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Older PLHIV who use drugs have an increased risk for comorbidities, and managing multiple health conditions is a growing concern among this population. However, in\u2010depth understandings of the lived realities and complexities of living with HIV alongside comorbidities among older PLHIV who use drugs remain limited. We sought to explore how older PLHIV who use drugs manage their comorbid conditions in a setting with universal ART access.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 2019 and March 2020, semi\u2010structured, in\u2010depth interviews were conducted in Vancouver, Canada with 42 older PLHIV who use drugs and were living with at least one comorbidity. All participants were currently on ART, and had initiated treatment at least 2 years prior to the interviews. Data were analysed using inductive and deductive approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Several themes were identified through this analysis. First, comorbidities were perceived as more urgent health concerns and prioritized over HIV. Second, stigma and discrimination hindered access to care for comorbidities. Third, the concurrent management of HIV and comorbidities was often challenging due to unmanaged or poorly managed comorbidities. Fourth, the potential impact of ART on the development of comorbidities was a source of concern and frustration. Finally, integrated treatment approaches facilitated engagement with HIV and comorbidities care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings underscore the need for HIV care to shift from a primary focus on managing HIV to an integrated, patient\u2010centred approach that addresses both HIV and non\u2010HIV\u2010related health needs, as well as an equitable and non\u2010judgemental delivery of such care for an ageing population of PLHIV who use drugs.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25785","type":"journal-article","created":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T13:24:28Z","timestamp":1634304268000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["\u201cIt's a burden, it's a nuisance. I wish I didn't have these other ailments\u201d: a qualitative exploration of comorbidities management among older people living with HIV who use drugs in Vancouver, British Columbia"],"prefix":"10.1002","volume":"24","author":[{"given":"Koharu Loulou","family":"Chayama","sequence":"first","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver British Columbia Canada"},{"name":"Department of Medicine University of British Columbia  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara","family":"Ng","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Will","family":"Small","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use  Vancouver British Columbia Canada"},{"name":"Faculty of Health Sciences Simon Fraser University  Burnaby British Columbia 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