Background: Older adults in Botswana have been shown to be sexually active and engage in risky sexual activities that make them vulnerable to HIV infection. In order to implement meaningful interventions to address older adults’ HIV and AIDS concerns it is important to understand how much knowledge they have concerning HIV and AIDS and practices. This study explored the knowledge of HIV and AIDS and sexual practices of 609 older adults in Botswana.

Methods: The study was cross-sectional and used a survey design. A total of 609 older adults were recruited using respondent-driven sampling (RDS) from four purposively selected health districts and interviewed on their individual HIV and AIDS-related knowledge and practices. Data were analysed using descriptive statistics and multivariate logistic regression.

Results: Although knowledge of HIV and AIDS was high (95.7%), knowledge of HIV infection through blood transfusion, transmission from mother to child, or sharing needles or syringes was lacking. Only 72% of males and 23.2% of females know that having fewer partners and avoiding blood transfusions (71% of males and 44.3% of females) can minimise risks of HIV infection. Age, marital status and employment status significantly predicted knowledge of transmission (p < 0.05), while sex significantly predicted knowledge of prevention and control methods.

Conclusion: The study concludes that age-appropriate and culturally relevant education and training of older adults are necessary for the prevention and control of HIV infection.