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INTRODUCTION Unhealthy alcohol use is common among persons with HIV (PWH) [1]. Sub‐Saharan Africa (SSA) is home to 68% of the 34 million PWH worldwide [2] and has the highest [...], : Introduction: Unhealthy alcohol use significantly contributes to viral non‐suppression among persons with HIV (PWH). It is unknown whether brief behavioural interventions to reduce alcohol use can improve viral suppression among PWH with unhealthy alcohol use in sub‐Saharan Africa (SSA). Methods: As part of the SEARCH study (NCT04810650), we conducted an individually randomized trial in Kenya and Uganda of a brief, skills‐based alcohol intervention among PWH with self‐reported unhealthy alcohol use (Alcohol Use Disorders Identification Test–Consumption [AUDIT‐C], prior 3 months, ≥3/female; ≥4/male) and at risk of viral non‐suppression, defined as either recent HIV viral non‐suppression (≥400 copies/ml), missed visits, out of care or new diagnosis. The intervention included baseline and 3‐month in‐person counselling sessions with interim booster phone calls every 3 weeks. The primary outcome was HIV viral suppression ( Results: Between April and September 2021, 401 persons (198 intervention, 203 control) were enrolled from HIV clinics in Uganda (58%) and Kenya (27%) and alcohol‐serving venues in Kenya (15%). At baseline, 60% were virally suppressed. Viral suppression did not differ between arms at 24 weeks: suppression was 83% in intervention and 82% in control arms (RR: 1.01, 95% CI: 0.93–1.1). Among PWH with baseline viral non‐suppression, 24‐week suppression was 73% in intervention and 64% in control arms (RR 1.15, 95% CI: 0.93–1.43). Unhealthy alcohol use declined from 98% at baseline to 73% in intervention and 84% in control arms at 24 weeks (RR: 0.86, 95% CI: 0.79–0.94). Effects on unhealthy alcohol use were stronger among women (RR 0.70, 95% CI: 0.56–0.88) than men (RR 0.93, 95% CI: 0.85–1.01) and among participants with a baseline PEth⩽200 ng/ml (RR 0.68, 95% CI: 0.53–0.87) versus >200 ng/ml (RR 0.97, 95% CI: 0.92–1.02). Conclusions: In a randomized trial of 401 PWH with unhealthy alcohol use and risk for viral non‐suppression, a brief alcohol intervention reduced unhealthy alcohol use but did not affect viral suppression at 24 weeks. Brief alcohol interventions have the potential to improve the health of PWH in SSA by reducing alcohol use, a significant driver of HIV‐associated co‐morbidities.

INTRODUCTION Adolescents and young people living with HIV (AYPLHIV) continue to have the worst health outcomes of all age groups living with HIV [1]. Rates of viral suppression remain lower [...], : Introduction: Achieving sustained HIV viral suppression is a key strategy to optimize the health and wellbeing of those living with HIV. Sub‐optimal adherence to antiretroviral therapy (ART) in adolescents and young people living with HIV (AYPLHIV) in Southern Africa, due to a range of social and contextual factors, including poor mental health, has presented a substantial challenge to meeting targets aimed towards improving treatment outcomes and reducing transmission. With the increasing availability of viral load (VL) testing in Southern Africa, there is an opportunity to better understand the relationship between VL literacy, wellbeing and adherence among adolescents. Methods: We conducted qualitative interviews with 45 AYPLHIV aged 10–24 years in three districts (urban, peri‐urban and rural) in Zimbabwe between March and August 2021. The sample was purposively selected to represent a range of experiences related to HIV status disclosure, gender, marital status and treatment experience. Separate workshops were conducted with 18 healthcare workers (HCWs) and 20 caregivers to better understand existing support mechanisms to AYPLHIV accessing ART. We used thematic analysis to examine adolescent VL literacy, treatment support networks, experiences of clinic interactions, VL testing procedures and barriers to adherence. Results: VL literacy was consistently under‐developed among participants. Comprehension of phrases commonly heard during clinic visits, such as TND (target not detected) and “high” and “low” VL, were better understood by older participants. VL testing was predominantly understood as a clinical procedure that enables HCWs to monitor treatment adherence. Absent throughout the interviews were descriptions of how viral suppression improves health and quality of life, likely fosters wellbeing and enhances self‐esteem, enables participation in education and social activities, and eliminates the risk of onward transmission. Conclusions: It is imperative that we reconsider how routine VL monitoring is communicated to and understood by AYPLHIV. Reframing ART, including VL test results, in terms of the psychosocial benefits that viral suppression can generate is likely to be crucial to motivating AYPLHIV to maintain optimal treatment engagement and develop self‐management approaches as they move into adulthood. Access to accurate information tailored to individual concerns and circumstances can support AYPLHIV to achieve wellbeing.

