How do you integrate HIV (+) serostatus into a patient's ASCVD if they would not otherwise qualify for a statin either for primary or secondary prophylaxis?

HIV (+) serostatus is a significant risk-enhancer for the development of cardiovascular disease and should be taken into account when making treatment decisions regarding statin initiation, even if the patient's viral load is low or not detectable. In a patient >40 years old and with a risk >5%, would recommend treatment with at least a moderate-intensity statin for primary prevention given this increased risk. For patients <40 years old or with a risk <5%, consideration of other risk factors (family history, viral load, etc.) will also weigh into the decision-making, not discounting a patient's preference on how aggressive to be with treatment. Additional items that may be considered if statin treatment is not initiated are a more aggressi...