The study investigates whether HIV infection is associated with an increased risk of acute myocardial infarction (AMI) compared to uninfected individuals, adjusting for standard Framingham risk factors. The Veterans Aging Cohort Study Virtual Cohort, which includes a large number of HIV-positive and demographically similar uninfected veterans, was analyzed. During a median follow-up of 5.9 years, 871 AMI events were observed. The results show that HIV-positive veterans had a significantly higher risk of AMI compared to uninfected veterans, with a hazard ratio (HR) of 1.48 (95% CI: 1.27-1.72) after adjusting for various factors. This increased risk persisted even among those with HIV-1 RNA levels below 500 copies/mL. The study concludes that HIV infection is independently associated with a 30% increased risk of AMI, and the Framingham risk score may underestimate this risk.The study investigates whether HIV infection is associated with an increased risk of acute myocardial infarction (AMI) compared to uninfected individuals, adjusting for standard Framingham risk factors. The Veterans Aging Cohort Study Virtual Cohort, which includes a large number of HIV-positive and demographically similar uninfected veterans, was analyzed. During a median follow-up of 5.9 years, 871 AMI events were observed. The results show that HIV-positive veterans had a significantly higher risk of AMI compared to uninfected veterans, with a hazard ratio (HR) of 1.48 (95% CI: 1.27-1.72) after adjusting for various factors. This increased risk persisted even among those with HIV-1 RNA levels below 500 copies/mL. The study concludes that HIV infection is independently associated with a 30% increased risk of AMI, and the Framingham risk score may underestimate this risk.