Introduction NK cells recognize ligands presented on the surface of HIV-1-infected cells, including infection-induced self-proteins (1, 2) and possibly the viral envelope protein (3), as well as Fc regions of [...], The role of NK cells against HIV-1 infections remains to be elucidated in vivo. While humanized mouse models potentially could be used to directly evaluate human NK cell responses during HIV-1 infection, improved functional development of human NK cells in these hosts is needed. Here, we report the humanized MISTRG-6-15 mouse model, in which NK cells were quick to expand and exhibit degranulation, cytotoxicity, and proinflammatory cytokine production in nonlymphoid organs upon HIV-1 infection but had reduced functionality in lymphoid organs. Although HIV-1 infection induced functional impairment of NK cells, antiretroviral therapy reinvigorated NK cells in response to HIV-1 rebound after analytic treatment interruption. Moreover, a broadly neutralizing antibody, PGT121, enhanced NK cell function in vivo, consistent with antibody-dependent cellular cytotoxicity. Monoclonal antibody depletion of NK cells resulted in higher viral loads in multiple nonlymphoid organs. Overall, our results in humanized MISTRG-6-15 mice demonstrated that NK cells provided direct anti- HIV-1 responses in vivo but were limited in their responses in lymphoid organs.

Role of NK cells in HIV infection NK cells are innate immune effectors capable of intrinsically recognizing and clearing virally infected cells through multiple mechanisms. Epidemiological and genetic studies have [...], NK cells are an Important subset of Innate Immune effectors with antiviral activity. However, NK cell development and immune responses in different tissues during acute and chronic HIV infection in vivo have been difficult to study due to the impaired development and function of NK cells in conventional humanized mouse models. In this issue of the JCI, Sangur et al. report on a transgenic MISTRG-6-15 mouse model with human IL-6 and IL-15 knocked into the previously constructed MISTRG mice. The predecessor model was deficient in Rag2 and [gamma] chain ([gamma]c) with knock-in expression of human M-CSF, IL-3, GM-CSF, and TPO, and transgenic expression of human SIRP[alpha]. The researchers studied tissue-specific NK cell immune responses during HIV infection and clearly show that the endogenous human NK cells in the humanized mouse model suppressed HIV-1 replication in vivo. These findings provide insight into harnessing the innate immune response for clinical antiviral therapies.

PE15.01 Transient viral exposures drive humoral responses in HIV-1 post-treatment controllers L.M. Molinos-Albert (1) ; V. Lorin (2) ; V. Monceaux (3) ; A. Essat (4) ; J. Dufloo (5) [...]

INTRODUCTION Resilience, defined as positive adaptation in the context of risk or adversity [1, 2], is instrumental to the quality of life and attainment of goals in young adulthood, particularly [...], : Introduction: Medical challenges, including perinatally acquired HIV (PHIV), can be considered adversity with the potential to compromise individuals? ability to meet societal expectations across the lifespan. Studies suggest that resilience, defined as positive adaptation in the context of adversity, helps individuals overcome challenges and improve their quality of life. Few longitudinal studies have examined resilience in young adults with perinatally acquired HIV (YAPHIV) or perinatal HIV exposure, uninfected (YAPHEU). We examined three young adult milestones, which can affect the life?long quality of life, as markers of resilience: high school graduation, postsecondary education and current employment. Methods: Analyses included YAPHIV and YAPHEU, ages 19?27 years, followed in longitudinal cohort studies: Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol (AMP) (7?17 years) and AMP Up (?18 years). Factors known to influence the attainment of milestones (outcomes) were examined: executive function, cognitive efficiency (working memory and processing speed), behavioural/social?emotional functioning, parent/caregiver mental/physical health and cumulative risk. HIV disease markers for YAPHIV were examined. The most recent AMP assessment was used for each factor; outcomes were measured at AMP Up 1?year follow?up. Separate robust Poisson regression models were used to assess associations of each factor with each outcome; PHIV status was explored as an effect modifier of each association. Results: Participants (N = 315; YAPHIV = 228): 58% female, 67% Black and 27% Hispanic. Compared to YAPHEU, YAPHIV were older and from families with higher median income and fewer symptoms of parent/caregiver mental health/substance use disorders. Proportions of YAPHIV and YAPHEU, respectively, who achieved each milestone were comparable: 82% versus 78% for high school graduation (p = 0.49), 45% versus 51% for postsecondary education (p = 0.35) and 48% versus 54% for current employment (p = 0.32). Higher cognitive efficiency was positively associated with postsecondary education and current employment. Higher executive function, age?appropriate behavioural/social?emotional functioning and lower cumulative risk were associated with academic milestones. Among YAPHIV, positive associations were: higher current CD4 with postsecondary education and lower nadir CD4 with current employment. PHIV status did not modify any association. Conclusions: YAPHIV and YAPHEU demonstrated resilience, attaining at least one young adult milestone. Cognitive, behavioural and social resources to support resilience in childhood and adolescence may provide the foundation for continued achievement throughout adulthood.

