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HIV and Bone Health

You know your HIV viral load but do you know how strong your bones are?

No matter what your age, you can find information here about how to monitor and maintain healthy, strong bones and prevent the onset of osteoporosis, a condition where bones are thin and weak.

Read below to find out more about:

  • What impacts bone health and how to keep yours as strong as possible
  • Real-life stories about living with HIV, including why it’s important to look after your bones
  • The meaning of osteoporosis and osteopenia
  • Risk factors and what to do if you already have osteoporosis (thinning bones)

To help you plan for your next appointment and helpful questions to ask, go to What To Ask for tips and downloadable questions.

What do I need to know?


HIV affects each person differently and it can impact bone health. For some people there may be an increased risk of developing osteoporosis (weak, thinner bones), although living with HIV does not necessarily mean you will go on to develop the condition.


  • Lifestyle factors, including:
    • Smoking
    • Low body weight
    • Alcohol consumption
  • The HIV virus itself 
  • Low hormone levels (particularly male and female sex hormones testosterone and oestrogen) 
  • Some HIV antiretroviral medicines associated with faster bone loss

The good news is there are tests available to monitor how strong your bones are, as well as information to help you to make choices to keep your bones as healthy as possible. Regardless of HIV status, anyone can develop osteoporosis.

Talk to your healthcare team about:

  • Your hormone levels
  • Your vitamin D and calcium levels
  • Whether you are on the best treatment for you

Become familiar with your test results to monitor your bone health.

A personal journey and why bone health matters

What is osteoporosis?


  • Osteoporosis literally means ‘porous bones’ and is often referred to as the fragile bone disease
  • It is a condition in which bones lose their strength and are more likely to break, usually following a minor bump or fall
  • After the age of about 35 years, our bones start to get thinner. This change in the quality of our bones is much more likely as you get older, which explains why bones become more fragile and fractures become more common in old age
  • Another condition – osteopenia – describes cases where bone mineral density (also known as BMD) is lower than normal, without being as severe as osteoporosis

Three decades on and still healthy with HIV

Can HIV cause osteoporosis?


There is no simple answer as HIV can affect each person differently, but studies suggest that up to 67% of people living with HIV have weak bones (low bone mineral density/thinning bones) and 15% have osteoporosis.


  • Women are more susceptible to osteoporosis because bone loss becomes more rapid for several years after the menopause
  • People over the age of 50 are at an increased risk, as bones become gradually thinner, weaker and more fragile over time
  • Ethnicity and family history can also impact your risk
  • Smoking, poor diet and alcohol consumption also increases your risks

To regularly monitor how strong your bones are, your healthcare team might:

  • Review your lifestyle choices with you to identify where changes can be made, this can include:
    • Diet
    • Alcohol consumption
    • Smoking  
  • Test your vitamin D levels
  • Review any medications you are on, including your HIV treatment


The good news is that its progress can be slowed and in some cases bone density can be improved to reverse thinning to some degree.

There are lifestyle changes you can make to help your bones stay healthy, such as:  

  • Stop smoking or look at cutting back
  • Keep a healthy diet
  • Cut down on alcohol
  • Getting enough calcium and vitamin D

What else can help?

There are also medications available for some people to reduce the risk of broken bones, talk to your healthcare team for more information. These medicines can:

  • Slow bone loss
  • Rebuild bone




  1. Discuss your bone health with your healthcare team
  2. Maintain a healthy weight
    By eating a balanced diet – it is important to not be underweight or overweight
  3. Do weight-bearing activities
    Like running, walking and climbing the stairs, under the guidance of your healthcare team
  4. Use weights (resistance training)
    To build strength, under the guidance of your healthcare team
  5. Don’t smoke
    Or look for ways to help you cut back
  1. Don’t drink too much alcohol
  2. Know your family history
  3. Make sure you eat enough calcium
    Found in foods such as milk, cheese, yoghurt, dark green vegetables and sardines
  4. Get enough vitamin D (from sunlight)
  5. Download apps that can help you monitor your health
    Such as recording your vitamin D level or offer support to stop drinking

To find out what else you can do to take care of Your Body and live well with HIV, click on the boxes below:

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