LAUSR

BACKGROUND People with HIV (PWH) have a higher prevalence of bone mineral density (BMD) loss compared to people without HIV. The Infectious Diseases Society of America (IDSA) recommends BMD screening via dual energy X-ray absorptiometry (DXA) in PWH starting at age 50. We aimed to evaluate adherence to this recommendation in a population of Veterans with HIV (VWH). METHODS Retrospective, cross-sectional analysis of VWH followed from 2014-2018 at the Michael E. DeBakey VA Medical Center Infectious Diseases Clinic, Houston, Texas. We collected data via registry extraction and chart review. We calculated the percentage of VWH with timely BMD loss screening by DXA within five years of turning 50. Secondary outcomes included prevalence of osteopenia, osteoporosis, and vitamin D deficiency. RESULTS We included data from 1,243 VWH. Their average age was 52 years (range 18 to 86). Most were male (95%) and 59% were black. Of the 346 VWH who turned 50 years old during the study period, 78 (22.5%) underwent DXA within five years. Of these, 42 (53.8%) had normal BMD, 28 (35.9%) had osteopenia, and eight (10.3%) had osteoporosis. 993 (79.9 %) VWH had available 25-hydroxyvitamin D levels; of these, 453 (45%) had normal levels, 304 (30.6%) had vitamin D insufficiency, 184 (18.5%) had vitamin D deficiency, and 52 (5.2%) had severe vitamin D deficiency. CONCLUSIONS Fewer than 25% of eligible VWH underwent timely BMD loss screening by DXA per IDSA guidelines. Almost half of screened VWH showed evidence of BMD loss. Though limited by lack of follow up and fracture data, this study emphasizes the importance of improving BMD loss screening in this vulnerable population.