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Older adults living with HIV in Spain have suffered the impact of many risk factors. This study aims to describe the biopsychosocial characteristics of the first generation of people living with HIV who have grown old in Spain. A digital questionnaire of 68 items was distributed by a non-profit community organization (gTt-VIH). Those living with HIV, being over 45 years old, and having permanent residency in Spain were included. The questionnaire covered: demographics; health condition; economic situation; health and social care; welfare and future perspectives. A total of 408 people completed the questionnaire. Most of the participants identified themselves as men (77%). 52.6% of respondents defined themselves as gay men. Mean age was almost 53 years (range: 45-78 years). The most prevalent comorbidities were hypertension, elevated lipid levels, and bone and joint problems. Being diagnosed before 1997 was associated with a worse state of health and more comorbidities (p<0,0001). Having a low educational level was related to mobility problems (p=0.038), kidney problems (p=0.015), and depression (p=0.0001). Suffering shame or suffering discrimination were related to a worse state of health (p=0.014). The study has identified several risk factors of vulnerability in older people with HIV in Spain such as low income, comorbidities, loneliness, self-esteem problems and an absence of services that meet their specific needs.