The topic remains socially and clinically taboo. Health providers often avoid discussing sexual behavior with older clients, contributing to delayed HIV diagnoses: in Ukraine, more than one-third of OPWH are diagnosed at a late stage, resulting in mortality rates 3–11 times higher than their HIV-negative peers.

Sexual health and perceptions of “time left” among older people with HIV in Ukraine: implications for HIV care

The study included 30 in-depth interviews and 8 focus group discussions with OPWH, as well as interviews and FGDs with HIV care providers. Participants discussed their experiences of living with HIV, their views on sexuality and relationships, stigma, and communication challenges. 

Researchers identified four core themes:

• The first was the perception of “time left,” where participants believed that while their social and professional lives could continue, their sexual lives were over.
• The second was internalized stigma — seeing oneself as less desirable than HIV-negative peers.
• The third involved anticipated stigma, leading many to consciously withdraw from romantic or sexual relationships to avoid discrimination.
• The fourth theme was the transformative role of successful HIV treatment: achieving viral suppression allowed some OPWH to reengage with intimacy and rediscover a sense of romantic possibility. 

The authors emphasized the need to integrate sexual health into routine HIV care for older adults. Open conversations about the possibility of safe and fulfilling sexual relationships, supported by real-life narratives, can help reduce fear and stigma, and strengthen motivation for treatment.

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The 13th IAS Conference on HIV Science (IAS 2025), organized biennially by the International AIDS Society, took place in Kigali, Rwanda, from July 13 to 17, 2025.