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Article Open access Published: 27 January 2026

High prevalence of polypharmacy and nervous system medications in people with HIV: a cross-sectional analysis

Scientific Reports, Article number:   (2026Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Polypharmacy is increasingly prevalent among people living with HIV (PLWH), especially as they age and manage multiple comorbidities. This cross-sectional study analyzed data from 268 PLWH in Vigo, Spain (2020–2023), revealing an aging cohort (mean age 49.8 years) and a 51.9% prevalence of multimorbidity. Descriptive, bivariate, and multivariable logistic regression analyses were performed. Polypharmacy, defined as the chronic use of ≥ 5 non-antiretroviral drugs, was observed in 35.7% of participants, increasing among older adults (≥ 50 years, 50.7%; p < 0.001) and those living with HIV for > 10 years (43.0%; p = 0.004). Nervous system medications (47.0%), alimentary tract/metabolism drugs (36.2%), and cardiovascular drugs (34.3%) were the most common. Psychotropic drugs were frequent, particularly anxiolytics (24.8%) and antidepressants (22.9%). In multivariable analysis, anxiolytic use was associated with older age (OR = 1.03; p = 0.038), female sex (OR = 1.97; p = 0.042), current smoking (OR = 3.74; p = 0.002), and past cocaine use (OR = 2.52; p = 0.008); antidepressant use with past (OR = 3.46; p = 0.015) and current smoking (OR = 4.46; p = 0.001). These findings highlight the complexity of managing polypharmacy in aging PLWH and underscore the need for strategies to optimize medication use.

Data availability

The datasets generated and analyzed during the current study are not publicly available, but are available from the corresponding author on reasonable request. Access will require adherence to appropriate ethical guidelines and approval from the relevant institutional review board.

References

  1. Trickey, A. et al. Life expectancy after 2015 of adults with HIV on long-term antiretroviral therapy in Europe and North America: A collaborative analysis of cohort studies. Lancet HIV 10, e295–e307 (2023).

    Google Scholar 

  2. Mahy, M., Autenrieth, C. S., Stanecki, K. & Wynd, S. Increasing trends in HIV prevalence among people aged 50 years and older. AIDS 28, S453–S459 (2014).

    Google Scholar 

  3. Guaraldi, G., Milic, J. & Mussini, C. Aging with HIV. Curr HIV/AIDS Rep 16, 475–481 (2019).

    Google Scholar 

  4. Zicari, S. et al. Immune activation, inflammation, and non-AIDS Co-morbidities in HIV-infected patients under long-term ART. Viruses 11, 200 (2019).

    Google Scholar 

  5. Feinstein, M. J. et al. Characteristics, prevention, and management of cardiovascular disease in people living with HIV: A scientific statement from the American Heart Association. Circulation 140, (2019).

  6. Van Epps, P. & Kalayjian, R. C. Human immunodeficiency virus and aging in the era of effective antiretroviral therapy. Infect. Dis. Clin. North Am. 31, 791–810 (2017).

    Google Scholar 

  7. Fragkou, P. C. et al. Cardiovascular disease and risk assessment in people living with HIV: Current practices and novel perspectives. Hellenic J. Cardiol. 71, 42–54 (2023).

    Google Scholar 

  8. Collins, L. F. et al. Aging-related comorbidity burden among women and men with or at-risk for HIV in the US, 2008–2019. JAMA Netw. Open 6, e2327584 (2023).

    Google Scholar 

  9. Fuster-RuizdeApodaca, M. J. et al. Prevalence and patterns of illicit drug use in people living with HIV in Spain: A cross-sectional study. PLoS ONE 14, e0211252 (2019).

    Google Scholar 

  10. Remien, R. H. et al. Mental health and HIV/AIDS. AIDS 33, 1411–1420 (2019).

    Google Scholar 

  11. Eshun-Wilson, I. et al. Antidepressants for depression in adults with HIV infection. Cochrane Database Syst. Rev. 2018, (2018).

  12. Mudra Rakshasa-Loots, A. Depression and HIV: a scoping review in search of neuroimmune biomarkers. Brain Commun. 5, (2023).

