The Lancet series on solid organ transplantation calls for global equity in access to transplantation. The authors describe various obstacles to solid organ transplantation. People with HIV face unique and overlapping barriers, despite improvements in life expectancy with antiretroviral therapy (ART). Equality in solid organ transplantation for people with HIV is essential. This approach helps achieve the fourth goal of UNAIDS 90. The goal is to optimize the health-related quality of life and healthy longevity of people living with HIV.