Description of the transmission characteristics among older adults is helpful for the tailored interventions. Epidemiological investigation combined with phylogenetic analysis were performed to reveal potential transmission linkage among the older people in Nanjing. During 2018-2022, 188 pol sequences were successfully amplified. Multiple genotypes were identified, including CRF07_BC (55.3%), CRF01_AE (30.3%), CRF08_BC (8.0%), B (3.2%), CRF55_01B (1.1%), CRF67_01B (0.5%),CRF68_01B (0.5%), and unique recombinant forms (URF) (1.1%). Transmission network analysis found 120 genetically linked patients forming 23 clusters (2-26 individuals). Multivariable logistic regression analysis showed that compared with farmers and heterosexuals, patients with other occupation (OR= 0.404, 95% CI:0.173-0.945) and MSM (OR= 0.193, 95% CI:0.050-0.738) were less likely to have high linkage. Subjects who lived in suburban places were more likely to have high linkage (OR= 10.932, 95% CI:3.335-35.830). The Sankey diagram suggested that patients who lived in suburban places mainly transmitted the disease within the locally district (χ 2=24.192, P＜0.001). Among 188 pol segments, the prevalence of pretreatment drug resistance was 8%. In suburban places with an increasing HIV-1 epidemic, there is a need to improve early detection and timely treatment. More tailored interventions for this subgroup are urgently needed.