Women With HIV More Likely to Get Vitamin D From Supplements, Not Diet

Women living with HIV in Canada showed lower dietary vitamin D intake but higher supplementation rates compared with women without HIV, according to a case-control study published in HIV Medicine.

The authors suggested women with HIV who smoke, have low income, and are non-White may especially benefit from targeted efforts to improve vitamin D intake, as these women had the lowest odds of adequate vitamin D intake. They also said these findings suggest health care providers are promoting supplementation for women with HIV.

This case-control study included 95 women with HIV from the Children and Women: AntiRetrovirals and Markers of Aging (CARMA) cohort, matched to 284 women without HIV from the Canadian Multicentre Osteoporosis Study (CaMos). The authors also used regression modelling to assess any barriers to supplementation and factors associated with dietary intake.

They noted that women living with HIV in this study had lower income and bone mineral density, and were more likely to smoke, take multiple medications, and be non-White.

Regardless of method, median (IQR) total vitamin D intake was fairly similar between women with and without HIV, at 8.28 (0.48-20.57) μg/day and 5.27 (1.43-11.61) μg/day, respectively.

According to the authors, vitamin D dietary intake was significantly lower in women with HIV compared with women without HIV. Median (IQR) daily dietary vitamin D intake among women with HIV was less than half that of women without HIV at 0.76 (0.20-2.58) μg/day vs 1.79 (0.62-3.93) μg/day, respectively.

Women with HIV were 71% less likely to consume dietary vitamin D above the median. These odds were 76% lower among women with HIV with low household income (adjusted odds ratio [aOR], 0.24; 95% CI, 0.09-0.59; P = .002). Further, non-White women—most of whom were living with HIV—had lower odds of adequate dietary vitamin D intake compared with White women (aOR, 0.31; 95% CI, 0.14-0.65; P = .002)

However, vitamin D supplementation intake was higher among women with HIV (62.2%) compared with controls (44.7%) (P = .003).

Among women taking vitamin D supplements in general, the daily dose was also higher among women living with HIV with a median dose of 20 μg/day, double the median dose of 10 μg/day for women without HIV (P < .0001).

“Only 34.2% of women with HIV (26/76) and 18.7% of HIV-negative women (53/284) met Health Canada's recommended intake of 15 μg/day (600 IU/day) from supplements and dietary dairy products,” the authors noted.

Being aged 55 years and older (aOR, 3.52; 95% CI, 1.4308.98; P = .007) or taking more than 5 medications (aOR, 3.57; 95% CI, 1.30-10.74; P = .02) were listed as additional factors linked to higher odds of vitamin D supplementation in this study.

Additionally, smoking was associated with no vitamin D supplementation, and non-White ethnicity and low income were related to lower dietary intake.

Several limitations such as time of data collection, changes in vitamin D supplement popularity in Canada, exclusion of other forms of vitamin D intake, and other factors were noted, and these findings should be interpreted with these limitations in mind.

“Further research should consider whether women living with HIV would benefit from higher than ‘adequate’ doses of vitamin D, given their numerous risk factors for osteoporosis and fracture,” the authors concluded.

Reference

King EM, Swann SA, Prior JC, et al. Vitamin D intakes among women living with and without HIV in Canada. HIV Med. Published online January 4, 2023. doi:10.1111/hiv.13454