INS and metabolic syndrome: These vascular effects, coupled with HIV-associated lipodystrophy (HALS), characterized by predominant central obesity and with ART-induced metabolic abnormalities, including hypertriglyceridemia, decreased HDL-C, reduced insulin sensitivity, and higher plasma glucose, combined with and synergize traditional lifestyle risk factors (e.g., aging and obesity) to determine high prevalence of MetS and hypertension in PWH.