The older person with HIV spends time and effort with their medical team to optimize use of ART to achieve sustained viral load suppression. But as one ages the management of age-associated illnesses (multimorbidity) requires different health care approaches. The patient needs to be aware of geriatric care principles that result in optimal health outcomes and sustained function as well as an awareness of the consequences of taking too many pills (polypharmacy). In addition, an emphasis needs to be placed on the importance of caregiving, as well as taking personal responsibility for medication management, avoiding falls, optimizing nutrition, monitoring needed immunizations and engagement in exercise programs. A knowledgeable patient interacting with care providers can achieve the best health outcomes possible.