People who have survived many years with HIV, some from the mid-1980s, are considered long-term survivors.  Key predictors of long-term survival include early diagnosis, engagement and retention in HIV care, and timely initiation of ART (8). 

Specific needs of long-term survivors of HIV include psychological and emotional concerns relating to grief and loss, particularly for gay men. Older gay men with HIV may struggle with issues such as the interruption of their life plans, maintaining good health and managing HIV treatments.  Ageism, homophobia, and stigma can also affect this group (9). Although the HIV population in Australia is diverse, it affects gay men disproportionately, especially those who have lived with the virus long term.  

There is global and Australian literature documenting that lesbian, gay, transgender, and intersex people (LGBTI) experience systemic discrimination within healthcare systems (10).  Now that many require aged-care services, they fear discrimination and a lack of knowledge about their needs at a vulnerable time (11). 

Along with clinical and biological factors, psychosocial and spiritual factors can contribute to long-term survival (12).  Having a hopeful attitude, being an active participant in health care and having excellent relationships with their healthcare team have long been associated with long-term HIV survival (13, 12). Nevertheless, the following concerns can be significant for long-term HIV survivors.