Women living with HIV(WLWH) in resource limited settings have benefited greatly from antiretroviral therapy(ART).However, they have several risk factors that can affect their bone health including being female, high parity/breastfeeding, use of life long ART, and HIV disease itself. This study assessed bone mineral density (BMD) among recently pregnant WLWH (WLWH-P), and compared BMD changes over3yr with WLWH who were not pregnant(WLWH-NP)and with recently pregnant HIV-negative
women (HIV-neg-P). We co-enrolled 104 WLWH-P from an ongoing cohort study in Malawi and Uganda, and used linear mixed models to compare standardized BMD values over 30-36 mo with 109 HIV-neg-P women matched for age-group/parity, and 99 age-group/parity matched WLWH who did not plan to become pregnant over 36 mo. BMD was assessed via DXA at baseline, 12, 24, and30-36mo. At baseline, median age of WLWH was 33yr withHIV-neg-Pbeing32yr.91.4%ofWLWH-P,and87.9%ofWLWH
NP were on Tenofovir-ART regimens. At baseline, 12, 24, and 30-36 mo postpartum, WLWH-P had lower mean standardized BMD values for FN, LS, and TH compared to HIV-neg-P women, although differences were not statistically significant except for baseline TH. In conclusion, both groups demonstrated BMD increase to above baseline scores by 30-36 mo. For WLWH-P compared to WLWH-NP, mean standardized BMD values trended lower between baseline and 24 mo. Both WLWH-P and HIV neg-P women showed BMD recovery to baseline for FN, LS, and TH by 30-36 mo postpartum. However, mean BMD standard
scores trended lower throughout follow-up for WLWH-P compared to HIV-neg-P women. WLWH-P and WLWH-NP women had similar BMD standardized scores by 30-36 mo. The BMD recovery results are encouraging, but longer follow-up is needed to assess fracture risk among older WLWH compared to HIV-negative women
