If you have HIV and your 'bad' cholesterol is already really high (190 or more), you're much more likely to see a big drop in it after starting a statin pill than someone whose reason for taking statins isn't clear — so your starting cholesterol level might tell doctors how well the medicine will work for you.

Only about 1 in 10 people with HIV are given the strongest cholesterol-lowering pills, and even when they are, those stronger pills don’t seem to work any better at lowering bad cholesterol than weaker ones—so doctors might not be prescribing them in the best way.

People with HIV don’t respond as well to cholesterol-lowering drugs called statins as healthy people do—even when they take the same dose. Their bad cholesterol only drops by about 17%, and only about 1 in 3 reach the goal of a 30% drop.

About 4 in 10 people with HIV are being given cholesterol-lowering pills even though they don’t clearly need them by current medical rules—meaning doctors might be prescribing them too often or not checking the guidelines properly.

A study of over 30,000 heart disease patients on statins suggests that aiming for very low cholesterol levels might not be necessary for everyone, even though guidelines recommend it.