Background: With the widespread use of antiretroviral therapy (ART), people living with HIV (PLHIV) are living longer, resulting in an increasing proportion of individuals aged ≥50 years. This aging population is at a higher risk of developing non-communicable diseases and multiple co-morbidities.

Objective: To assess the prevalence of co-morbidities and their association with demographic, clinical, and treatment-related factors among PLHIV aged ≥50 years.

Methods: This observational cross-sectional study included 500 HIV-positive patients aged ≥50 years attending a tertiary care ART centre. Data on demographic characteristics, clinical profile, laboratory parameters, and treatment history were collected and analyzed using appropriate statistical methods.

Results and Discussion: Diabetes mellitus and hypertension were the most prevalent co-morbidities. Females showed a higher prevalence of diabetes and ischemic heart disease, while males had higher rates of tuberculosis, dyslipidaemia, and renal dysfunction. Males also demonstrated poorer glycemic control, whereas females showed better treatment uptake and adherence. Longer duration of HIV infection and ART exposure was significantly associated with an increased burden of co-morbidities.