  13. Mudra Rakshasa-Loots, A., Whalley, H. C., Vera, J. H. & Cox, S. R. Neuroinflammation in HIV-associated depression: evidence and future perspectives. Mol. Psychiatry 27, 3619–3632 (2022).

    Google Scholar 

  14. Earnshaw, V. A. et al. HIV stigma, depressive symptoms, and substance use. AIDS Patient Care STDS 34, 275–280 (2020).

    Google Scholar 

  15. World Health Organization. Medication Safety in Poly-Pharmacy. https ://apps.who.int/iris/bitst ream/handl e/10665 /32545 4/WHO-UHC-SDS-2019.11-eng.pdf?ua=1 (2019).

  16. Edelman, E. J., Rentsch, C. T. & Justice, A. C. Polypharmacy in HIV: recent insights and future directions. Curr. Opin. HIV AIDS 15, 126–133 (2020).

    Google Scholar 

  17. Rubin, L. H. et al. Degree of polypharmacy and cognitive function in older women with HIV. AIDS Res. Hum. Retrovir. 38, 571–579 (2022).

    Google Scholar 

  18. Psomas, C. K. et al. Polypharmacy is associated with falls in women with and without HIV. JAIDS J. Acquir. Immune Defic. Syndr. 90, 351–359 (2022).

    Google Scholar 

  19. Danjuma, M. I. et al. Prevalence and global trends of polypharmacy among people living with HIV: A systematic review and meta-analysis. Ther. Adv. Drug Saf. 13, 204209862210807 (2022).

    Google Scholar 

  20. López-Centeno, B. et al. Polypharmacy and drug-drug interactions in people living with human immunodeficiency virus in the region of Madrid, Spain: A population-based study. Clin. Infect. Dis. 71, 353–362 (2020).

    Google Scholar 

  21. Paudel, M. et al. Comorbidity and comedication burden among people living with HIV in the United States. Curr. Med. Res. Opin. 38, 1443–1450 (2022).

    Google Scholar 

  22. Gimeno-Gracia, M., Crusells-Canales, M. J., Armesto-Gomez, F. J., Compaired-Turlan, V. & Rabanaque-Hernandez, M. J. Polypharmacy in older adults with human immunodeficiency virus infection compared with the general population. Clin. Interv. Aging 11, 1149–1157 (2016).

    Google Scholar 

  23. Naito, T. et al. Comorbidities and co-medications among 28 089 people living with HIV: A nationwide cohort study from 2009 to 2019 in Japan. HIV Med. 23, 485–493 (2022).

    Google Scholar 

  24. Altice, F. L., Kamarulzaman, A., Soriano, V. V, Schechter, M. & Friedland, G. H. Treatment of medical, psychiatric, and substance-use comorbidities in people infected with HIV who use drugs. The Lancet 376, 367–387 (2010).

  25. Harris, P. A. et al. Research electronic data capture (REDCap)—A metadata-driven methodology and workflow process for providing translational research informatics support. J. Biomed. Inform. 42, 377–381 (2009).

    Google Scholar 

  26. Harris, P. A. et al. The REDCap consortium: Building an international community of software platform partners. J. Biomed. Inform. 95, 103208 (2019).

    Google Scholar 

  27. Gutiérrez Ibarzábal, M. L., Berraondo Zabalegui, I., Bilbao Madariaga, J. L. & Gorroñogoitia Iturbe, A. I. Análisis y desarrollo del plan de actividades preventivas de atención primaria. Revisión de la oferta preferente y del programa informático de soporte. Vitoria-Gasteiz: Departamento de Sanidad y Consumo, Gobierno Vasco (2011).

  28. Silla Stoel, M. & Rosón Hernández, B. Evaluación del consumo de alcohol y diagnóstico de patrón de consumo. Trastor. Adict. 11, 191–199 (2009).

  29. University of Liverpool. HIV drug interactions. https://www.hivdruginteractions. org.

  30. Smit, M. et al. Future challenges for clinical care of an ageing population infected with HIV: A modelling study. Lancet Infect. Dis. 15, 810–818 (2015).

