Adherence to Bone Mineral Density Screening Recommendations in Older Adults with HIV

HIV guidelines recommend bone mineral density (BMD) screening by dual-energy x-ray absorptiometry (DXA) for all postmenopausal women and all men ≥50 years, but uptake of these recommendations has been low. We conducted a retrospective cross-sectional analysis of people with HIV (PWH) aged ≥65 or older engaged in routine care to determine DXA completion. We reviewed records of 300 patients (243 men; 57 women). 48% had a DXA scan ordered, and 85% of those with a DXA order had results available within the electronic record. Of those screened, 13% of women and 27% of men had normal BMD; 45% of women and 53% of men had osteopenia; and 42% of women and 20% of men had osteoporosis. Older PWH at the highest fracture risk were under-screened for low BMD, per current HIV guidelines. Improved fracture risk screening is needed for this high-risk patient population.