Introduction HIV-1 cure is a global health priority. Although an HIV-1 cure is possible, there are multiple challenges that hinder the design of a durable cure (1). Long-lived cellular reservoirs [...], Long-lived HIV-1 reservoirs that persist despite antiretroviral therapy (ART) are a major impediment to a cure for HIV- 1. We examined whether human liver macrophages (LMs), the largest tissue macrophage population, comprise an HIV-1 reservoir. We purified LMs from liver explants and included treatment with a T cell immunotoxin to reduce T cells to 1% or less. LMs were purified from 9 HIV-1-infected persons, 8 of whom were on ART (range 8-140 months). Purified LMs were stimulated ex vivo and supernatants from 6 of 8 LMs from persons on ART transmitted infection. However, HIV-1 propagation from LMs was not sustained except in LMs from 1 person taking ART for less than 1 year. Bulk liver sequences matched LM-derived HIV- 1 in 5 individuals. Additional in vitro experiments undertaken to quantify the decay of HIV-1-infected LMs from 3 healthy controls showed evidence of infection and viral release for prolonged durations (>170 days). Released HIV-1 propagated robustly in target cells, demonstrating that viral outgrowth was observable using our methods. The [t.sub.1/2] of HIV-1-infected LMs ranged from 3.8-55 days. These findings suggest that while HIV-1 persists in LMs during ART, it does so in forms that are inert, suggesting that they are defective or restricted with regard to propagation.

INTRODUCTION A tenacious driver of the higher rates of morbidity and mortality amongst adolescents living with HIV (ALHIV) is suboptimal adherence to HIV treatment [1?4] Although the global target is [...], : Introduction: Low rates of viral suppression among adolescents living with HIV (ALHIV) indicate that more effective support is urgently required at scale. The provision of peer support has generated considerable enthusiasm because it has the potential to ameliorate the complex social and relational challenges which underpin suboptimal adherence. Little is known about the impact on young peer supporters themselves, which is the focus of this paper. Methods: We present qualitative findings from the Zvandiri trial investigating the impact of a peer support intervention on the viral load for beneficiaries (ALHIV, aged 13 to 19 years) in Zimbabwe. The Zvandiri peer supporters aged 18 to 24 years, known as community adolescent treatment supporters (CATS), are themselves living with HIV. Individual in?depth interviews were conducted in late 2018 with 17 CATS exploring their experiences of delivering peer support and their own support needs. Interviews were analysed iteratively using thematic analysis. Results: The CATS reported that being peer supporters improved their own adherence behaviour and contributed to an improved sense of self?worth. The social connections between the CATS were a source of comfort and enabled them to develop skills to manage the challenging aspects of their work. Two substantial challenges were identified. First, their work may reveal their HIV status. Second, managing the emotional labour of this caring work; given how commonly the complexity of the beneficiaries? needs mirrored the circumstances of their own difficult lives. Both challenges were ameliorated by the support the CATS provided to each other and ongoing supervision from the adult mentor. There was variation in whether they felt their roles were appropriately valued through the remuneration they received and within the health system. There was a consensus that their experience meant that they would graduate from being a CATS with transferable skills that could enhance their employability. Conclusions: Their experiences illustrate the advantages and opportunities of being a CATS. To minimize potential harms, it is vital to ensure that they feel valued in their role, which can be demonstrated by the provision of appropriate remuneration, recognition and respect, and that there is continued investment in ongoing support through ongoing training and mentoring.

