OBJECTIVES: Gender differences in cardiovascular risk (CVR) among HIV-infected patients have been reported, with conflicting results. We have previously reported data from the Registry and Prospective Analysis of Patients Infected with HIV and Dyslipidemia (RAPID II study) a higher CVR in males and higher rates of obesity, metabolic syndrome (MS), and lack of physical exercise in females. We now compare gender differences among Brazilian individuals METHODS: Adult HIV-infected patients with at least 6 months of HAART were enrolled in this longitudinal study that is being conducted in 7 countries. Metabolic profile, anthropometric parameters, CD4-cell count, viral load (VL), types of HAART, CVR factors, and Framingham score were compared by gender RESULTS: A total of 1001 Brazilian patients were enrolled, 655 (65.4%) were males. Mean (SD) age was 44 (10) years, mean time on HAART was 48.4(36.4) months, 48% were on a protease inhibitors-based HAART, mean CD4-cell count was 519 (274) cells/mm3, and mean VL was 2.29 (0.9) log10 copies/ml. Males were found to have higher 10-year CVR (15.9 ± 30.1 vs 11.0 ± 29.6; P=0.0136) and were more likely to belong to the high-risk category (15.9% vs 10.4%; P=0.021) than females. No gender differences were found in the rates of hypertension, type II diabetes, or MS. Female patients showed higher prevalence of obesity (12.7% vs 7.2%; P=0.005) and physical inactivity (66.5% vs 53.6%; P<0.001) than males. In contrast, male patients were older (44.5 ± 9.4 vs 43.0 ± 10.4 years; P=0.0194), and had higher rates of smoking (24.4% vs 17.6%; P=0.016) and dyslipidemia (81.8% vs 74.6%; P=0.009) than females CONCLUSIONS: Brazilian individuals sheds light on gender differences whose recognition may be important for appropriate intervention on modifiable CVR factors