There is limited published research on sexually transmissible infections (STI) among aging HIV populations. The available literature on sexual behaviour and STI among older people with HIV is reviewed here and contrasted with data from older individuals in the general population and from older populations at high risk of HIV. A sizeable minority of older people with HIV continue to engage in higher risk sexual behaviour and thus remain at high risk of STI. There is no clear evidence of a consistent effect of older age on STI rates, clinical presentation or clinical course among HIV-infected populations, although gay men with HIV aged in their 40s or older seem to be at higher risk than younger men of acquiring several STI, including syphilis and lymphogranuloma venereum. STI risks in older people living with HIV need to be regularly assessed. Higher risk sexual behaviour and disproportionately higher rates of STI indicate that regardless of age, a thorough STI assessment should be regularly undertaken for all HIV-positive gay men as part of their routine HIV care.