The main mechanisms that hinder HIV-1 eradication despite effective ART are the existence of long-lived latently-HIV-1-infected resting memory CD4 T cells and/or the existence of residual virus replication that replenishes [...], The mechanisms responsible for the persistence of HIV-1 after many years of suppressive antiretroviral therapy (ART) have been only partially elucidated. Most of the studies investigating HIV-1 persistence have been performed with blood, although it is well known that germinal centers (GCs) within lymph nodes (LNs) serve as primary sites for HIV-1 replication. We sought to identify the memory CD4 T cell populations in blood and LNs that are responsible for the production of replication-competent and infectious HIV-1, as well as for active and persistent virus transcription in ART-treated (for 1.5-14.0 years), aviremic (

Targeting the latent HIV-1 reservoir: challenge for a cure Despite the efficacy of antiretroviral therapy (ART) in suppressing HIV-1 replication, there is still no cure for HIV-1 infection due to [...], While antiretroviral therapy (ART) can reduce HIV-1 to undetectable levels, the virus generally reappears if treatment is stopped. Resurgence of the virus is due to the reactivation of T cells harboring latent integrated provirus, and recent studies indicate that proliferation of these latently infected cells helps maintain the HIV-1 reservoir. In this issue of the JCI, Lee et al. evaluated [CD4.sup.+] T cell subsets to determine whether certain populations are more likely to harbor full-length, replication-competent provirus. The authors identified an enrichment of clonally expanded Th1 cells containing intact HIV-1 proviruses, suggesting that this polarized subset contributes to the persistence of the reservoir. Strategies to target these provirus-harboring cells need to be considered for future therapies aimed toward HIV-1 cure.

PU02.01 Subtle variations in HIV-1 subtype C env sequence features obtained from a slow progressing Indian donor and their association with sensitivity to neutralizing antibodies with distinct epitope specificities S. [...]

P094 Phylodynamics of sexually acquired HCV-3a in HIV coinfected patients in Hong Kong T Kwan (1); B Wong (2); D Chan (1); N Wong (1) and S Lee (1) (1) [...]

P072 A 10-year case series of HHV8-related diseases in an ethnically diverse HIV cohort: is human herpesvirus 8 level a clue to the underlying pathology? A Oliveira (1); N Patel [...]

Introduction Maternal body composition and its changes during pregnancy have an impact on women's health and their birth outcomes. The interaction of HIV/AIDS disease progression and nutrition is well established [...], We describe change in weight, midupper arm circumference (MUAC), arm muscle area (AMA) and arm fat area (AFA) in 1130 pregnant HIV-infected women with CD4 counts > 200 as part of the BAN Study (www. thebanstudy.org), a randomized, controlled clinical trial to evaluate antiretroviral and nutrition interventions to reduce mother-to-child transmission of HIV during breast feeding. In a longitudinal analysis, we found a linear increase in weight with a mean rate of weight gain of 0.27 kgs/week, from baseline (12 to 30 weeks gestation) until the last follow-up visit (32-38 weeks). Analysis of weight gain showed that 17.1% of the intervals between visits resulted in a weight loss. In unadjusted models, MUAC and AMA increased and AFA declined during late pregnancy. Based on multivariable regression analysis, exposure to the famine season resulted in larger losses in AMA [-0.08, 95% CI -0.14, -0.02; p = 0.01] while AFA losses occurred irrespective of season [-0.55, 95%: -0.95, -0.14, p = 0.01]. CD4 was associated with AFA [0.21, 95% CI 0.01, 0.41, p = .04]. Age was positively associated with MUAC and AMA. Wealth was positively associated with MUAC, AFA, and weight. While patterns of anthropometric measures among HIV-infected, pregnant women were found to be similar to those reported for uninfected women in sub-Saharan Africa, effects of the famine season among undernourished, Malawian women are of concern. Strategies to optimize nutrition during pregnancy for these women appear warranted. Keywords HIV * Pregnancy * Malawi * Seasonality * Body composition * MUAC

PU03.01 Generation of HIV-specific CD4 and CD8 T-cell clones for use in HIV viral inhibition assays N. Fernandez; J. Makinde; P. Hayes; L. Black; D. King and J. Gilmour IAVI [...]

