Advances in antiretroviral therapy have resulted in a significant increase in life expectancy and quality of life of people living with human immunodeficiency virus (HIV) (PLWH). However, long-term observation of this population revealed an increased risk of cardiovascular diseases (CVDs). Moreover, development of atherosclerosis may be secondary to numerous factors. Traditional risk factors of ischemic heart disease, such as hypertension, diabetes, and cigarette smoking, are more common in HIV-infected population than in non-HIV-infected one. Many antiretroviral drugs have an unfavorable metabolic profile, leading to dyslipidemia, lipodystrophy, and impaired glucose metabolism. Markers of immuno-activation, coagulation, and endothelium dysfunction, may remain elevated despite an effective antiretroviral treatment (ART). Inflammation affects arterial endothelium, leading to an increased deposition of lipids in the arterial wall. HIV infection may also affect blood pro-thrombotic activity. All these factors lead to more rapid atherosclerosis formation and increased risk of myocardial infarction. In order to lower cardiovascular risk in PLWH, traditional risk factors should be modified, and ART with less impact on patients’ metabolisms should be used. If necessary, a lipid-lowering treatment should be introduced. Treatment with statins brings an additional benefit of reducing inflammatory markers associated with an increased CVD risk. When selecting a statin, possible interactions with ART need to be considered.