This review examines the complex relationship between HIV infection and breast cancer (BC), highlighting the epidemiological, biological, and clinical aspects of this intersection. Despite significant advancements in antiretroviral therapy (ART), the incidence of non-AIDS-defining cancers, including BC, remains a critical concern for people living with HIV (PLWH). The review discusses the altered risk profile, earlier onset, and more advanced disease at diagnosis in HIV-infected individuals. It explores the molecular mechanisms underlying this relationship, such as immunosuppression, chronic inflammation, and gene expression alterations. The complexities of managing BC in the context of HIV, including drug–drug interactions and cross-toxicities, are also addressed. The review underscores the need for improved cancer care in this population, particularly in addressing survival disparities. By identifying gaps in knowledge and areas requiring further research, the review aims to enhance understanding of the epidemiology, molecular basis, and clinical management challenges of HIV-associated breast cancer, contributing to better outcomes for individuals at the intersection of these two conditions.This review examines the complex relationship between HIV infection and breast cancer (BC), highlighting the epidemiological, biological, and clinical aspects of this intersection. Despite significant advancements in antiretroviral therapy (ART), the incidence of non-AIDS-defining cancers, including BC, remains a critical concern for people living with HIV (PLWH). The review discusses the altered risk profile, earlier onset, and more advanced disease at diagnosis in HIV-infected individuals. It explores the molecular mechanisms underlying this relationship, such as immunosuppression, chronic inflammation, and gene expression alterations. The complexities of managing BC in the context of HIV, including drug–drug interactions and cross-toxicities, are also addressed. The review underscores the need for improved cancer care in this population, particularly in addressing survival disparities. By identifying gaps in knowledge and areas requiring further research, the review aims to enhance understanding of the epidemiology, molecular basis, and clinical management challenges of HIV-associated breast cancer, contributing to better outcomes for individuals at the intersection of these two conditions.