To characterize comorbid disease and medication burden among women living with HIV (WLWH) in British Columbia (BC), Canada.We examined baseline data from 267 WLWH and 276 HIV-negative females, ≥19 years, enrolled in the Children and Women: Antiretrovirals and Markers of Aging (CARMA) cohort.Self-reported demographic, medical condition, medication, vitamin, and substance exposure data were collected at baseline CARMA study visits. We considered conditions with appropriate concomitant medications to be "treated". Wilcoxon rank-sum and Fisher's exact tests compared continuous and categorical variables between WLWH and HIV-negative women. Number of diagnoses, prescribed medications (excluding HIV/antiretrovirals), vitamins, and prevalence of depression/anxiety/panic disorder were compared using negative binomial and logistic regressions for continuous and binary variables respectively.WLWH were younger (median [IQR] 39.9 [33.6-46.9] vs 43.6 [31.8-54.6] years, p = 0.01), attained lower education (40.5% vs 69.6% college/university, p < 0.001), and more often currently smoked tobacco (47.9% vs 31.9%, p < 0.001), or had income <$15,000/year (49.0% vs 43.1%, p < 0.001). Although younger, and despite omitting HIV infection, WLWH had a greater number of diagnoses (IRR [95%CI] 1.58 [1.38-1.81], p <0.001), and more depression/anxiety/panic disorder versus controls (OR [95% CI], 1.86 [1.22-2.83], p = 0.004). Our model predicts that with mean BMI (26.3), WLWH and HIV-negative peers would have two comorbid diagnoses by age 30 and 60, respectively.WLWH living in BC have more comorbid illness earlier in life than their HIV-negative peers, and have very high rates of depression/anxiety/panic disorder. Addressing mental health and comorbid conditions is essential to improving health outcomes among WLWH.