressed feeling judged or treated differently at their primary care provider or clinic (12%), the ER (11.3%) and urgent care (9%).

Improving Access

Older respondents indicated several policy and practice solutions to improve access to HIV prevention, care or treatment. Top responses include a call for increased funding for HIV clinics and community health centers, a need to reduce out-of-pocket care of HIV testing, PrEP, and treatments, and a call to expand Medicaid and/or other health insurance coverage.

What This Means for National HIV/AIDS and Aging Awareness Day

The AIDS Institute established National HIV/AIDS and Aging Awareness Day (NHAAD) in 2008 as a way of highlighting the growing number of people aging and living with HIV. It is a day to raise awareness about HIV, address stigma and barriers to care, improve the lives of older people with HIV, and encourage those aged 50 or older to get tested and know their status. The BRIDGE Survey results highlight the importance of creating inclusive spaces for older adults who have historically faced stigma and discrimination in healthcare.

Methodology

The BRIDGE Survey was fielded from April 6 to June 1, 2026, to better understand experiences with HIV prevention, care, and treatment. Responses were collected through the HRC Foundation’s Community Insights Panel and partner organization outreach, yielding 5,000 responses and a final analytical sample of 4,689 respondents after quality assurance and data cleaning. This analysis uses a subsample of respondents 55 years and older (n=2080). Reported percentages are weighted using benchmark distributions from the U.S. Census Bureau’s Household Pulse Survey for age, race and ethnicity, educational attainment, Census region, and sexual identity. Full methodology is available here.