Sharma A, et al. - Women with and without HIV were compared regarding skeletal microarchitecture using trabecular bone score (TBS). Researchers, in addition, assessed the relationships between change in TBS and lumbar spine (LS) bone mineral density (BMD). They performed dual-energy X-ray absorptiometry on 319 women with HIV and 118 without HIV in the Women's Interagency HIV Study at baseline and 2 and 5 years, to measure regional BMD and lean and fat mass. Compared to uninfected women, women with HIV displayed worse bone microarchitecture, but the two were similar in terms of annual percent change in LS BMD or TBS. Further study is recommended focusing on TBS use as an adjunct to BMD to improve prediction of fragility fractures in women with HIV.