Introduction

Osteoporosis and osteopenia are familiar terms to many older adults. A diagnosis of osteoporosis, a serious loss of bone mass, can bring on a lot of anxiety, as it generally means that a person's bones have become weaker and are more likely to break. And while a diagnosis of osteopenia, a less serious loss of bone, does not mean the same thing as an osteoporosis diagnosis, it can be of concern just the same. Unfortunately, many HIV-positive people – many of whom are younger than those who typically experience weakening bones – are learning that they, too, have osteopenia or osteoporosis.

The increased rates of osteopenia and osteoporosis among HIV-positive people is a concern, especially to those who have been diagnosed with these bone-related problems. However, we've come to understand that osteoporosis in young or middle-aged HIV-positive people is not quite the same as a diagnosis of osteoporosis in older adults. As research continues, we are learning more about osteopenia and osteoporosis in HIV – including their possible causes – and the ways in which to slow (or reverse) their progression.

This lesson reviews what we know – and what we don't know – about osteopenia and osteoporosis in HIV-positive people. The first part of this lesson reviews the basics of bone physiology. The second part of this lesson reviews osteoporosis, osteopenia, and the ways in which they are diagnosed. The third part of this lesson reviews the connections between HIV and these bone-related problems. Finally, in the fourth part of this lesson, we review the most common ways to prevent and treat osteoporosis, including some of the data from clinical trials involving HIV-positive people and some general tips for all HIV-positive people to be aware of.

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