People with HIV are living longer because of treatment advances. This also means they may be living with several other health conditions, such as heart disease, type 2 diabetes, and more.

With the right management plan, HIV is now considered a chronic condition. People with HIV are living longer, meaning they’re more likely to be managing multiple chronic conditions at some point.

If you live with HIV plus other health conditions, you’re not alone. For example, in a 2024 study with 433 Canadians living with HIV, 78%Trusted Source lived with two or more other chronic conditions.

Some conditions are more likely to develop in someone with HIV. Here’s more about how they’re connected and how to manage them.

With the right treatment, people with HIV are living long, full lives. Antiretroviral therapy (ART) prevents HIV from copying itself and spreading throughout the body. This has been a huge advancement in HIV care.

A simple reason more people with HIV are juggling another chronic condition is that they are living longer. HIV-positive or not, you’re more likely to develop other health conditions as you get older.

Inflammation also plays a role. The goal of HIV treatment is to lower the viral load in your body to a level where HIV is undetectable. This undetectable level helps keep you well and means that HIV can’t be transmitted to anyone else.

Even with an undetectable level, there’s still some dormant HIV in your body. This small amount of HIV can trigger the immune system. The ongoing inflammatory response from the immune system may contribute to the development of some chronic conditions.

Rates of heart disease are higherTrusted Source among people with HIV. This is partly due to ongoing inflammation. It can contribute to a buildup of plaque in your arteries, which reduces blood flow.

Research has shown that people with HIV are more likely to have high blood pressure and cholesterol, which are both risk factors for heart disease.

In a 2024 study including more than 400 people with HIV, 44% had high blood pressure and 51% had dyslipidemia (high levels of cholesterol and triglycerides).

StudiesTrusted Source on the effects of ART show that it can raise LDL (bad) cholesterol and triglycerides.

When it comes to heart disease, it’s important to look at all the factors that may increase or lower your risk. Some things you can’t control, including your age, sex, and family history.

Things you do have some control over include:

  • diet
  • activity level
  • completing regular blood work
  • monitoring your blood pressure

Ask your healthcare professional to discuss your overall risk profile with you. If your risk is high, they may recommend that you start a statin. These medications help prevent heart disease by lowering your cholesterol and reducing inflammation.

According to a 2021 study, the risk for incident diabetes was 40% higher among people with HIV than people without HIV. The study included more than 1,500 men with prediabetes, half of whom also had HIV. Over a 12-year follow-up, 23% of them developed type 2 diabetes.

The results also suggest that people with HIV are more likely to receive a diagnosis of type 2 diabetes at a younger age than the larger population.

ART may increaseTrusted Source insulin resistance. This means that your body doesn’t use insulin properly, which can lead to type 2 diabetes. Ask your doctor about how often to get blood work done so you can monitor your blood sugar levels.

Older researchTrusted Source suggested that people with HIV did not respond as well to blood sugar–lowering medications. A 2016 study found that people with and without HIV responded in similar ways. Many medications for type 2 diabetes also reduce inflammation in the body. This helps improve insulin resistance in people with and without HIV.

Along with medications, eating a high fiber diet and staying active can help you manage blood sugar levels. Examples of high fiber foods include fruits, vegetables, nuts, seeds, beans, and whole grains.

People with HIV are also more likely to experience mental health challenges. Living with any chronic condition can take a toll and increase the risk of depression and anxiety.

Researchers estimate that 39% of people with HIV also have depression. People with depression are more likely to have higher viral loads.

There continues to be stigma surrounding HIV, which may contribute to depression and isolation. People with depression or anxiety may have a harder timeTrusted Source sticking with ART and seeking physical and mental health care.

When you start ART, you might notice changesTrusted Source in your mental health. Some people feel their mental health improves as they actively manage their HIV. Other people notice an increase in anxiety and depression as side effects of ART.

Stay in touch with your healthcare team so they can help you with any issues or side effects.

If you have any concerns about your mental health, reach out to your care team. You can also consider peer support groups or therapy.

People with HIV have higher rates of COPD. Study findings vary, but some research suggests that nearly 1 in 4 peopleTrusted Source with HIV also live with COPD.

Inflammation from HIV can impair lung and airway health. Smoking is a risk factor for COPD. Studies have found that people with HIV are more likelyTrusted Source to smoke.

Many COPD treatments are safe for people with HIV, but there’s some debateTrusted Source about inhaled corticosteroids.

Inhaled corticosteroids can be helpful to reduce inflammation during a flare of COPD symptoms. They can also lower your immune response. In some people, this may increase the risk of pneumonia. If you have HIV and a history of pneumonia, other medications may be better options for you.

People with HIV might alsoTrusted Source be more likely to develop asthma or have wheezing, a common symptom of asthma.

