Because older persons living with HIV are experiencing both age-associated and HIV-related problems, new care models to address this combined burden are necessary. Investigators in San Francisco sought out more first-hand information on needs from patients older than 50 years and their providers at an HIV clinic. They used surveys with 77 patients and 26 providers as well as separate focus groups with 31 older patients and 20 staff members. Transcripts were used to identify frequent themes. Four areas were identified: Expertise in HIV and aging; Focus on important medical conditions as well as other determinants of health, such as marginal housing; Having specialty services nearby the primary care area and; Need to address social isolation. Using this information, a multidisciplinary program was designed and implemented for older adults with HIV. Although this model is currently functioning, there is a need for longer-term evaluation. This experience may be useful to other sites serving this growing population.