A large study of about 20,000 individuals with HIV including women, men who have sex with women, and men who have sex with men (MSM) was done over 5 years. The goal was to assess the contribution of gender, age, and sexual orientation on person-time spent in: retention in care, ART use, and viral suppression.
An ongoing study of men 50-75 years of age with HIV (279) or at risk for HIV (379) found that about 40% suffered one or more falls over a 2-year period. In both groups with two or more falls, illicit drug use, taking diabetes medications or depression medications, and peripheral neuropathy were the most frequent risk factors.
A total of 782 gay couples, median age 40 years, with one partner HIV positive and the other negative were followed for 3 years. There were 76,000 episodes of anal intercourse without condoms. The investigators reported no episodes of HIV transmission from the positive to the negative partner.
In a cohort of 2,308 persons, mean age 60, hospitalized for heart failure, there were 374 with HIV. On follow-up for short-term readmission and longer-term cardiovascular mortality, the adults with HIV had significantly higher readmissions as well as greater cardiovascular and all-cause mortality rates compared to the HIV-negative group.
HIV is associated with an increased risk of stroke from both the effect of the virus and known risk factors. It appears that traditional risk factors, such as hypertension and smoking, may be even more elevated as risk factors.
Smoking cessation and blood pressure control are recommended for prevention and use of statins is suggested, pending the result of an ongoing clinical trial. Cardiovascular disease is a major comorbidity in older adults with HIV and demands attention.
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