People living with HIV are at greater risk for myocardial infarction (MI), or heart attacks, than their HIV-negative peers, a disparity that has widened over time. Previous research showed that HIV-positive people have higher rates of cardiovascular problems. Traditional risk factors (such as smoking), chronic inflammation and antiretroviral medications likely play a role. Researchers looked at changes in MI rates among HIV-positive and HIV-negative members of two large health systems in the San Francisco Bay Area and Boston. During 2005 to 2009, five-year MI incidence was the same in the two groups, at 1.1%. But the rates diverged during 2010 to 2017, rising to 1.2% in the HIV-positive group while falling to 0.9% in the HIV-negative group. This meant that people with HIV had a 60% higher heart attack risk, which appears to be driven more by a reduction in the HIV-negative group than an increase in the HIV-positive group. These findings underscore the importance of cardiovascular prevention for people living with HIV.