Background: The population of people living with HIV (PLWH) who are 50 years of age and older will increase significantly by 2030. Older adults are at an increased risk for malnutrition, but because PLWH experience age-related conditions 10-15 years sooner than those living without HIV, understanding what predicts nutritional risk, what is associated with nutritional risk, and exploring how PLWH (50+) understand and experience their diet and nutritional risk is essential for maintaining quality care for PLWH, especially as they age. Purpose: The purpose of this dissertation was to: (1) identify predictors of nutritional risk, including (1a) common malnutrition biomarkers in an urban, community dwelling sample of PLWH aged 50 and older; (2) examine the relationship between physical and mental health-related quality of life (HRQoL) and nutritional risk in an urban, community dwelling sample of PLWH (50+), to (3) explore how urban, community dwelling, Black/African American PLWH (50+) understand and experience their nutritional risk and the factors that shape that risk, as well as (3a) explore how the COVID-19 pandemic influenced their understanding and risk. Methods: Secondary data analysis using baseline data from A) the Strengthening Therapeutic Resources in Older patients aging with HIV (STRONG) Study, B) the Frailty Study, and C) retrospective medical record data. A total of n = 184 were included in the quantitative sample. Linear regression models were used to identify predictors of nutritional risk and to examine the relationship between HRQoL (physical and mental) and nutritional risk. Prospective qualitative interview data, analyzed using the qualitative descriptive approach, were used to explore how urban, community dwelling, Black/African American PLWH who are 50 years of age and older understand and experience their diet and nutritional risk. Results: Depressive symptomology, not BMI, was positively associated with nutritional risk in PLWH (50+), even after control variables were added to the multivariable regression model. None of the blood biomarkers assessed (total cholesterol, triglycerides, albumin, and vitamin D) were associated with nutritional risk. Both physical and mental HRQoL were associated with nutritional risk in PLWH (50+); however, sex did not modify these relationships. Three themes were developed that describe how Black/African American, urban, community-dwelling, nutritionally at-risk PLWH 50+ understand and experience their diet: 1) control, choices, and influence around consumption, 2) the cycle of physical and emotional health and diet, and 3) compensating for barriers related to eating a healthy diet. Finally, a mixed methods analysis was provided in Chapter 6 that integrates qualitative and quantitative findings in the current dissertation. Conclusions: Research examining PLWH (50+) is important to the field of gerontology as it adds to the general knowledge of the aging through a uniquely stigmatized, younger population with compromised immune systems and complex care needs. Future research should continue to elevate the voices of people with lived experience to enhance their care experience and minimize nutritional risk.