A retrospective chart review was performed at the VA Portland Healthcare System Infectious Disease clinic. We identified all patients who received TRT for >6 months from 2000-2013. The comparison group was randomly selected with a 2:1 ratio of HIV patients who never took TRT (non-TRT group). The non-TRT group was group level matched based on age and duration of HIV diagnosis, and was selected from the same time period. Baseline data included demographics, comorbidies, medications, labs, CV risk factors and ART. Duration of TRT and adverse events (AE) were also collected. The primary outcomes were death and new CVE. Step-wise logistic regression was performed with a significance level of 0.05. There were 56 patients on TRT (median TRT duration 2.8 years, range 0.5-18.2 years) and 113 non-TRT patients evaluated. The TRT group had higher baseline hyperlipidemia, SBP>140 mmHg, and use of abacavir therapy (Table 1). There were 15/56 (26.8%) deaths in the TRT group v.s. 10/113 (8.8%), p=0.002. Incident CVE during the study interval was also significantly higher in the TRT group (Table 2). The odds of having a new CVE was significantly associated with TRT (OR=6.13, 95% CI=1.92,19.61, p=.002) even when controlling for antihypertensive therapy at baseline (OR=9.69, 95% CI=2.52,37.22, p=.001), CD4 count <200 at baseline (OR=2.89,CI=0.84,9.88, p=0.09), and use of abacavir (OR 2.89,CI=0.99,9.01, P=0.056).