Impact of an Early Body Mass Index Maintenance Intervention at ART initiation on Diabetes Risk: Insights from a Computer Simulation Study
6 affiliations
- 1The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- 2The Johns Hopkins Whiting School of Engineering, Baltimore, MD
- 3Vanderbilt University Medical Center, Nashville, TN
- 4Nashville CARES, Nashville, TN
- 5University of Colorado Anschutz Medical Campus, Aurora, CO
- 6The George Washington University, Washington, DC
Abstract
BACKGROUND: Weight gain after antiretroviral therapy (ART) initiation increases type 2 diabetes risk among people with HIV (PWH). We assessed whether a hypothetical body mass index (BMI) maintenance intervention post-ART initiation could reduce diabetes risk among PWH in the United States. METHODS: ) and no prior diabetes diagnosis. Participants were followed under intervention and control (no intervention) scenarios. Diabetes risk was calculated as new diagnoses per 1,000 person-years over seven years after ART initiation. RESULTS: The model forecasted a median of 171000 ART initiations between 2013-2017, with 73% eligible for this intervention. Without intervention, 66% would gain BMI, and 12% would become obese in the first two years post-ART initiation. The forecasted diabetes risk was 10.7 per 1000 person-years (9500 new diagnoses over seven years). The intervention reduced diabetes risk (relative risk=0.86; 0.82-0.89), averting a median of 1300 cases, with the largest reductions among women who inject drugs and Hispanic heterosexual men. CONCLUSION: Preventing BMI increases post-ART initiation could significantly reduce diabetes risk and improve health outcomes among PWH. Tailored weight maintenance strategies are needed to address diverse subgroup needs.
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BibTeX
@article{kasaie2026impact,
title = {{Impact of an Early Body Mass Index Maintenance Intervention at ART initiation on Diabetes Risk: Insights from a Computer Simulation Study}},
author = {Parastu Kasaie and Yao Zhao and Elizabeth Humes and Lucas Gerace and Kendall Reid and Catherine R. Lesko and Katherine E. Kurgansky and John R. Koethe and Peter F. Rebeiro and Kassem Bourgi and Kristine M. Erlandson and Kelly Gebo and Keri N Althoff},
journal = {Annals of epidemiology},
year = {2026},
month = sep,
doi = {10.1016/j.annepidem.2026.110292},
url = {https://doi.org/10.1016/j.annepidem.2026.110292},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Impact of an Early Body Mass Index Maintenance Intervention at ART initiation on Diabetes Risk: Insights from a Computer Simulation Study
AU - Parastu Kasaie
AU - Yao Zhao
AU - Elizabeth Humes
AU - Lucas Gerace
AU - Kendall Reid
AU - Catherine R. Lesko
AU - Katherine E. Kurgansky
AU - John R. Koethe
AU - Peter F. Rebeiro
AU - Kassem Bourgi
AU - Kristine M. Erlandson
AU - Kelly Gebo
AU - Keri N Althoff
PY - 2026
DA - 2026/09/22
JO - Annals of epidemiology
DO - 10.1016/j.annepidem.2026.110292
UR - https://doi.org/10.1016/j.annepidem.2026.110292
AB - BACKGROUND: Weight gain after antiretroviral therapy (ART) initiation increases type 2 diabetes risk among people with HIV (PWH). We assessed whether a hypothetical body mass index (BMI) maintenance intervention post-ART initiation could reduce diabetes risk among PWH in the United States. METHODS: ) and no prior diabetes diagnosis. Participants were followed under intervention and control (no intervention) scenarios. Diabetes risk was calculated as new diagnoses per 1,000 person-years over seven years after ART initiation. RESULTS: The model forecasted a median of 171000 ART initiations between 2013-2017, with 73% eligible for this intervention. Without intervention, 66% would gain BMI, and 12% would become obese in the first two years post-ART initiation. The forecasted diabetes risk was 10.7 per 1000 person-years (9500 new diagnoses over seven years). The intervention reduced diabetes risk (relative risk=0.86; 0.82-0.89), averting a median of 1300 cases, with the largest reductions among women who inject drugs and Hispanic heterosexual men. CONCLUSION: Preventing BMI increases post-ART initiation could significantly reduce diabetes risk and improve health outcomes among PWH. Tailored weight maintenance strategies are needed to address diverse subgroup needs.
SN - 1047-2797
SN - 1873-2585
ER -