OA20.01 L. Romero-Martin (1); M.L Rodriguez de la Concepcion (2); J. Carrillo (2); J. Blanco (2); B. Mothe (3); M. Ruiz-Riol (2); C. Brander (2) and A. Olvera (2) (1) [...], Background: T cell populations showing a particular cytokine polarization may have a key role in inducing and maintaining effective cellular and humoral immunity to HIV. In addition to the commonly assessed Th1 and CTL responses, other T cell profiles involved in the immune response to HIV infection are not well characterized and their contribution to virus control remains unknown. Methods: Cryopreserved PBMCs from HIV-1 controllers (n = 15, median plasma HIV-1 RNA, pVL: 210 copies/mL, median CD4+ T-cell count: 786 cells/[mm.sup.3]) and non-controllers (n = 15, median pVL: 52,435 copies/mL, median CD4+ T-cell count: 406 cells/[mm.sup.3]) were stimulated with 17 peptide pools covering the entire HIV proteome. Effector function profiles of virus-specific T-cells were evaluated by "boosted flow cytometry"; a novel methodology based on labeling cytokines that characterize specific T cell profiles with the same fluorochrome (Th1/Tc1: INFg, IL-2, TNFa; Th2/Tc2: IL-4, IL-5, IL-13; Th17/Tc17: IL-17A, IL-22; Treg: IL-10, TGFb and Tfh/Tfc: IL-4, IL-21). We also evaluated the humoral response to HIV (IgM, IgA and IgG) to identify T-cell profile associated with humoral response. Finally, cellular and humoral responses correlated with respective clinical parameters (pVL, CD4 count). Results: The total magnitudes of HIV-specific CD4+ Tfh and CD8+ responses with a Tc2 or Tfc profiles were significantly higher in HIV controllers. Total Tfh/Tfc (CD4+ and CD8+) responses correlated negatively with pVL. Different polarization profiles were observed for responses targeting different HIV proteins, and overall a broader range of alternative effector functions were seen in cells from HIV controllers (Rev/Vpr/Env-specific Tc2, Pol/Env-specific Tfc and Pol-specific Tfh responses). HIV controllers also showed higher IgG responses to HIV-gp120 while their virus-specific IgM antibodies titers were lower than in HIV non-controllers. IgM titers correlated positively with pVL and negatively with HIV Tfc-specific responses. The frequency of Tfc cells correlated with the gp120-IgG/IgM ratio, supporting a possibly pivota role of those in HIV control and antibody isotype switching. Conclusions: We have identified a subpopulation of CD8+ T-cells with Tfc-like cytokine profile targeting HIV Pol and Env that correlated with pVL and antibody class switching. Further characterization of those Tfc-like cells is needed to confirm their role in natural HIV control.

OA14.02 L. Franchitti; Z. Zhang; M. Statzu; H. Wang; M. Paiardini; G. Silvestri and D. Kulpa Emory University, Department of Pathology and Experimental Medicine, Atlanta, United States https://doi.org/10.1002/jia2.25659 Please Note: [...], Background: Therapeutic strategies to reactivate the latent reservoir to facilitate clearance of HIV-infected cells have had limited success in vivo. Recent studies have demonstrated that the presence of CD8+ T cells may inhibit virus replication during treated HIV/SIV infection; however, the mechanisms responsible for this antiviral effect remain poorly understood. Methods: We used our primary cell based in vitro model of HIV latency to study the CD8+ T cell mediated suppression of HIV expression. To examine the impact of CD8+ T cells on the activity of latency reversing agents (LRA), CD4+ T cells generated in our in vitro latency model were treated with IL-15, the IL-15 superagonist N-803, or TCR stimulated in the presence or absence of activated autologous CD8+ T lymphocytes (1:1 or 1:5 target: effector ratios). To identify the phenotype of CD8+ T lymphocytes with pro-latency activity, we sorted memory and naive subsets based upon CD45RA, CD27 and CCR7 surface expression, followed by co-culture with HIV-infected CD4+ T cells. All assays were monitored for intracellular Gag expression on CD4+ T cells, and the frequency of integrated HIV DNA was determined by qPCR. Results: Treatment with LRA in the presence of activated CD8+ T lymphocytes resulted in a significant suppression of HIV latency reversal. TCR activation induced a high frequency of Gag+ cells in the monoculture (~27%, n = 8), that was reduced 3-fold at 1:1 (p = 0.0002) and 17-fold at 1:5 ratio (p < 0.0001). Treatment with IL-15 or N-803 induced a lower frequency of Gag expression in the monocultures (~4% and 3% respectively), but also showed a significant decrease in latency reversing activity in the presence of CD8+ T cells at a 1:1 (p = 0.0041; 0.005) or 1:5 (p < 0.0001) target: effector ratio. CD45RA-CD27+ CCR7+ CD8+ T cells displayed the highest suppression activity in our assays. Conclusions: Our studies demonstrated a CD8+ lymphocyte mediated suppression of HIV expression in CD4+ T cells capable of maintaining latency in the presence of activation signaling. Understanding the mechanisms by which CD8+ lymphocytes suppress virus transcription and ultimately promote HIV latency in ART-treated HIV-infected individuals may provide critical insight to the design of HIV eradication approaches.

