Reference no: EM133815871

Question 

While substantial progress has been made in mitigating HIV-specific risk factors for ASCVD, less progress has been made in reducing the traditional risk factors related to the development of ASCVD. Hypertension, hyperlipidemia, obesity, tobacco and other substance use, sedentary lifestyles, and poor diet (high in sodium, high in fat, low in fiber) are elevated in PLWH and are significant contributors to their ASCVD risk. In high resource settings, approximately 42% of PLWH have hypertension and 36% have hyperlipidemia (Olaiya et al., 2018; Wong et al., 2017). Rates of obesity among PLWH range from 8% to 25%, with higher rates of obesity in women, racial and ethnic minorities, and with initiation of some HIV medications (e.g., integrase inhibitors; Bailin et al., 2020; Lake, 2017). Lifestyle factors, including tobacco and other substance use, sedentary behaviors, and diet, influence both traditional ASCVD risk factors and the pathways between inflammation and atherosclerosis. Approximately 37% to 50% of PLWH currently smoke tobacco (Mdodo et al., 2015; Weinberger et al., 2017), 48% of PLWH report a substance use disorder, and 20% report polysubstance use (Hartzler et al., 2017). While the estimated effect of tobacco and substance use on ASCVD varies (Raposeiras-Roubín etc