Effect of Testosterone Use on Bone Mineral Density in HIV-Infected Men

Philip M. Grant, Xiuhong Li, Lisa P. Jacobson, Frank J. Palella, Lawrence A. Kingsley, Joseph B. Margolick, Adrian S. Dobs, Jordan E. Lake, Keri N. Althoff, Todd T. Brown

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


HIV-infected men have increased rates of osteoporosis and fracture compared to HIV-uninfected men. Testosterone use among HIV-infected men is common. In HIV-uninfected men, testosterone increases bone mineral density (BMD), but its effects have not been evaluated in HIV-infected men. In a substudy of Multicenter AIDS Cohort Study (MACS), the Bone Strength Substudy (BOSS) enrolled 202 HIV-infected and 201 HIV-uninfected men aged between 50 and 69 years. Study participants underwent dual-energy X-ray absorptiometry (DXA) at the lumbar spine (LS), total hip (TH), and femoral neck (FN) and detailed assessment of osteoporosis risk factors. We used multivariable linear regression to determine associations and 95% confidence intervals (CIs) between self-reported testosterone use and T-scores at the LS, TH, and FN after adjustment for demographics, behavioral covariates, comorbidities, and other traditional osteoporosis risk factors. HIV-infected men reported more frequent testosterone use (22% vs. 4%; p < .001) and had lower median BMD T-score at TH than HIV-uninfected men (0.0 vs. 0.3; p = .045) but similar T-scores at LS and FN. In the overall study population, testosterone use was associated with significantly greater BMD T-score at LS (0.68; 95% CI: 0.22-1.13). In HIV-infected men with virologic suppression, testosterone was significantly associated with higher BMD T-score at LS (0.95; 95% CI: 0.36-1.54) and TH (0.45; 95% CI: 0.04-0.86). Current testosterone use is common in HIV-infected men and was associated with higher BMD, compared to those not taking testosterone. Testosterone's role in reducing fracture risk in HIV-infected men should be investigated.

Original languageEnglish (US)
Pages (from-to)75-80
Number of pages6
JournalAIDS research and human retroviruses
Issue number1
StatePublished - Jan 2019


  • HIV infection
  • anti-HIV agents
  • bone density
  • humans
  • testosterone

ASJC Scopus subject areas

  • Infectious Diseases
  • Virology
  • Immunology


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