Purpose of review The evolving epidemiology of people living with HIV (PLWH) shows growing trends towards age-related conditions and diseases. As antiretroviral therapies (ART) have improved, AIDS-related cancers have declined but non-AIDS-related cancers are on the rise. Despite advances in HIV care, there continues to be significant health outcome disparities between PLWH with cancer compared to the general population. This literature review aims to highlight evidence on healthcare and biological risk factors, such as screening rates, age at diagnosis, stage at diagnosis, ART treatment, and cancer treatment that could be contributing to disparities in cancer outcomes. Recent findings Engagement in HIV care with early initiation and continuous adherence to ART impacts diagnosis and progression of cancer and cancer type, morbidity, and mortality. Unfortunately, early cancer detection may still not reduce the adverse cancer outcomes among PLWH since receipt of any cancer treatment and guideline-concordant cancer treatment are frequently lower among PLWH than the general population. Integrated, multidisciplinary clinics for PLWH and cancer, as described in this review, may offer one way to meet the changing needs of this population. Other strategies that can help improve diagnosis, treatment, and prognosis of cancer among the 1.2 million PLWH in the USA are imperative.