Objective  To construct and validate a mortality prediction nomogram for patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) undergoing hemodialysis, and to evaluate its predictive performance and clinical utility. Methods  A retrospective cohort study was conducted, enrolling 81 HIV-infected patients (age≥18 years, CKD stage G5) who received regular hemodialysis (≥3 months) at Chengdu Public Health Clinical Medical Center from July 2013 to June 2024. Patients were randomly divided into a training set (n=40) and a validation set (n=41) at a 1:1 ratio. Univariate COX regression analysis was used to screen prognostic variables, and stepwise regression was applied to build a multivariate model, from which a nomogram was constructed. Model performance was assessed using receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis (DCA). Results  Univariate Cox regression in the training set identified hemoglobin (HR= 0.942, 95% CI: 0.904～0.981, P=0.004), albumin (HR=0.848, 95% CI:0.739～0.973, P=0.019), and age (HR=1.090, 95% CI:1.010～1.170, P=0.023) as candidate prognostic variables. Multivariate stepwise Cox regression confirmed all three as independent prognostic factors. The AUC values of the nomogram for predicting 1-, 3-, and 5-year survival in the training set were 0.846 (95% CI: 0.692～1.000), 0.750 (95% CI: 0.566～0.934), and 0.791 (95% CI: 0.618～0.964), respectively; the corresponding values in the validation set were 0.806 (95% CI: 0.644～0.968), 0.723 (95% CI: 0.540～0.906), and 0.640 (95% CI: 0.446～0.834). The calibration curve slopes were close to 1. Decision curve analysis demonstrated significant clinical net benefit across threshold probabilities ranging from 10% to 80%. Conclusion The mortality prediction nomogram based on hemoglobin, albumin, and age exhibits good discriminative ability, calibration, and clinical utility, providing a concise and robust quantitative tool for individualized risk assessment and clinical decision‑making in HIV/AIDS patients on hemodialysis.