While kidney and liver transplants from donors with HIV to recipients with HIV have become clinical practice, the HOPE Act promise of heart transplants from donors with HIV to recipients with HIV remains unrealized because no research has established whether these recipients will have good outcomes. Transplanting hearts from donors with HIV could lead to substantial public health benefit by decreasing wait times and waitlist mortality for people with and without HIV on the heart waitlist. In this multicenter trial, we will evaluate the safety and efficacy of transplanting hearts from donors with HIV to recipients with HIV, and we will study dysregulated adaptive immune responses common to HIV and transplantation.