<p>Healthy aging is an important area of research across many populations, but less work has focused on this area among sexual and gender diverse individuals relative to the general population. On the whole, it is known that as the U.S. population ages, increasing attention is needed to understand the intersections between aging, health, and wellbeing. One area of consideration to address in regard to healthy aging is that of HIV prevention, in particular, pre-exposure prophylaxis (PrEP) use. For the current study we assessed these factors in a cross-sectional survey designed to assess disease status and related risk factors among a sample of individuals ≥ 50&#xa0;years of age (<i>N</i> = 794, <i>M</i>_age = 58.5, range = 50–88) who resided in a metropolitan area in Ohio, USA. Results demonstrated that as overall age increased, general aging concerns decreased. Although HIV status was not related to general aging concerns, in additional models, lifetime PrEP use and six-month PrEP use were both related to greater aging concerns. When evaluating sexual orientation-specific aging concerns, we noted the opposite direction in terms of its relationship with age; as these concerns increased so did age. Further, cisgender women, transgender women, transgender men, and those identifying with a different identity each reported greater sexual orientation related aging concerns compared with cisgender men. Based on the current findings, additional research is needed to more fully understand aging related concerns for older individuals who identify as sexual orientation diverse.</p>