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Traditional and HIV-Specific Risk Factors Associated With Atrial Fibrillation Among Underrepresented Minority Groups

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|October 28, 2025
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Summary

Nonvalvular atrial fibrillation (NVAF) incidence is understudied in racial and ethnic minority groups with HIV. Traditional and HIV-specific factors increase NVAF risk, yet oral anticoagulation (OAC) prescribing for stroke prevention remains low.

Keywords:
HIVatrial flutternonvalvular atrial fibrillationoral anticoagulationunder-represented racial/ethnic minority groups (UREGs)

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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Nonvalvular atrial fibrillation (NVAF) evaluation in under-represented racial and ethnic minority groups (UREGs) living with HIV is limited.
  • Understanding NVAF burden and management in this population is crucial for cardiovascular risk reduction.

Purpose of the Study:

  • To determine the incidence of NVAF among UREGs with HIV.
  • To identify factors associated with NVAF development in this cohort.
  • To describe oral anticoagulation (OAC) patterns for stroke prophylaxis.

Main Methods:

  • Secondary analysis of the retrospective PATHWAYS study data (NCT04025125).
  • Cox regression analysis to assess associations between risk factors and incident NVAF.
  • Examination of OAC prescribing patterns for eligible patients.

Main Results:

  • NVAF incidence was 4.54 per 1,000 person-years in 10,945 UREGs with HIV (2015-2019).
  • Associated factors included age, diabetes, heart failure, renal disease, and specific antiretroviral therapies.
  • Only 44.2% of eligible NVAF patients received OAC for stroke prophylaxis.

Conclusions:

  • Both traditional and HIV-specific risk factors contribute to NVAF incidence in UREGs with HIV.
  • There is a significant gap in appropriate OAC prescribing for stroke prevention in this population.