Globally, aging populations and older persons living with HIV (OPLWH) are emerging socioeconomic and health care concerns. Aging adults living in rural communities have less access to and lower utilization of health care services; they rely heavily on available peer and family networks. Although social networks have been linked to positive mental and physical health outcomes, there is a lack of understanding about social networks in rural-dwelling OPLWH. The purpose of this integrative literature review was to compare emerging themes in the social network components of rural versus urban-dwelling OPLWH and network benefits and barriers. Overarching themes include: limited and/or fragile networks, social inclusion versus social isolation, social capital, and health outcomes. Results demonstrate an overall lack of rural-focused research on OPLWH and a universal lack of informal and formal networks due to isolation, lack of health care services, and omnipresent HIV stigma.