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Introduction: The association of subclinical myocardial degeneration and cardiac function in human immunodeficiency virus (HIV) cohort is not fully investigated. The goal of this study was to assess the late gadolinium enhancement (LGE) scar amount or the fibrosis on T1 indices (native T1 and extracellular volume (ECV)) and evaluate their association with left ventricular (LV) ejection function (EF) in women with, or at risk for HIV infection. Methods: Women with and without HIV infection, but similar behavioral risk factors, participating in the Bronx and Brooklyn sites of the Women's Interagency HIV Study (WIHS) were included. Cardiac MRI was performed on Philips 3T scanner. Cine and LGE were multi-slice images covering the whole LV while T1 map was single-slice image at mid LV. Statistical linear regression analysis was used to assess the correlation coefficient. Data with skewed distribution were transformed to log scales. Results: Forty randomly chosen women were included. Participant and MRI characteristics were summarized in Table 1. LGE scar percentage of whole LV (Fig.1(a)) and ECV (Fig.1(b)) were significantly associated with EF while not in native T1 value. The association between ECV and LGE scar in whole LV (Fig.1 (c)) or in the mid LV slice (Fig. 1(d)) were not significant but exhibited a similar tendency. Conclusion: These findings linking myocardial scar and fibrosis to lower LVEF demonstrate the substrate for subclinical LV systolic dysfunction in a middle-aged women from race-ethnic minorities. Understanding the determinants for these widespread abnormalities could allow interventions to prevent heart failure in this high-risk population. [ABSTRACT FROM AUTHOR]