Hearing the medical and emotional journey of Long Term Survivors is key to developing models and strategies that work.  There are biopsychosocial effects of thriving with HIV, Avoidance behaviors from practitioners, depression, substance use, weak social support structure impact the outcome of functional status and quality of care. There is a dire need to better understand and address the experience of Black MSM as they age. The socio-cultural constructs and intersections of HIV stigma, aging and spirituality are compounded by race. We have clinical models that drive higher stand and quality of care that directly impact health outcomes for LTS. Some Models include Mindfulness-based Stress Reduction, Patient centric healthcare service delivery model and Anderson’s Behavioral Model. There are still gaps in service that have been in adequately addressed such as obstacles in adherence, social support, harm reduction and clinical efficacy of social determinants of health.