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

Sci Rep. 2026 Jan 27;16(1):6413. doi: 10.1038/s41598-026-36832-4.

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.

Keywords: HIV; Multimorbidity; Non-antiretroviral medication; Polypharmacy; Psychotropic drugs.

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Polypharmacy*
  • Prevalence
  • Psychotropic Drugs* / therapeutic use
  • Spain / epidemiology

Substances

  • Psychotropic Drugs