Impaired ability to communicate can impact care and quality of life for deaf people aging with HIV, according to a recent small study. The researchers conducted a focus group with three deaf HIV-positive people over age 55 and four caregivers and community organizers. The participants reported challenges with access to care because English is a second language after American Sign Language (ASL). In fact, some deaf people with HIV prefer to communicate via ASL interpreters rather than written English. Limited proficiency in reading English rendered many websites and other written health information inaccessible. And without culturally competent communication, deaf people were less able to advocate for themselves in health care settings. The participants stressed the need for more health care providers who can directly communicate via ASL as well as improved training for ASL interpreters who assist with health care visits. They cited partner support, meditation, exercise and art as factors that improved quality of life.