BACKGROUND: Advanced antiretroviral treatment has led to a growing population of older persons with HIV. To understand the characteristics of persons aging with HIV, this analysis examines epidemiological profiles of persons with diagnosed HIV through 2021 aged 50 years and older in New York State. METHODS: Persons diagnosed with HIV and reported to the NYS HIV registry by December 31, 2021, were included in the analysis. Characteristics of persons aged 50 years and older were compared with persons younger than 50 years. RESULTS: Persons diagnosed with HIV and aged 50 years and older more often reported heterosexual transmission risk and were more often females than individuals diagnosed with HIV younger than 50 years. Among new diagnoses in 2021, persons aged 50 years and older were more likely to have a stage 3 HIV diagnosis. By the end of 2021, 57% of persons living with diagnosed HIV were aged 50 years and older. There was an upward trend of deaths with cardiovascular disease as an underlying cause of death among persons aged 50 years and older. CONCLUSIONS: More females diagnosed with HIV and a higher percentage of persons who reported heterosexual transmission risk among persons aged 50 years and older suggest a need for enhanced clinician education and sexual health discussions with this adult population. A greater rate of stage 3 HIV diagnoses in persons aged 50 years and older emphasizes the need for specialized HIV testing and treatment, care for comorbidities, and social supports for this aging population.