    Google Scholar 

  31. Subdirección General de Información Sanitaria. Salud Mental en datos: Prevalencia de los Problemas de Salud y Consumo de Psicofármacos y Fármacos Relacionados a Partir de Registros Clínicos de Atención Primariahttps://www.sanidad.gob.es/estadEstudios/estadisticas/estadisticas/estMinisterio/SIAP/Salud_mental_datos.pdf (2021).

  32. Rasmussen, L. et al. Utilization of psychotropic drugs prescribed to persons with and without <scp>HIV</scp> infection: a <scp>D</scp> Anish nationwide population-based cohort study. HIV Med. 15, 458–469 (2014).

    Google Scholar 

  33. Cholera, R. et al. Mind the Gap: Gaps in antidepressant treatment, treatment adjustments, and outcomes among patients in routine HIV care in a multisite U.S. clinical cohort. PLoS One 12, e0166435 (2017).

  34. Kiely, K. M., Brady, B. & Byles, J. Gender, mental health and ageing. Maturitas 129, 76–84 (2019).

    Google Scholar 

  35. Xu, Y. et al. Association between depression and HIV infection vulnerable populations in United States adults: A cross-sectional analysis of NHANES from 1999 to 2018. Front. Public Health 11, (2023).

  36. de Pinho, C. S. N., Santana, R. D., Campos, E. de M. & Pires Neto, R. da J. Prevalence and factors associated with depression in people living with HIV/AIDS in a Brazilian metropolitan region. AIDS Care 34, 1580–1585 (2022).

  37. Mitra, P., Jain, A. & Kim, K. HIV and AIDS in older adults: Neuropsychiatric changes. Curr. Psychiatry Rep. 24, 463–468 (2022).

    Google Scholar 

  38. Skogen, V. et al. Prevalence of mental distress and factors associated with symptoms of major depression among people living with HIV in Norway. AIDS Care 36, 173–180 (2024).

    Google Scholar 

  39. Pérez-Valero, I., Blanch, J. & Martínez, E. Perception of HIV physicians in Spain towards diagnosis and management of neuropsychiatric comorbidities in people with HIV. HIV Med. 23, 969–977 (2022).

    Google Scholar 

  40. Brown, L. A., Mu, W., McCann, J., Durborow, S. & Blank, M. B. Under-documentation of psychiatric diagnoses among persons living with HIV in electronic medical records. AIDS Care 33, 311–315 (2021).

    Google Scholar 

  41. Ballester-Arnal, R. et al. A Spanish study on psychological predictors of quality of life in people with HIV. AIDS Behav. 20, 281–291 (2016).

    Google Scholar 

  42. GeSIDA. Consenso de GeSIDA sobre comorbilidad neuropsiquiátrica – cognitiva y VIHhttps://gesida-seimc.org/wp-content/uploads/2020/07/Guia_GESIDA_ManejoClinicoComorbilidad.pdf (2020).

  43. Crane, H. M. et al. Prevalence and factors associated with hazardous alcohol use among persons living with HIV across the US in the current era of antiretroviral treatment. AIDS Behav. 21, 1914–1925 (2017).

    Google Scholar 

  44. Langan, K., Wall, M., Potts, W. & Himelhoch, S. Prevalence and potential predictors of gambling disorder among people living with HIV. AIDS Care 31, 421–426 (2019).

    Google Scholar 

  45. Shiau, S., Arpadi, S. M., Yin, M. T. & Martins, S. S. Patterns of drug use and HIV infection among adults in a nationally representative sample. Addict. Behav. 68, 39–44 (2017).

    Google Scholar 

  46. Fluharty, M., Taylor, A. E., Grabski, M. & Munafò, M. R. The association of cigarette smoking with depression and anxiety: A systematic review. Nicotine Tob. Res. 19, 3–13 (2017).

    Google Scholar 

  47. Fiorentini, A. et al. Substance-induced psychoses: An updated literature review. Front. Psychiatry 12, (2021).

  48. Ma, L., Steinberg, J. L., Moeller, F. G., Johns, S. E. & Narayana, P. A. Effect of cocaine dependence on brain connections: Clinical implications. Expert Rev. Neurother. 15, 1307–1319 (2015).

