Bone Health

As people get older, it's normal to lose calcium and phosphorus from bone, which causes something called 'osteopenia'. Mineral content gives bone its hardness and resistance to fractures. Osteopenia can therefore cause fragile, brittle bones, a condition known as 'osteoporosis'.

Being inactive can also cause problems with bone density. Equally, as people get older, their body stops making as many sex hormones. The loss of sex hormones in post-menopausal women and gradual decline in testosterone in ageing men are associated with increased risk of osteoporosis. Visit the AFAO Bone Health page to learn about lifestyle risk factors for osteopenia.

Collectively, people with HIV are at increased risk for osteopenia and osteoporosis because:

• They tend to be more likely to have the lifestyle risk factors for loss of bone mineral density, such as smoking or being inactive, excessive alcohol, and a lack of calcium and vitamin D.
• Some HIV medications can increase your risk.
• HIV itself may cause metabolic changes that decrease bone mineral density.

What you can do to live well:

• Ensure you have adequate calcium in your diet. Low fat dairy products and leafy green vegetables are good sources of calcium.
• Have your vitamin D blood levels measured and talk with your doctor about how to manage low levels.
• Get enough sunlight to produce vitamin D, while still being 'sun smart'. A person needs to expose their hands, face and arms (around 15% of body surface) to sunlight for about 6–8 minutes, 4–6 times per week (before 10am or after 2pm Standard Time in summer, for moderately fair people)
• Do regular weight-bearing exercise. Walking, jogging, weight training, regular dancing and a host of other physical activities help to strengthen bones. Exercise classes like aqua-aerobics may be an alternative to walking if pain is a problem.
• Stop smoking, and avoid excessive alcohol. Both of these accelerate bone loss.
• Get appropriate screening for your bone mineral density. Talk to your doctor about whether or not you need to get screened.
• Talk to your doctor about treatments if you have low bone mineral density such as supplements of calcium and vitamin D and prescription drugs used to prevent and treat osteoporosis.
• If you are experiencing pain, things like canes and walkers can reduce the risk of falls and reduce pain.
• For HIV-positive women, talk to your doctor about hormone replacement therapy (HRT) as an option for short term treatment of menopausal symptoms and to address your increased risk of osteoporosis. The decision to go on HRT may be more complex for HIV-positive women so discuss this with your doctor