SPONSORED RESEARCH: Effects of HIV Pre-Exposure Prophylaxis (PrEP) on Cardiovascular-Kidney-Metabolic Health and Risk for Cardiovascular Disease

March 13, 2026

Above: Ado Rivera, PhD

Read a Q&A Below: 

Ado Rivera, MD, PhD, Assistant Professor at Northwestern University’s Feinberg School of Medicine Department of Medical Social Sciences (MSS) received a grant from the National Heart, Lung, and Blood Institute titled: "Effects of HIV Pre-Exposure Prophylaxis (PrEP) on Cardiovascular-Kidney-Metabolic Health and Risk for Cardiovascular Disease.” The team is led by researchers from Kaiser Permanente Southern California (Rulin Hechter, MD, PhD, MS; Matthew Mefford, PhD; Margo Sidell, ScD, MSPH). As co-investigator, Rivera provides expertise in target trial emulation and cardiovascular health research. Other co-investigators are researchers from Kaiser Northwestern California (Michael Silverberg, PhD, MPH), and Mid-Atlantic States Permanente Research Institute (Michael Horberg, MD, MAS, FACP, FIDSA).

What are the aims of the project? 

The project aims to delineate the long-term effects of oral HIV pre-exposure prophylaxis (PrEP) drugs on cardiovascular-kidney-metabolic health. Specifically, we will assess the impact of using PrEP on risk of hypertension, dyslipidemia, diabetes, chronic kidney disease, and cardiovascular disease. We will also assess if PrEP use influences the management of cardiometabolic conditions.

What are your next steps?

We will achieve the aims of the project by conducting a series of target trial emulations using electronic health records data from Kaiser Permanente. Target trial emulation is a methodologic framework that enables rigorous and transparent analysis of observational data. In our first year, we are currently designing the target trials and creating data pull specifications for the project.

What do you hope will come out of this funded research?

We will generate empirical evidence on the long-term impacts of oral HIV PrEP drugs on cardiovascular-kidney-metabolic health. Through this, we hope to inform guidelines and tailored prevention strategies that will reduce cardiovascular morbidity and mortality among individuals taking HIV PrEP. This work can also help develop evidence-based guidelines for prescribing tenofovir-based oral PrEP that consider not just a person’s risk of acquiring HIV, but also a person’s cardiovascular health.