Diabetes Care Significantly Lacking For People With HIV

The prominence of comprehensive diabetes care was minimal among people with HIV (PWH) and diabetes, according to a study published in JAPhA Practice Innovations.¹ The study’s results highlight the need for increased interventions in the diabetes and HIV populations to benefit the management of chronic diseases.

“PWH are at a higher risk of diabetes and cardiovascular disease (CVD) compared to the general population,” wrote authors of the study. “However, screening rates for age-related comorbidities remain low in this population.”

While it’s not the first time experts explored the relationship between diabetes and HIV, previous research yielded a complex connection between the 2 conditions. HIV, which is the human immunodeficiency virus, is a disease that attacks the immune system. While it is often associated with flu-like symptoms,² HIV can lead to increased risk of hepatitis, CVD, and even substance use disorder.³

A lack of understanding toward diabetes and HIV, and how they impact each other, persists. | image credit: sofiko14 / stock.adobe.com

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Despite new revelations in the HIV space leading to the increased treatment and prevention of the virus, it still presents a significant number of complications for those living with diabetes, compared with PWH not reporting a diabetes diagnosis.

“Due to various variables, including the aging of the HIV-infected population and the high prevalence of chronic medical conditions among PWH, the crossroads of diabetes and HIV infection has become a significant research topic,” wrote authors of a study published in Cureus.⁴ “Although the connection between HIV and diabetes is not simple, many aspects of the virus and its treatment have been connected to the onset of diabetes.”

Regardless of the increased attention the HIV-diabetes relationship may require, a lack of understanding of these 2 complex health issues and how they impact each other persists.

“PWH are at a higher risk of diabetes and CVD compared to the general population,” continued the authors of the current study.¹ “However, screening rates for age-related comorbidities remain low in this population. The objective of this study [was] to assess adherence to comprehensive diabetes care measures among patients with both diabetes and HIV receiving care at Southwest Care Center.”

Researchers conducted a retrospective chart review of patients at least 18 years with HIV and diabetes in the years 2019 and 2020. Researchers collected data describing patients’ demographics, comorbidities, duration of HIV, blood pressure, prescription medication use, clinic appointment number, and adherence. After screening 521 patients, a total of 121 (mean age, 57.5 years; 86.8% men; 76.9% white) were included in the researchers’ final analysis.

Among the study population, 98.3% missed at least 1 clinic appointment, and 94.2% were overdue for at least 1 screening metric. Furthermore, 14 patients (11.5%) were overdue for all screening metrics included at clinic appointments. Compared with factors like demographics, statin use, and number of appointments attended, polypharmacy—defined as the use of 5 or more non-HIV medications—was the main predictor of patients being screened for hemoglobin A_1c.¹

“PWH are at increased risk for diabetes and CVD, yet our study found that nearly all patients (94.2%) were overdue for at least one diabetes screening metric, with eye exams being the most commonly missed screening,” they wrote. “This is much lower than the general population.”

With over 94% of the study population with diabetes and HIV failing to adhere to screening appointments, researchers determined that overall diabetes care among the HIV population is significantly lacking. Since polypharmacy stood out as the only factor leading to better adherence and more screenings, researchers discovered that increased monitoring of patients with comorbidities led to greater screening and diabetes management efforts.

Diabetes and HIV, as previously mentioned throughout, are significantly complex health conditions. While the 2 play off each other in complex manifestations, they are their own complications that require increased attention compared with other diseases and disorders. Future care models need to expand and include HIV management within primary care and models that cover diabetes management as well. In this space, researchers noted that there are also heightened opportunities for pharmacists to get involved and further advance HIV and diabetes care.

“As PWH live longer, care models must expand beyond HIV management to include comprehensive primary care, which includes preventative screenings for chronic comorbidities,” concluded the authors of the study.¹ “Pharmacists can be key players in the delivery of comprehensive, guideline-based primary care.”

READ MORE: Diabetes Resource Center

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REFERENCES

1. Hardman MM, Aragon KG, Cloud Floyd CB, et al. Adherence to comprehensive diabetes measures in people with HIV managed in a primary care clinic. JAPhA Pract Innov. 2025;2(4):100075. https://doi.org/10.1016/j.japhpi.2025.100075

2. About HIV. CDC. January 14, 2025. Accessed September 8, 2025. https://www.cdc.gov/hiv/about/index.html

3. Other health issues of special concern for people living with HIV. Minority HIV/AIDS Fund. February 22, 2024. Accessed September 8, 2025. https://www.hiv.gov/hiv-basics/staying-in-hiv-care/other-related-health-issues/other-health-issues-of-special-concern-for-people-living-with-hiv

4. Kumar M, Singh H, Chakole S. Exploring the relation between diabetes and HIV: a narrative review. Cureus. 2023 Aug 22;15(8):e43909. doi: 10.7759/cureus.43909.