When it comes to managing two key risk modifiers for cardiovascular disease, PLWH are a mixed bag: On the one hand, compared to HIV-negative people, they’re less likely to be physically active; but on the other, they’re better at taking medications that reduce the risk of atherosclerotic cardiovascular disease (ASCVD). That’s according to results from a single-site U.S. study reported in AIDS.
All 191 study participants, 105 of whom were living with HIV, had an elevated risk for ASCVD (on average, they had a 10% chance of experiencing a cardiovascular event within the next 10 years). Participants wore accelerometers to measure physical activity and completed surveys about other aspects of their lifestyle, as well as their perception of ASCVD risk.
Overall, the percentage of people who reported any physical activity in the past week was significantly lower among PLWH (44%) than HIV-negative people (65%), and PLWH spent an average of almost 43 fewer minutes in the past week in moderate to vigorous physical activity. That said, there were no significant differences between the groups in reported intake of fruits, vegetables, salt, sugar, and dietary fiber—although PLWH did have a lower ratio of polyunsaturated vs. saturated fats in their diet.
Among study participants who were taking medications for cardiovascular disease, self-reported adherence in the past 30 days was 94% among PLWH and 68% among HIV-negative people. Better adherence to lipid-lowering and similar drugs among the PLWH group may be related to their experience taking antiretroviral therapy, and could be harnessed to prevent ASCVD in that population, study authors suggested.
Meanwhile, the researchers found that HIV status was not associated with ASCVD risk perception. They did see a modest association between thinking one is at risk and modifying one’s behavior, but there was no relationship between calculated individual risk and the person’s belief that they might have an ASCVD event. Focus groups conducted among 38 of the HIV-positive participants showed mixed awareness of the relationship between serostatus and cardiovascular risk.
“Our findings suggest that an intentional, focused, and ongoing conversation between PLHIV and their clinical team about their ASCVD risk, with attention to the patients’ values and preferences, may help to improve cardiovascular health,” the study authors concluded.