Gender Disparities in Statin Prescriptions in People With HIV With Low/Moderate to High Cardiovascular Risk

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Cardiovascular disease (CVD) is a leading cause of mortality in people with human immunodeficiency virus (HIV).
• The REPRIEVE trial investigated the efficacy of statin therapy for primary CVD prevention in people with HIV.
• Existing guidelines recommend CVD risk assessment and management for individuals with HIV.

Purpose of the Study:

• To evaluate the potential for primary cardiovascular disease (CVD) prevention in people with HIV, particularly those at lower CVD risk.
• To assess disparities in statin prescribing patterns between cisgender women and cisgender men with HIV across different CVD risk levels.

Main Methods:

• Analysis of data from the REPRIEVE trial, focusing on participants' baseline CVD risk and statin utilization.
• Comparison of statin receipt rates between cisgender women and cisgender men stratified by CVD risk categories (low/moderate and high).

Main Results:

• The REPRIEVE trial suggests that primary CVD prevention strategies, including statin use, can be considered for people with HIV, even those at low CVD risk.
• Cisgender women with HIV were found to be less likely to receive statin therapy compared to cisgender men, irrespective of their CVD risk level (low/moderate or high).

Conclusions:

• Primary CVD prevention is a relevant consideration for people with HIV, including those with lower estimated CVD risk.
• Significant sex-based disparities exist in statin prescribing for CVD prevention among people with HIV.
• Targeted interventions are necessary to ensure equitable access to evidence-based CVD prevention therapies, such as statins, for all individuals with HIV, particularly cisgender women.