Petersen KJ, Metcalf N, Cooley S, et al. - Persons with HIV (PWH) are reported to have altered brain structure and function, so researchers sought to understand potential interactions between HIV and aging by comparing MRI biomarkers between PWH with undetectable viral load (UVL; ≤ 50 genomic copies/ml; n = 230), PWH with detectable viral load (DVL; > 50 copies/ml; n = 93), and HIV uninfected (HIV-) controls (n = 206). Age and current VL (viral load) were identified as influencing cerebral blood flow (CBF), and medication adherence correlated with improved CBF. Structural aging was identified to be an indicator of cognitive function and was reflective of serostatus rather than current VL. Older PWH with DVL had lower CBF vs PWH with UVL. compared to HIV- controls, structurally predicted brain aging was accelerated in PWH, regardless of VL. Compared to HIV- controls, PWH overall had impaired learning, executive function, psychomotor speed, and language. Structural brain aging was correlated with reduced psychomotor speed.