A generation of people who survived the worst years of the HIV epidemic are now growing old with the virus, and the medical systems built to keep them alive have not yet learned how to help them age well. Researchers from Johns Hopkins and Yale, writing in Lancet HIV, argue that antiretroviral therapy — though a triumph of modern medicine — was never designed to address the full arc of a human life. As nearly a third of people living with HIV are already over 50, and half will be by 2040, the question before health systems is no longer only how to suppress a virus, but how to honor the complex