HIV is a worldwide public health priority, with major advances being achieved in recent years. Currently, there are the lowest rates of AIDS-related deaths and the highest number of people receiving antiretroviral therapy (ART) in the world. Antiretroviral therapy has increased patients’ life expectancy, and HIV infection has become a chronic disease, with many potential complications, including kidney disease. Before the availability of ART, the most common kidney disease observed in people living with HIV was “HIVAN” (HIV-associated nephropathy), an injury directly associated with the virus. Currently, there is a spectrum of kidney diseases associated with HIV, which is a combination of comorbidities and toxicities of drugs in a population living longer with a chronic viral disease. HIVAN occurs predominantly in people of African descent and is associated with polymorphisms in the apolipoprotein L1 gene (APOL1), and novel potential therapies are being investigated. Kidney transplantation is currently a good option in the treatment of people with HIV and end-stage kidney disease, with excellent outcomes.