Undesired weight gain and associated healthcare outcomes among people living with HIV on antiretroviral therapy

Managing overall health beyond viral suppression, including weight gain, is essential for improving quality of life of people living with HIV (PLHIV). This cross-sectional, web-based survey collected data from PLHIV aged ≥18 years in the US, from February-June 2022. Bivariate and multivariable analyses identified factors associated with undesired weight gain in the past 12 months. Of 781 PLHIV who participated (median age 41 years; 52% overweight/ obese), 230 (29%) reported weight gain in the past 12 months, of which 172 (75%) experienced undesired weight gain. PLHIV with undesired weight gain were more likely to report dissatisfaction with primary HIV clinician, multimorbidity, higher prevalence of comorbidities, multiple ART switching, and longer HIV infection duration (<i>p</i> < 0.05). Majority (76%) reported that HIV clinicians sometimes/rarely/never discussed their weight. PLHIV had higher adjusted odds of undesired weight gain in those who switched ART regimens vs never switched and were obese or overweight vs normal, and lower adjusted odds of undesired weight gain in cisgender females vs cisgender males and those having cardiovascular disease (vs not) (all <i>p</i> < .01). Present findings underscore the need for proactive weight monitoring and individualized ART management to prevent excess weight gain in PLHIV.