WONDER: HIV in Women bOne miNeral Density fracturE and Frailty: a qualitative evaluation of the knowledge and attitudes of bone health in women living with HIV

With the advent of combination antiretroviral therapy (cART), people living with HIV (PLWH) are living longer, leading to increased prevalence of age-related comorbidities such as low bone mineral density (BMD). Women living with HIV (WLWH) are disproportionately affected due to intersecting risk factors, including menopause and long-term cART use. To explore this issue, a qualitative study was conducted in Sussex, England, involving focus groups and interviews with 16 cis-gendered WLWH (median age: 56; range: 35-72). Participants were ethnically represented: Black African (50%), White British (31.2%), and mixed backgrounds (12.5%). Discussions were co-facilitated by a researcher and a woman with lived experience of HIV, using a topic guide. Recruitment was supported by community organisations in May-June 2024. Thematic analysis revealed key themes: sources of information, perceived symptoms, menopause, HIV and comorbidities, healthcare experiences, stigma, support, ownership of care, and barriers to bone health and polypharmacy. Findings showed limited awareness among WLWH about BMD risk factors and management strategies. Participants voiced a strong need for tailored resources and educational materials to support bone health. The study highlights the importance of inclusive, community-based approaches to improve health literacy and empower WLWH in managing age-related comorbidities.