This study examined service priorities and needs in a sample of 287 adults with HIV/AIDS from the Pacific Northwest. Sixty-eight of these individuals were age 50 or over. The study found older adults to be less likely than their younger counterparts to have used street drugs or been homeless in the past year. Both populations in this sample received similar care for their HIV disease, including antiretroviral medications. While both populations rated services such as primary medical care, dental care, case management, and the AIDS drug program as important, the older population was significantly more likely to identify and use services such as physical therapy, adult day care, home chore services, and home delivered meals. Service providers must be aware and sensitive to the potential differences in service needs for older clients with HIV/AIDS and recognize the possibility of accessing services from both the HIV and aging networks.