Objectives With the increasing impact of cardiovascular disease among populations aging with HIV, contemporary prevalence estimates for predisposing metabolic comorbidities will be important for guiding the provision of relevant lifestyle and pharmacological interventions. We estimated the citywide prevalence of hypertension, type 2 diabetes, dyslipidemia, and obesity; examined differences by demographic subgroups; and assessed clinical correlates. Methods Utilizing an electronic medical record (EMR) database from the DC Cohort – a multi-center prospective cohort study of HIV outpatients – we assessed the period prevalence of metabolic comorbidities between 2011–2015 using composite definitions that incorporated diagnoses, pharmacy records, and clinical/laboratory results. Results Of 7,018 adult patients (median age 50 years; 77% black), 50% (95% CI: 49–51) had hypertension, 13% (95% CI: 12–14) had diabetes, 48% (95% CI: 47–49) had dyslipidemia, and 35% (95% CI: 34–36) had obesity. Hypertension was more prevalent among blacks, diabetes and obesity were more prevalent among females and blacks, dyslipidemia was more prevalent among males and whites, and comorbidities were more prevalent among older patients (all p<0.001). For many patients, evidence of treatment for these comorbidities was not available in the EMR. Longer time since HIV diagnosis, greater duration of antiretroviral treatment, and having controlled immuno-virological parameters were associated with metabolic comorbidities. Conclusions These findings underscore the pervasive burden of metabolic comorbidities among HIV-infected persons, serve as the basis for future analyses characterizing their impact on subsequent adverse cardiovascular outcomes, and highlight the need for an increased focus on the prevention and control of comorbid complications in this population.

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