Background Of myocardial infarctions (MI) recorded in two large HIV observational studies from North America, approximately half were classified as type 2. In the REPRIEVE clinical trial of pitavastatin vs. placebo in people with HIV (<3% of participants were from Europe), 20.6% of MIs were type 2. It is unknown what the proportion of type 1 and type 2 MI (T1MI, T2MI) is in European people with HIV. Methods Retrospective chart review, ascertainment of prospectively recorded and medically validated MIs, differentiation of T1MI and T2MI, MI time trend analysis in the Swiss HIV Cohort Study (01.01.2000-31.05.2021). Exploratory analysis of the associations of T1MI and T2MI with blood leukocyte count and two validated genome-wide coronary artery disease (CAD)-associated polygenic risk scores (metaGRS and GPSMult). Results Between 2000 and 2021, 16’027 SHCS participants accumulated 181’598 years of follow-up, and 379 had a validated first MI. Of these, 359 (94.7%) participants had T1MI, and 20 (5.3%) participants had T2MI. Invasive coronary angiography was done in 95% and 60% of participants with T1MI and T2MI, respectively. We found no evidence for increasing or decreasing incidence trends over time for T1MI (p=0.863) and T2MI (p=0.852). Participants in the highest quintile of leukocyte count, meta-GRS, and GPSMult had significantly increased adjusted odds ratio for T1MI; power was limited for detecting associations with T2MI. Conclusions The proportion of T2MI in people with HIV in Switzerland is approximately 5%, consistent with data from the general population, and lower than in previous North American reports among people with HIV.