    Google Scholar 

  49. Mena, Á. Central nervous system disorders in HIV-infected individuals using distinct antiretroviral drugs. AIDS Rev. 23, (2023).

  50. Hoffmann, C. & Llibre, J. M. Neuropsychiatric adverse events with Dolutegravir and other integrase strand transfer inhibitors. AIDS Rev. 21, (2019).

  51. Cid-Silva, P. et al. Clinical experience with the integrase inhibitors Dolutegravir and Elvitegravir in <scp>HIV</scp> -infected patients: Efficacy, safety and tolerance. Basic Clin. Pharmacol. Toxicol. 121, 442–446 (2017).

    Google Scholar 

  52. Elzi, L. et al. Adverse events of raltegravir and dolutegravir. AIDS 31, 1853–1858 (2017).

    Google Scholar 

  53. European Pharmacovigilance Assessment Report. European Medicines Agency (EMA). Prezista. 68–69 https://www.ema.europa.eu/en/documents/product-information/prezista-epar-product-information_en.pdf (2024).

  54. European Public Assessment Report. European Medicines Agency (EMA). Symtuza. 48 https://www.ema.europa.eu/en/documents/product-information/symtuza-epar-product-information_en.pdf (2024).

  55. Altunal, L. N. et al. Prevalence of polypharmacy and potential drug-drug interactions associated with risk factors in the era of HIV integrase inhibitors: A prospective clinical study. AIDS Patient Care STDS 37, 138–145 (2023).

    Google Scholar 

  56. Deutschmann, E. et al. Prevalence of potential drug-drug interactions in patients of the Swiss HIV cohort study in the era of HIV integrase inhibitors. Clin. Infect. Dis. 73, e2145–e2152 (2021).

    Google Scholar 

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Acknowledgements

We want to particularly acknowledge the patients and the Biobank at the Galicia Sur Health Research Institute for their collaboration.

Funding

A.L.L. was supported by a Río Hortega contract (CM22/00243) from the Instituto de Salud Carlos III (ISCIII), Spanish Ministry of Science and Innovation. J.A.D. was supported by a predoctoral contract for research training in health (PFIS) (FI23/00006) from the Instituto de Salud Carlos III (ISCIII), Spanish Ministry of Science and Innovation.

Author information

Authors and Affiliations

  1. Virology and Pathogenesis Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), Complexo Hospitalario Universitario de Vigo, SERGAS-UVIGO, 36213, Vigo, Spain

    Aida López López, Alexandre Pérez González, Jacobo Alonso Domínguez & Eva Poveda

  2. Department of Pharmacy, Complexo Hospitalario Universitario de Vigo, Sergas, Vigo, Spain

    Aida López López & Noemí Martínez López de Castro

  3. Infectious Diseases Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, Sergas, Vigo, Spain

    Alexandre Pérez González, Antonio Ocampo & Celia Miralles

  4. Infectious Diseases Unit, Complexo Hospitalario Universitario de Vigo, Sergas, Vigo, Spain

    Luis Morano

  5. Statistics and Methodology Unit, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain

    José Aguayo Arjona

  6. Innovation in Clinical Pharmacy (I-FARMA-Vigo) Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain

    Noemí Martínez López de Castro

Contributions

A.L.L. contributed to the formal analysis, investigation, methodology, and writing of the original draft. A.P.G., J.A.D., A.O., C.M., L. M., and N.M.L.C. were responsible for investigation. J.A.A. contributed to methodology. E.P. contributed to conceptualization, investigation, and writing of the original draft. All authors reviewed and approved the final manuscript.

Corresponding author

Correspondence to Aida López López.

Ethics declarations

Competing interests

The authors declare no competing interests.

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Cite this article

López López, A., Pérez González, A., Alonso Domínguez, J. et al. High prevalence of polypharmacy and nervous system medications in people with HIV: a cross-sectional analysis. Sci Rep (2026). https://doi.org/10.1038/s41598-026-36832-4

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  • Received28 January 2025

  • Accepted16 January 2026

  • Published27 January 2026

  • DOIhttps://doi.org/10.1038/s41598-026-36832-4


This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License

Source: Nature
https://www.nature.com/articles/s42003-025-09284-1


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