Infection by the human immunodeficiency virus (HIV) is increasing among women. After the advent of highly active antiretroviral therapy (HAART), a decrease occurred in the mortality rate, which now seems to have stabilized. One of the consequences of this current situation is that more and more HIV-infected women are now reaching menopause. Therefore, factors often investigated in seronegative women need to be evaluated in middle-aged, HIV-positive women. In midlife, HIV-positive women will experience the onset of menopause, while concomitantly they may also be affected by metabolic complications related to the HIV infection and to HAART. This literature review was therefore carried out to identify studies dealing with conditions related to middle-aged women with HIV with the aim of providing data on age at menopause, menopausal symptoms, reproductive hormones, cognitive function, bone mineral density, cardiovascular disease, and lipid and glucose metabolism in middle-aged women with HIV and discussing these issues. Some of these factors may be aggravated by the HIV infection and by HAART. The prevention and treatment of these conditions in middle-aged, HIV-positive women are discussed in the light of current knowledge.