Objective: To identify trends in reported HIV/AIDS cases and annual reporting rates based on surveillance data, and to describe the epidemiological characteristics of HIV/AIDS among older adults in the state of Maranhão.

Methods: This descriptive epidemiological study employed a quantitative approach using secondary data from 2014 to 2023. Data were collected in February 2024 from the HIV/AIDS Notifiable Diseases Information System. The variables included year of diagnosis, age group, sex, race/skin color, education level, and exposure category. Annual rates of reported HIV/AIDS cases were calculated for each year, and temporal trend analysis was performed using Prais–Winsten regression. Epidemiological characteristics were examined using descriptive statistics.

Results: A total of 346 cases were reported. The highest annual reporting rate was recorded in 2016 (7.47 per 100,000 older adults), while the lowest was observed in 2023 (1.49 per 100,000 older adults). Temporal trend analysis indicated a statistically significant decrease in the annual reporting rate of HIV/AIDS cases among older adults in the state (p < 0.05). Most cases occurred among males (67.9%), individuals aged 60–69 years (75.1%), those of mixed race/skin color (64.2%), and heterosexual individuals (83%).

Conclusion: The annual reporting rate of HIV/AIDS cases among older adults declined during the study period. However, the epidemiological characteristics highlight the need to improve awareness and address existing taboos by openly discussing sexuality and promoting all forms of prevention. These efforts are essential to ensuring healthy and safe aging through shared responsibility.