Prostate cancer presentation, treatment selection, and outcomes among men with HIV/AIDS: A clinical stage, race, and age-matched contemporary analysis

•In a contemporary series of racially diverse men with prostate cancer and HIV treated at an inner-city safety net hospital, while the majority of men had presented with AIDS previously, at the time of diagnosis with HIV, 91% were on HAART at the time of diagnosis with prostate cancer with well-controlled HIV.•No differences in oncologic outcomes including progression and cancer-specific mortality were observed between men with prostate cancer with and without HIV, matched by age, race, and clinical stage. However, HIV was associated with an increased risk of all-cause mortality.•Differences were observed with respect to treatment receipt on the basis of HIV status such that men with HIV and localized prostate cancer were more likely to receive radiation therapy compared to surgery or AS than men without HIV. To compare the clinical presentation, treatment receipt, and oncologic outcomes between human immunodeficiency virus-seropositive (HIV+) and seronegative (HIV−) men with prostate cancer (CaP) matched by age, clinical stage, and race. A retrospective review of 3,135 men treated for CaP from 2000 to 2016 was performed. HIV+ patients (N = 46) were matched 1:2 to 3 to HIV− men (N = 137) by age, race, and clinical stage. Clinicopathologic features and primary treatment received were compared between cohorts. Associations between HIV status and progression-free, cancer-specific, and overall survival were compared by HIV status using the Kaplan-Meier method and Cox proportional hazards analysis. After matching, men with and without HIV were similar with respect initial prostate-specific antigen, Gleason Sum, and Eastern Cooperative Oncology Group (ECOG) performance status. Among HIV+ men, 67.4% had a history of acquired immune deficiency syndrome, and 91.3% were on highly active antiretroviral therapy at CaP diagnosis. Among men with localized disease, HIV+ men were more likely to receive radiation (59.5% vs. 44.8%) or no therapy (13.5% vs. 4.3%) and less likely to receive surgery (16.2% vs. 30.2%), or to initiate active surveillance (10.8% vs. 16.4%; P = 0.04 overall). There were no differences in rates of clinical progression, development of castration resistance, or CaP death by HIV status. However, HIV+ status was associated with inferior overall survival (hazard ratio 2.89, P = 0.04). While most HIV+ patients had a history of acquired immune deficiency syndrome; HIV was well controlled in the majority of patients at the time of CaP diagnosis. While onco