As World AIDS Day 2025 approaches, this Behind the Paper article reflects on over three decades of data from Uganda’s AIDS Support Organization (TASO). It explores how clinical, nutritional, and social determinants have shaped survival among people living with HIV—transforming what was once a fatal diagnosis into a story of resilience, adaptation, and longevity.

With this year’s World AIDS Day theme, “Ending AIDS through equity, resilience, and dignity,” our team revisits a 36-year journey of progress in HIV care. Our study, Predictors of survival among older adults with HIV in Uganda’s AIDS Support Organization centers of excellence (1987–2023): a retrospective longitudinal study, examines how older persons living with HIV (OPLHIV) in Uganda have survived, aged, and thrived. It is not only a record of scientific and clinical advancement but also a reflection of human endurance, community solidarity, and health system transformation.

Founded in 1987, TASO emerged at a time when HIV was widely regarded as a death sentence. Through counseling, community mobilization, and treatment, TASO built one of Africa’s most resilient HIV care models. Its approach—centered on compassion, empowerment, and continuity—redefined care and reduced stigma. Today, TASO’s Centers of Excellence continue to deliver holistic, person-centered services that embody hope and dignity.

As a demographer and researcher focused on aging, I was struck by the growing number of patients in their sixties and seventies—people who had lived through the earliest and most uncertain years of HIV care. This observation sparked our central question: what predicts long-term survival among older adults living with HIV in Uganda? Using TASO’s extensive data from 1987 to 2023, we analyzed survival trends among adults aged 50 years and above. We examined both clinical and non-clinical factors, including ART adherence, viral load suppression, nutrition, social support, and management of co-morbidities. Beyond statistics, this research captures decades of lived experiences and evolving care models.

Our analysis confirmed that consistent viral load suppression and high ART adherence remain the strongest predictors of long-term survival. Yet, other often-overlooked factors play equally vital roles. Older adults who regularly consumed protein-rich foods, fruits, and vegetables had better health outcomes. Proper nutrition enhances immune recovery, energy, and mental well-being—crucial for healthy aging. Active family involvement and regular psychosocial counseling improved adherence and emotional stability. TASO’s community-based counseling demonstrates that connection is as vital as medicine. However, chronic conditions such as hypertension, diabetes, and tuberculosis reduced survival, underscoring the need for integrated care models that address HIV alongside non-communicable diseases.

As more people live longer with HIV, the global response must adapt. Our findings call for age-sensitive HIV programs that integrate geriatric care, nutrition, and psychosocial support into HIV services. Aging with HIV is now the norm—demanding a shift from focusing solely on survival to promoting healthy and dignified aging. Longevity with HIV is possible, but dignity in aging requires continued commitment to care, inclusion, and research.

This study is a reminder that HIV is not only a medical condition but a human story of perseverance, innovation, and hope. The older adults behind these data embody progress in science and compassion in care. As we mark World AIDS Day 2025, we celebrate their resilience and reaffirm our commitment to ensuring that living longer with HIV also means living well. Our next steps focus on enhancing health-related quality of life among older adults with HIV—through policies, interventions, and research that honor their contributions and uphold their dignity.

About the Author

Christine Atuhairwe, PhD(c), is a researcher, demographer, and public health specialist at Uganda Martyrs University. Her work focuses on health-related quality of life, viral load suppression, and survival among older persons living with HIV. She passionate about care and promoting healthy aging among people with HIV.