Obesity is a chronic disease with multiple adverse effects on health. The prevalence of obesity is increasing worldwide, and people of African ancestry are disproportionally affected. Several widely used antiretrovirals have been associated with weight gain and contribute to the rising burden of obesity in people with HIV.Obesity and weight gain on antiretroviral therapy are risk factors for the development of type 2 diabetes mellitus, a condition which also disproportionally affects black populations. In this review, we discuss recent data on weight gain in relation to initiating or switching antiretroviral therapy and advances in the management of obesity. Availability of highly effective treatments for obesity have the potential to address, and potentially reverse, the epidemics of obesity and diabetes mellitus in people with HIV.

We evaluated glycaemic status in 948 Black adults with HIV and report a high prevalence of dysglycaemia (37.2%). HbA1c testing identified 38 (4.0%) individuals not previously known to have diabetes mellitus (DM) and showed suboptimal or poor glycaemic control in more than half of those with a prior DM diagnosis despite high levels of HIV control.