{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:58:44Z","timestamp":1780451924352,"version":"3.54.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T00:00:00Z","timestamp":1737763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["NIHR302394"],"award-info":[{"award-number":["NIHR302394"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NHMRC Investigator","award":["GNT1197958"],"award-info":[{"award-number":["GNT1197958"]}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["206764\/Z\/17\/Z"],"award-info":[{"award-number":["206764\/Z\/17\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>HIV-related mortality has fallen due to the scale-up of antiretroviral therapy (ART), so more women living with HIV (WLH) now live to reach menopause. Menopausal estrogen loss causes bone loss, as do HIV and certain ART regimens. However, quantitative bone data from WLH are few in Africa. A cross-sectional study of women aged 40-60\u00a0yr (49% WLH) was conducted in Harare, Zimbabwe. Menopause status, fracture history, HIV status and treatment, and anthropometry were collected, and radial\/tibial peripheral QCT (pQCT) scans were performed. pQCT outcomes were distal radius and tibia trabecular volumetric BMD (vBMD), total area, and compressive bone strength (BSIc); proximal radius and tibia cortical vBMD, BMC, cortical thickness, bone area, and stress\u2013strain index (SSI). Linear regression determined differences by HIV status, minimally adjusted for age and menopause status, and further adjusted for height and fat mass. Relationships between pQCT parameters and major osteoporotic fracture history were explored using univariate logistic regression. In WLH, linear regression assessed associations between HIV and ART durations on pQCT measures. 384 women mean (SD) age 49.7 (5.8) yr had pQCT data. WLH had lower absolute pQCT measures at all sites. Overall, HIV-related deficits were robust to adjustment for age, menopause status, height, and fat mass: WLH had lower trabecular vBMD (radius \u22127.3 [\u221212.5; \u22122.0]%, tibia \u22125.4 [\u22129.1; \u22121.7]%), and cortical vBMD (radius \u22123.5 [\u22125.9; \u22121.1]%, tibia \u22121.1 [\u22121.6; \u22120.5]%). Strength estimates were lower in WLH and of similar magnitude at the radius and tibia. Longer HIV duration was associated with lower radius bone area, BMC, and estimates of bone strength, independent of ART duration. Trabecular deficits predominate in WLH, though with age cortical compartment bone loss may increase in importance. This is particularly concerning as these differences were observed at the radius, a common site of postmenopausal osteoporotic fracture.<\/jats:p>","DOI":"10.1093\/jbmr\/zjaf021","type":"journal-article","created":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T17:12:58Z","timestamp":1737825178000},"page":"454-462","source":"Crossref","is-referenced-by-count":6,"title":["Trabecular bone deficits predominate in the appendicular skeleton of midlife women living with HIV: findings from a cross-sectional study in Zimbabwe"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9695-6378","authenticated-orcid":false,"given":"M\u00edche\u00e1l","family":"\u00d3 Breasail","sequence":"first","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences, Monash Medical Centre, Monash University , Clayton, Victoria, 3168 ,","place":["Australia"]},{"name":"Population Health Sciences, Bristol Medical School , Bristol BS8 1NU ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2449-0027","authenticated-orcid":false,"given":"Tafadzwa","family":"Madanhire","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute , Harare ,","place":["Zimbabwe"]},{"name":"Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London WC1E 7HT ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia","family":"Kahari","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute , Harare ,","place":["Zimbabwe"]},{"name":"Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London WC1E 7HT ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter R","family":"Ebeling","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, Nursing and Health Sciences, School of Clinical Sciences, Monash Medical Centre, Monash University , Clayton, Victoria, 3168 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Simms","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute , Harare ,","place":["Zimbabwe"]},{"name":"Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine , London WC1E 7HT ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa K","family":"Micklesfield","sequence":"additional","affiliation":[{"name":"SAMRC\/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg , Johannesburg ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashida A","family":"Ferrand","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute , Harare ,","place":["Zimbabwe"]},{"name":"Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine , London WC1E 7HT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia L","family":"Gregson","sequence":"additional","affiliation":[{"name":"The Health Research Unit Zimbabwe, Biomedical Research and Training Institute , Harare ,","place":["Zimbabwe"]},{"name":"Global Musculoskeletal Research Group, Musculoskeletal Research Unit, Bristol Medical School, University of Bristol, Bristol BS10 5NB, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate A","family":"Ward","sequence":"additional","affiliation":[{"name":"MRC Lifecourse Epidemiology Centre, Human Development and Health, University of Southampton , Southampton SO16 6YD ,","place":["United Kingdom"]},{"name":"MRC Unit, The Gambia @ London School of Hygiene and Tropical Medicine , Banjul ,","place":["The Gambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,1,25]]},"reference":[{"key":"2025042106115611500_ref1","author":"UNAIDS"},{"issue":"15","key":"2025042106115611500_ref2","doi-asserted-by":"publisher","first-page":"2423","DOI":"10.1097\/QAD.0000000000002374","article-title":"Decreased HIV-associated mortality rates during scale-up of antiretroviral therapy, 2011-2016","volume":"33","author":"Otieno","year":"2019","journal-title":"AIDS (London, 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