This article discusses the long-term impact of HIV on the gut and its implications for the health of individuals living with HIV. The gut is a crucial part of the immune system, and HIV specifically targets the gut T-cells, leading to damage to the gut barrier. Even with antiretroviral therapy (ART), the gut T-cells do not fully recover, resulting in a less tight gut barrier. This can lead to microbial translocation, inflammation, and potential health conditions. Ongoing research is being conducted to understand and improve gut health in individuals with HIV.