When to Refer

The EACS Guidelines on prevention and management of co-morbidities in HIV recommend that patients are referred to a specialist in complicated cases, including:1

  • young men with osteoporosis
  • premenopausal women with osteoporosis
  • recurrent fracture despite bone protective therapy

Patients can also be referred:2

  • when the osteoporosis is unexpectedly severe
  • when there are significant secondary causes contributing to low bone mineral density (BMD)
  • in cases of treatment intolerance or failure


  1. European AIDS Clinical Society.  EACS Guidelines: Version 8.2. January 2017. Accessed 19 April 2017.
  2. McComsey GA, Tebas P, Shane E, et al. Bone disease in HIV infection: a practical review and recommendations for HIV care providers. Clin Infect Dis. 2010;51:937–946.