Book excerpt: The first decade of the HIV/AIDS epidemic was defined by young gay men dying and activism. The second decade saw people of colour and women account for the majority of those with HIV, as well as the development of effective drugs and the hope that HIV could become treatable or even curable. In this third decade, HIV has evolved into a chronic manageable disease. Few would have ever thought that there would be large numbers of older adults living with HIV in our lifetimes. Developing a strategy to best sustain the health and quality of life for the ageing population living with HIV requires a rigorous assessment of this group's characteristics and needs. Research on Older Adults with HIV (ROAH), conducted by the AIDS Community Research Initiative of America (ACRIA), is the first step to begin to establish a valid comprehensive knowledge-base of the unique characteristics and needs of this growing population.