Medication management abilities are reduced in older persons living with HIV compared with healthy older HIV- controls.

Although combination antiretroviral therapy (cART) has simplified over the past decade, polypharmacy is increasing for older people living with HIV (PLWH) due to the emergence of multiple health comorbidities. This study examined predictors of, and relationships between, objective (Medication Management Test-Revised (MMT-R)) and self-reported medication management ability in older (≥ 50 years) PLWH (n = 146) compared with HIV-uninfected (HIV-) individuals (n = 60). PLWH scored worse on the MMT-R and had a higher pill burden compared with HIV- individuals. MMT-R failure was predicted by HIV status, race, reading level, and worse executive functioning, as well as history of Hepatitis C and detectable viral load in PLWH. Self-reported ability to manage medications did not relate to MMT-R score. Older PLWH may not self-describe concerns regarding their ability to manage complex medication regimens. Our results emphasize the need for objective measurements of medication management ability.