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An important question is the effect of unmet basic needs, such as food security and stable housing, on persons with HIV. A study to address this question is reported using a cohort of 496 adults with HIV living in Ontario, Canada. Needs were determined by questions, such as: In the last 12 months have you experienced difficulty in buying enough food? and How difficult is it for you to meet monthly housing costs? The outcome variables were derived from the Medical Outcomes Study HIV Health Survey and measured physical health and mental health. About 85% of respondents had one or more unmet basic needs. These unmet needs were associated with poorer physical health and mental health. Specifically, physical health and mental health were lowered more by unmet needs in the oldest age group (50 years plus) when compared to the middle age group (age 35-49). These findings can have clinical implications and indicate the need to address the unmet basic needs in parallel with medical management.