The enhanced longevity of patients living with chronic HIV infection has resulted in an increasing burden of chronic diseases, and while there is growing evidence that HIV infected patients at risk for coronary artery disease at rates of up to two fold higher than the uninfected, the significance of chronic HIV infection in the peripheral vasculature is largely unknown. My principle clinical appointment has been at San Francisco General Hospital, which was at the center of the HIV epidemic in the 1980’s. This research program grew in response to the burden of disease witnessed in clinic on a weekly basis. A cursory review of the literature will show how little we understand about the link between HIV infection and peripheral arterial disease (PAD). My research focus is to bridge the gap in our understanding of the contribution of HIV infection to the development of PAD using a combination of clinical, epidemiological and translational research methodologies.