Mixed

Initiation of modern antiretroviral therapy (ART), specifically integrase strand transfer inhibitors (INSTIs) like dolutegravir and bictegravir combined with tenofovir alafenamide (TAF), causes significant, sustained weight gain in people living with HIV, disproportionately affecting women and Black patients.

If you are living with HIV and starting or taking modern medication (specifically drugs ending in '-gravir' like dolutegravir or bictegravir, and TAF), expect significant weight gain, especially if you are a woman or Black. This is not just 'getting older' or 'eating too much'; it is a known side effect of the medication's interaction with your metabolism. Talk to your doctor about your risk factors. They may consider regimens with TDF (which mitigates weight gain) or other alternatives, though these may have other side effects. Be aware that standard diet and exercise might be less effective for this specific type of gain, and emerging weight-loss medications might be considered in the future.