Underutilization of Statins When Indicated in HIV-Seropositive and Seronegative Women

Jonathan V. Todd, Stephen R. Cole, David A. Wohl, Ross J. Simpson, Michele Jonsson Funk, M. Alan Brookhart, Jennifer Cocohoba, Daniel Merenstein, Anjali Sharma, Jason Lazar, Joel Milam, Mardge Cohen, Stephen Gange, Tené T. Lewis, Greer Burkholder, Adaora A. Adimora

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Increased life expectancy of persons living with HIV infection receiving antiretroviral therapy heightens the importance of preventing and treating chronic comorbidities such as cardiovascular disease. While guidelines have increasingly advocated more aggressive use of statins for low-density lipoprotein (LDL) cholesterol reduction, it is unclear whether people with HIV, especially women, are receiving statins when indicated, and whether their HIV disease is a factor in access. We assessed the cumulative incidence of statin use after an indication in the Women's Interagency HIV Study (WIHS), from 2000 to 2014. Additionally, we used weighted proportional hazards regression to estimate the effect of HIV serostatus on the time to initiation of a statin after an indication. Cumulative incidence of statin use 5 years after an indication was low: 38% in HIV-seropositive women and 30% in HIV-seronegative women. Compared to HIV-seronegative women, the weighted hazard ratio for initiation of a statin for HIV-seropositive women over 5 years was 0.94 [95% confidence interval (CI) 0.62, 1.43]. Applying the American College of Cardiology and the American Heart Association (ACC/AHA) guidelines increased the proportion of HIV-seropositive women with a statin indication from 16% to 45%. Clinicians treating HIV-seropositive women should consider more aggressive management of the dyslipidemia often found in this population.

Original languageEnglish (US)
Pages (from-to)447-454
Number of pages8
JournalAIDS Patient Care and STDs
Issue number11
StatePublished - Nov 2017


  • cardiovascular disease
  • human immunodeficiency virus
  • hydroxymethylglutaryl-CoA reductase inhibitors
  • lipids
  • statins
  • women's health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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