New Yorkers over the age of 50 make up the majority of New Yorkers living with HIV and are estimated to be 70% of the population by 2030. In 2022, 16% of all new HIV diagnoses were among New Yorkers over 50. Long-term survivors also face unique medical and social challenges, including the risk of comorbidities such as heart disease and cancer, as well as higher levels of depression and social isolation due to HIV stigma and loss of community. New York State must fund prevention and education to address the complex medical and social needs of long-term survivors.