How are people living with HIV affected by other health conditions?

🧪 What was the study about?

As people with HIV live longer, they are more likely to be affected by other long-term health conditions such as heart disease, diabetes, arthritis or mental health conditions. People experiencing multiple health conditions are described as having 'multimorbidity'. Multimorbidity can affect quality-of-life, mental wellbeing, day-to-day functioning and the ability to manage HIV treatment alongside medications for their other conditions.  

We wanted to understand which health conditions commonly occur together in people living with HIV, what factors increase the risk of multimorbidity, and how multimorbidity affects long-term health in people with HIV.

❓ Why is this important?

Understanding how different health conditions cluster together, and who is most at risk, can help healthcare professionals identify people who may benefit from earlier support and more personalised care. It can also help researchers and policymakers develop better prevention strategies, improve clinical guidelines and plan healthcare services for an ageing population with HIV.
🔍 What did we do?

We carried out a series of studies using data from a large UK-based cohort of people living with HIV:  

• Reviewed previous research to understand how multimorbidity has been defined and measured in HIV research

• Identified common patterns of health conditions that occur together;

• Examined how these patterns changed over time;  

• Investigated the biological, behavioural and clinical factors linked to multimorbidity and;

• Explored how multimorbidity affects health outcomes such as quality of life, healthcare use and cognitive function

📊 Key findings

• We found that different studies defined multimorbidity among people living with HIV in different ways. For example, the number of conditions included in definitions was often different, as were the conditions included themselves.  

• Several distinct patterns of co-occurring conditions were identified, including cardiovascular disease, metabolic conditions, cancers, sexually transmitted infections, neurological disorders, and combined mental health and musculoskeletal conditions.  

• We found that older age, body mass index (BMI), history of injection drug use, current recreational drug use, sex between men, time living with diagnosed HIV and a prior AIDS diagnosis were associated with greater multimorbidity at the start of the study.

• However, only age, BMI and time living with diagnosed HIV were linked to an increase in multimorbidity over the study period

• Multimorbidity was associated with poorer quality of life, increased healthcare use and worse cognitive function. Mental health and neurological conditions had some of the greatest impacts on people's wellbeing.

💡 What do these findings mean?

As the population of people living with HIV continues to age, healthcare needs are becoming increasingly complex. This research highlights the need for more consistent ways of measuring multimorbidity, helping researchers compare studies and build a stronger evidence base. It also provides valuable insights into which groups of individuals are most at risk and which combinations of conditions have the greatest impact on health.

Ultimately, these findings can support the development of more personalised care, improve clinical guidelines and help healthcare services better meet the needs of people living with HIV as they age.