BACKGROUND: Few reports have focused on renal cell carcinoma (RCC) in the people with HIV(PWH). METHODS: We analyzed patients diagnosed with RCC at our center between January 2011 and June 2024, divided into groups based on their HIV status. Categorical variables were compared using the chi-square test, and continuous variables were analyzed with the t-test. We estimated median and 1-, 3-, and 5-year cancer-specific survival (CSS) using Kaplan-Meier curves and conducted univariate and multivariate Cox analyses to evaluate variables associated with CSS. RESULTS: In total, 144 RCC patients were assigned to either PWH group (n = 48) or PWoH (people without HIV) group (n = 96). Patients in the PWH group were significantly more likely to be male (91.7% vs. 71.8%, p = 0.014), and their median age was 7 years younger than that in the PWoH group (51 vs. 58 years, p <
0.01). Both groups had small-diameter, early-stage, low-grade tumors, with no significant differences in short-term outcomes. Higher tumor stage (>
T1 vs. T1: hazard ratio = 8.621, 95% confidence interval = 3.76-20, p <
0.01) and larger tumor diameter (≥ 7 vs. <
7 cm: hazard ratio = 3.525, 95% confidence interval = 1.697-7.321, p <
0.01) were significantly associated with CSS, whereas the HIV status did not significantly affect long-term survival. CONCLUSIONS: RCC tends to be diagnosed at a younger age in PWH, highlighting the need for earlier RCC screening in this population. The HIV status does not affect postoperative recovery, short-term outcomes, or long-term survival in patients with RCC.