If you currently smoke, the best thing you can do is quit or cut down the amount. This can help slow or prevent the progression of COPD and potentially help avoid other health conditions associated with HIV.

Any medications have the potential to interact with one another. The more medications you take, the greater chance of an interaction.

It’s smart to do a yearly medication review with your doctor or pharmacist. They can review side effects and ensure your medication plan still makes sense for you.

Here are some things to consider when you’re balancing managing HIV and other health conditions.

Cardiovascular disease

Statins are medications that lower cholesterol and inflammation to prevent heart disease.

The statins least likely to interact with ART include:

  • atorvastatin (Atorvaliq, Lipitor)
  • pravastatin (Pravachol)
  • rosuvastatin (Crestor)

The statins more likelyTrusted Source to interact with ART include:

  • fluvastatin (Lescol)
  • lovastatin (Mevacor)
  • simvastatin (Zocor)

Several classes of medications are used to manage hypertension (high blood pressure), including beta-blockers, angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs).

Beta-blockers may increase the risk of a cardiac event in people with HIV, according to research from 2021Trusted Source. ACE inhibitors and ARBs are better options to manage hypertension in people with HIV. The same research found that these drugs may be protective against cardiac events.

Type 2 diabetes

Metformin is often a first-line medication to treat type 2 diabetes. This medication helps your body use insulin better and reduces inflammation.

New research from 2024 found a potential extra benefit in people with HIV: Metformin may help lower the viral load in your body.

HIV can hide from your immune system, which is why even when your viral load is undetectable, there’s still a bit of HIV in your body. Metformin might help your immune system find the virus and destroy it, lowering the amount in your body.

Some types of ART may increase or decrease the action of type 2 diabetes medications. For example, dolutegravir (Tivicay, Juluca) may increase the side effects of metformin. In cases where a combination of type 2 diabetes medications and ART causes an increase in side effects, it’s best to adjust the type 2 diabetes medication rather than changing the ART.

Glucagon-like peptide-1 (GLP-1) medications (Ozempic, Trulicity, Victoza) may cause changes to your heart rate if you also take rilpivirine (Edurant) or medications with a protease inhibitor like atazanavir (Reyataz), darunavir (Prezista), or lopinavir (Kaletra). These medications may not be a good fit for you if you have a history of an irregular heart rate.

Depression and anxiety

Several medications are used for depression and anxiety. Most do not interact with ART. The right medication can make a huge difference for someone with HIV. When people with HIV have their depression treated, they are better able to take ART consistently.

Two medications that are more likely to interact with ART are bupropion (Wellbutrin, Zyban) and trazodone (Desyrel, Oleptro, Trialodine). This combination can cause more antidepressant side effects.

Selective serotonin reuptake inhibitors (SSRIs) are first-line medications for depression and anxiety since they have fewer drug-drug interactions. Some examples of SSRIs are:

  • sertraline (Zoloft)
  • citalopram (Celexa)
  • escitalopram (Cipralex, Lexapro)

COPD and asthma

Inhaled medications are an important part of managing COPD or asthma. Some are short-acting for symptom flares, while others are long-acting and help prevent flares. These inhalers are generally safe and effectiveTrusted Source in people with HIV.

Inhaled corticosteroids are another medication to treat flares of COPD. When you have HIV, you and your doctor will need to discuss the potential risks and benefits of inhaled corticosteroids. People with HIV already have a higher risk of developing bacterial pneumonia. Inhaled corticosteroids can increase this riskTrusted Source.

There will be times when inhaled corticosteroids are the best option for someone with HIV. If you also have asthma or frequent flares, inhaled corticosteroids might be your best bet, even with the possible risk.

Inhaled corticosteroids might also interact with protease inhibitors, a class of ART. Ritonavir (Norvir) and cobicistat (Tybost) can interactTrusted Source with inhaled corticosteroids and may lead to high cortisol levels, similar to what happens in Cushing syndrome.

A specific statin might play a role in COPD management. A small 2017 studyTrusted Source with 22 participants found that rosuvastatin may also slow the progression of COPD in people with HIV. Researchers believe this is likely because rosuvastatin helps lower HIV-related inflammation in the airways.

Consistently taking ART exactly as directed is the best thing you can do to manage your HIV. The life expectancy of someone with HIV is now similar to that of someone without HIV.

With a longer life, many people with HIV will also develop another chronic condition. Some health conditions are more likely to develop in someone with HIV because of ongoing inflammation.

It’s very possible to manage HIV alongside other health conditions. Many people with HIV also live with other chronic health conditions.

Some conditions are more likely to develop in someone with HIV. These include type 2 diabetes, heart disease, some lung conditions, and depression and anxiety. Try to keep your healthcare team informed so they’re aware of any changes to your physical and mental health.