This review explores the complex relationship between HIV and breast cancer (BC), highlighting the increased risk of BC in people living with HIV (PLWH), earlier onset, and more advanced disease at diagnosis. It examines the molecular mechanisms underlying this association, including immune suppression, chronic inflammation, and gene expression changes. The review also addresses the challenges of managing BC in PLWH, such as drug interactions between antiretroviral therapy (ART) and anticancer agents, and the impact of HIV on cancer outcomes. Epidemiological data show that BC incidence in PLWH varies by region, with higher rates in sub-Saharan Africa. Factors such as age, race, and socioeconomic status influence BC risk and outcomes in PLWH. The review discusses the biological interplay between HIV and BC, including immune system impairment, chronic inflammation, and gene expression alterations. It also highlights the impact of HIV on BC clinical characteristics, such as earlier diagnosis, more advanced stages, and poorer survival outcomes. The review emphasizes the need for further research to understand the molecular basis of the HIV-BC relationship and to improve cancer care for PLWH. It also addresses the challenges of managing BC in PLWH, including drug interactions between ART and anticancer agents, and the importance of personalized treatment strategies. The review concludes that a deeper understanding of the HIV-BC relationship is essential for improving outcomes for individuals affected by both conditions.This review explores the complex relationship between HIV and breast cancer (BC), highlighting the increased risk of BC in people living with HIV (PLWH), earlier onset, and more advanced disease at diagnosis. It examines the molecular mechanisms underlying this association, including immune suppression, chronic inflammation, and gene expression changes. The review also addresses the challenges of managing BC in PLWH, such as drug interactions between antiretroviral therapy (ART) and anticancer agents, and the impact of HIV on cancer outcomes. Epidemiological data show that BC incidence in PLWH varies by region, with higher rates in sub-Saharan Africa. Factors such as age, race, and socioeconomic status influence BC risk and outcomes in PLWH. The review discusses the biological interplay between HIV and BC, including immune system impairment, chronic inflammation, and gene expression alterations. It also highlights the impact of HIV on BC clinical characteristics, such as earlier diagnosis, more advanced stages, and poorer survival outcomes. The review emphasizes the need for further research to understand the molecular basis of the HIV-BC relationship and to improve cancer care for PLWH. It also addresses the challenges of managing BC in PLWH, including drug interactions between ART and anticancer agents, and the importance of personalized treatment strategies. The review concludes that a deeper understanding of the HIV-BC relationship is essential for improving outcomes for individuals affected by both conditions.