A handful of studies have suggested that lipodystrophy affects men and women differently. According to one large study, based on surveys completed by patients and their doctors, women appear to be more likely to see fat increases in their upper bodies while men are more likely to see decreases in the amount of fat in their legs, arms, buttocks, or faces. Many men and women, however, suffer from both symptoms. It is not clear why there might be differences based on sex. It might be that HIV-positive men burn fat faster than HIV-positive women. It might also be due to different hormonal influences.
Some researchers believe that it might indicate two different syndromes—one that is more likely to cause fat loss and another that is associated with fat gains. More research is definitely needed to determine if there really are differences between HIV-positive men and women with respect to lipodystrophy. If there are differences, it will be even more important to determine what they mean and why the occur.
Several more recent studies have also confirmed that lipoatrophy is more common among white people with HIV and least common among black people with HIV. Hispanics fall somewhere in the middle. Some of the same studies have shown that fewer black HIV-positive women develop accumulation of fat in their gut than white or Hispanic women. These data are based on large cohort studies, so they may not offer a perfect picture of what happens in the real world.
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