Special Issue: Palliative Care in Minority Populations Predictors of End of Life Discussions Among Minority Older Women Living With HIV Infection Rosina Cianelli, MPH, RN, IBCLC, FAAN 1,2 , Natalia Villegas, PhD, MSN, RN, IBCLC 3 , LaToya Lewis-Pierre, Ed.D-CI, MSN, RN 1 , Beatriz Valdes, PhD, RN, CHSE 1 , and Evelyn Iriarte, MSN, RN, BSN 1,2 Abstract Background: Among the 39,782 newly HIV diagnosed individuals in the U.S., 17% were aged 50þ. Although premature aging, morbidity, and mortality are issues for older people living with HIV that threaten their quality of life, less attention has been focused on end of life (EOL) discussions. Objectives: To examine predictors of EOL discussions with significant others, family members, and friends. Methods: Cross-sectional design was used for this study guided by the The Socio Ecological Model (SEM). Sample: 119 Black and 19 Hispanic women aged 50þ living with HIV. Results: Predictors of EOL discussions were education, living with a partner, religiosity, and pain, which were at the individual-intrapersonal level of the SEM. Discussion: Findings from this study have important implications for health policy makers and clinicians because they cast a bright light on the substantial continued effort that is needed to improve EOL discussions. Keywords End of life, Minority, Hispanic women, Black women, HIV, AIDS Introduction The minority groups Black and Hispanics represent 13.4% and 18.3% of the total United States (U.S.) population. 1 However, they constitute 69% of the U.S. population that received a new HIV diagnosis in 2018. 2 Remarkably, human immunodefi- ciency virus (HIV) among minority females is also alarming considering that in 2016 the rate of Black females living with HIV was 17.3 times higher than non-Hispanic white women. For Hispanic females, the rate was 2.5 times higher than non- Hispanic white women. 3 Another group impacted by HIV is people aged 50 years and older. The CDC 4 estimated that this group will account for 71% of the people living with HIV (PLWH) by 2020. Among the 39,782 newly HIV diagnosed individuals, 17% of them were aged 50 years and older, 24% were women, and 60% were minorities (42% Black and 18% Hispanic) 5,6 Despite the advances in the antiretroviral therapy (ART) and the increase in life expectancy, older PLWH have high mortal- ity rates due to the late HIV diagnosis and severe comorbid conditions that also may lead to long-term survival with severe disability or incapacity. 7,8 Comorbidities are more severe in older PLWH, who often develop, cardiovascular, kidney, liver, and neurologic disease related to the antiretroviral therapy (ART) treatment and the aging process. 9-11 In addition, there are a number of somatic symptoms associated with the long- evity of HIV infection itself (or duration of HIV serostatus). These symptoms include fatigue, pain, insomnia, decreased libido/hypogonadism, decreased memory and concentration (HIV-associated neurocognitive disorders), depression, and distorted body image. Former causes of morbidity and mortal- ity have shifted primarily from complications due to immuno- suppression to those related to aging in the general population. 12 Also, HIV produces immunological changes that speed up the aging process or premature aging and older adults are often susceptible to experiencing reduced HIV care for their 1 University of Miami School of Nursing and Health Studies, Coral Gables, FL, USA 2 Pontificia Universidad Catolica de Chile Escuela de Enfermeria, Santiago, Chile 3 University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA Corresponding Author: Rosina Cianelli, PhD, MPH, RN, IBCLC, FAAN, University of Miami School of Nursing and Health Studies, 5030 Brunson Drive, Coral Gables, FL 33146, USA. Email: rcianelli@miami.edu American Journal of Hospice & Palliative Medicine  1-7 ª The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1049909120971826 journals.sagepub.com/home/ajh