GLP-1s and HIV: What You Need to Know Before Starting

GLP-1 receptor agonists (GLP-1s), including semaglutide, tirzepatide, and liraglutide, are increasingly used for weight management and show promise for people living with HIV (PLWH). While these medications are generally safe, PLWH may face additional considerations when using them due to how GLP-1s function and interact with antiretroviral therapy (ART). GLP-1s slow gastric emptying and suppress appetite, which may affect ART absorption; gastrointestinal side effects such as nausea or vomiting may also interfere with consistent ART dosing. Weight gain in PLWH is influenced by ART regimens (especially integrase inhibitors and formulations containing TAF) and demographic factors; lifestyle and diet remain important components of weight management. Medical experts advise consultation with HIV care providers before beginning GLP-1 therapy, particularly to monitor ART drug levels and to manage risks like loss of lean muscle mass, especially among older patients. Overall, GLP-1s offer a promising tool for weight loss in HIV care, but their use should be individualized and paired with careful medical oversight.