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Background People living with HIV (PLHIV) are at increased risk of cardiovascular disease. The REPRIEVE trial demonstrated benefits of statin therapy for all PLHIV ≥40, regardless of traditional risk scores. 1 Aim To assess how often statins are recommended in HIV clinics, whether these lead to prescriptions in primary care, and key barriers to uptake.Methods A random sample of PLHIV aged ≥40 who attended HIV clinics in a region of England between March 2024 and December 2024 was selected. Statin prescribing was assessed using electronic records and GP data. Patients recommended a statin in clinic but not taking one at follow-up were invited to complete a questionnaire exploring information received in clinics, reasons for non-initiation and strategies to improve uptake.Results 271 cases were reviewed (26% female, mean age 53). Lifestyle advice was documented in 70.8%. Among 203 patients not already on statins, 111 (54.7%) were recommended one. Recommendation was more likely with QRISK3 >5% (χ²(1)=37.85, p<0.001) and increasing age (β=0.01, p=0.001), suggesting clinician bias toward traditional risk factors. Of 83 patients who did not decline a statin, 73.6% had no prescription at follow-up.36 patients completed a questionnaire; only 42% felt fully informed about statins. Key barriers included tablet burden, difficulty accessing GP appointments, and side effects (figure 1). Eight preferred more emphasis on lifestyle changes before medication. Participants suggested clearer discussions on side effects and more personalised information on risk could support decision-making.Abstract P12 Figure 1Key barriers to statin uptake in people living with HIV identified from patient questionnairesConclusion PLHIV face unique challenges to statin uptake, including polypharmacy, younger age, and disconnects between HIV services and primary care. Addressing clinician bias and improving patient communication are essential. A patient information leaflet is in development, and future work should include targeted educational sessions for primary care to support prescribing.Reference Grinspoon SK, Fitch KV, Zanni MV, et al. Pitavastatin to prevent cardiovascular disease in HIV infection. N Engl J Med. 2023;389:687–99.