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This review article provides an in-depth exploration of the current trends and challenges associated with blood transfusion practices in individuals living with HIV. As advancements in antiretroviral therapy (ART) have significantly improved the life expectancy of HIV-positive individuals, the landscape of blood transfusion strategies and safety considerations has evolved. The review delves into key trends, including personalized transfusion approaches, hemovigilance systems, and innovations in blood screening technologies. Additionally, it addresses challenges such as potential interactions between blood transfusion and antiretroviral medications, the impact on viral load dynamics, and emerging infectious risks. By synthesizing existing literature, this review aims to provide insights that guide healthcare professionals in optimizing blood transfusion practices for individuals with HIV while addressing the unique challenges posed by this patient population.