Abstract
BACKGROUND AND AIMS: The population of older adults living with HIV (OALHIV) in Nigeria is growing, bringing forth a dual challenge of chronic comorbidities and barriers to adequate healthcare. This narrative review aims to synthesize empirical evidence on multimorbidity, treatment access, and systemic healthcare gaps affecting OALHIV in Nigeria. METHODS: A structured narrative review was conducted using peer-reviewed articles and institutional reports published between 2005 and 2024. Searches were performed across PubMed, Google Scholar, African Journals Online (AJOL), ScienceDirect, and WHO and UNAIDS databases. Eligible studies focused on individuals aged 50 years and older living with HIV in Nigeria and addressed at least one of the following themes: chronic disease burden, healthcare access, mental health, or socioeconomic vulnerabilities. RESULTS: Findings show that multimorbidity is common among OALHIV; yet, HIV programs rarely integrate screening for non-communicable diseases. Gender disparities further shape access: older women often face economic hardship, while older men are more likely to delay care-seeking. Depression and social isolation are frequently reported but rarely addressed within existing care frameworks. Structural barriers such as poverty and limited social protection hinder consistent ART adherence and engagement in care. CONCLUSION: OALHIV in Nigeria face intersecting clinical, economic, and psychosocial burdens that are under-recognized in the current HIV response. There is an urgent need for integrated service delivery models, mental health integration, and sustainable financing strategies. Future research should prioritize longitudinal and qualitative studies on aging with HIV, especially concerning multimorbidity, stigma, and structural inequality.