Physical Activity Is Associated with Lower Odds of Cognitive Impairment in Women but Not Men Living with Human Immunodeficiency Virus Infection

Background Cardiovascular comorbidities are risk factors for human immunodeficiency virus (HIV)-associated cognitive impairment. Given differences in cardiometabolic risk profiles between women and men with HIV, we investigated whether associations between cardiometabolic risk factors and prevalent cognitive impairment differ by sex. Methods Separate logistic regression models were constructed for women and men at entry into a prospective study of older persons with HIV (PWH) to assess the association of cardiometabolic and other risk factors with cognitive impairment. Results Of 988 participants, 20% were women. Women had higher total cholesterol (194 vs 186 mg/dL; P =.027), hemoglobin A1c (5.9% vs 5.7%; P =.003), and body mass index (30.8 vs 27.4 kg/m 2; P <.001) compared with men, and were less physically active (43% vs 55%; P =.005). In a multivariable model, physical activity was associated with lower odds of cognitive impairment in women (odds ratio, 0.35 [95% confidence interval,.15-.80]; P =.013) but not men. Conclusions Physical activity may have a greater positive impact on cognitive health in women than in men with HIV. This finding should be confirmed in studies examining the longitudinal association between physical activity and incident cognitive impairment in PWH and the effect of interventions that increase physical activity on cognitive impairment in women with HIV.