Evaluation of screening practices for low bone mass and prevalence of osteoporosis and fractures in people living with HIV attending a sexual health clinic

BACKGROUND: Adults with human immunodeficiency virus (HIV) infection commonly experience fractures and have a high prevalence of osteoporosis. The reasons for low bone mineral density (BMD) in HIV patients are multifactorial and there are now guidelines for screening. AIMS: The aims of this study were to determine the screening practices for osteoporosis at this sexual health clinic, the prevalence of osteoporosis and to examine the risk factors for bone disease. METHODS: We performed a retrospective cohort study of all HIV patients attending the Sunshine Coast Health Service District Sexual Health Clinic. Through chart review we collected the following details: patient demographics, co-morbid conditions, HIV status and anti-retroviral therapy, BMD screening, fractures, screening for secondary causes of bone disease and treatment interventions for osteoporosis. RESULTS: A total of 243 patients with HIV attended the sexual health clinic. Of these, 149 met screening criteria for BMD assessment and 93 (61%) of those eligible underwent BMD examination. In those who had a BMD performed, 13 (19%) had sustained a previous fracture, 28 (30%) had osteoporosis and 42 (45%) had osteopenia. In the osteoporosis group, 21 (78%) were treated with vitamin D and calcium, 7 (26%) had a change in ART, 19 (68%) were treated with anti-resorptive therapy and 9 received testosterone replacement. CONCLUSIONS: In this cohort, there was a high prevalence of low bone mass and BMD screening rates of 60%. Our results highlight the importance of this condition and the need to improve screening and availability of BMD assessment.