Positive HIV status may be associated with an increased risk of complications and less favorable outcomes following total joint arthroplasty (TJA). Emerging evidence suggests that patients living with HIV may experience higher rates of postoperative complications, potentially related to immune dysfunction, comorbidities, and differences in overall health status. Despite advances in antiretroviral therapy that have improved life expectancy and surgical eligibility, these findings highlight the need for careful perioperative assessment and optimization in this population. Individualized risk stratification and coordinated multidisciplinary care may help mitigate complications and support successful outcomes. The results underscore the importance of considering underlying medical conditions when planning arthroplasty procedures.