Table 1: Association between clinical and demographical variables and risky alcohol consumption Coef. Std.Err. z p 95% Conf. interval Ethnicity 1.757 0.639 2.75 0.006 0.503?3.011 Sex ?1.811 0.767 ?2.36 0.018 [...], Introduction: The prevalence of risky alcohol consumption, associated factors and its impact on the brain is not well established in clinically stable HIV patients. Materials and Methods: Within the PIVOT neurocognitive sub?study, effectively suppressed HIV?infected adults on either standard cART or ritonavir?boosted PI monotherapy completed the Alcohol Use Disorders Identification Test (AUDIT) designed to detect risky alcohol consumption. They also completed a brief neuropsychological assessment (NPZ 5) composed by five measures. For this cross?sectional analysis, we calculated rates of hazardous (AUDIT=8?15) or harmful (AUDIT=16?19) consumption and likely dependence (AUDIT>20). We explored the association between risky alcohol intakes (AUDIT>8) and clinical/demographical variables, conducting logistic regressions when significant association was found (p Results: Of the 146 included participants, the majority were male (86.3%), white (81.5%) and educated (mean years on formal education=15, SD=3.9). Average age was 47.6 years (SD=8.7), and 36.3% had risky consumption (29.5% hazardous, 6.2% harmful, 0.7% likely dependence). White ethnicity and male sex were positively associated with risky consumption (Table 1). After adjustments, white ethnicity remained significantly associated with risky consumption (1.64 [95% CI 0.34?2.95]; p=0.013). Better cognitive performance was associated with risky alcohol consumption in the univariate analysis (p Conclusions: Despite the substantially high prevalence of risky alcohol consumption, it was not associated with worse adherence, immunological or quality of life measures in this cohort of effectively suppressed patients but prevalence of likely alcohol dependency was extremely low. White patients were more vulnerable to risky consumption. Moreover, positive association between cognitive performance and risky alcohol consumption remained after adjustment. In our study, the association we found between cognitive function and alcohol consumption does not reflect the effect of alcohol dependency on cognition.

Table 1: Adjusted association of age with symptom prevalence among PWH N=3258 Physical symptom distress Depression Anxiety Health?related QoL problem Age (years) % Adjusted OR* (95% CI) % Adjusted OR* [...], Introduction: The evolving HIV epidemic, coupled with advances in HIV treatment, has resulted in an ageing HIV?diagnosed population. It has been suggested that adverse physical and psychological effects of HIV may be higher among older people. However, few studies have examined the effect of older age on well?being for people with HIV. Materials and Methods: The ASTRA study included 3258 HIV?diagnosed individuals (2248 MSM; 373 heterosexual men; 637 women) recruited from eight UK clinics in 2011?12 (64% response rate). Participants completed a questionnaire that included standard inventories on symptoms and health?related quality of life (HrQoL). Associations of age group with: physical symptom distress (reporting significant distress for ?1 of 26 symptoms), depression and anxiety (score ?10 on PHQ?9 and GAD?7, respectively) and HrQoL problem (reporting problems on ?1 of 5 Eurqol?5D domains) were assessed; adjustment was made for gender/sexuality and time with diagnosed HIV. Results: Of all participants, 87% were taking ART, 76% had VL ?50c/mL and 19% had CD4 Conclusions: Physical and psychological symptoms are common among people living with HIV, but the burden of these symptoms is not highest among the older age group. While HrQoL tended to worsen with older age, physical symptom distress did not, and mental health improved. This may reflect greater resilience in older adults, or the potential for ?successful ageing?: maintaining mental health despite age?related health losses.