Almost one-third of people living with HIV in the U.S., and in New York City, are over 50. It is estimated that by 2015, half of those living with HIV will be over 50. Many older adults with HIV are longtime survivors. However, others are newly diagnosed or newly infected. Among people over 50 new diagnoses increased by 25% from 2006 to 2007. Since 2003, the number of newly-diagnosed women 50 and older has gone up by 40%. Overall, people over 50 made up 15% of newly-diagnosed cases of HIV in 2007. We must insure that policies around prevention, treatment and care proactively address the particular needs of HIV-positive and at risk older adults.