The Prevalence and Burden of Non-AIDS Comorbidities among Women living with or at-risk for HIV Infection in the United States

INTRODUCTION: The prevalence and burden of age-related non-AIDS comorbidities (NACM) is poorly characterized among women living with HIV (WLWH). METHODS: Virologically-suppressed WLWH and HIV-seronegative participants followed in the Women's Interagency HIV Study (WIHS) through >/=2009 (when >80% WLWH used antiretroviral therapy) were included, with outcomes measured through 3/31/2018. Covariates, NACM number and prevalence were summarized at most recent WIHS visit. We used linear regression models to determine NACM burden by HIV serostatus and age. RESULTS: Among 3232 women (2309 WLWH, 923 HIV-seronegative) with median observation of 15.3 years, median age and body mass index (BMI) were 50 years and 30 kg/m2 respectively, 65% were black, 70% ever used cigarettes. WLWH had a higher mean NACM number than HIV-seronegative women (3.6 vs. 3.0, p /=60 years (p=0.0009) (HIV*age interaction p=0.0978). In adjusted analyses, NACM burden was associated with HIV, age, race, income, BMI, alcohol abstinence, cigarette and crack/cocaine use; in WLWH, additional HIV-specific indices were not associated, aside from recent abacavir use. CONCLUSIONS: Overall, NACM burden was high in the cohort, but higher in WLWH and in certain age groups. Non-HIV traditional risk factors were significantly associated with NACM burden in WLWH and should be prioritized in clinical guidelines for screening and intervention to mitigate comorbidity burden in this high-risk population.