This is an English idiom, meaning something like "what do you think?". An approximation in Spanish would be "¿Qué te piensas?"
It can also, in English, be a response to a question about one's health, etc.
Person A: How are you (these days)?
Person B: Oh, I'm fine. HOW ABOUT YOU?
In this case, the Spanish 'How about you?' would be: 'Y tu?', if you know the person well,
while 'Y usted?' would suit if your relationship is more formal.
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