As if tired bones weren’t enough, a new study shows that middle-aged HIV positive women are more likely to have bone loss than their negative sisters. Most past research on bone loss (osteopenia or the more advanced osteoporosis) was done in positive men and didn’t make comparisons to those without HIV. In the April 1st issue of Clinical Infectious Diseases, Julia Arnsten, MD, of New York’s Montefiore Medical Center, compared 263 positive and 232 negative women age 40 or older—most not yet menopausal—with similar risk profiles such as being overweight or, for some, a history of heroin or cocaine use. Overall, 27% of the positive women had some bone loss in the hips and spine, compared with 19% of the negative women. The HIV link appeared in white and Latina women but not black women.

Bone thinning didn’t correlate to length of infection, nor was it linked to HIV meds, which had been fingered in some previous studies. The causes remain mysterious, though hormone levels may be involved. Arnsten recommends regular bone-density screening.

Also be sure to exercise, shun cigarettes and chug vitamin D and calcium. You’ll find vitamin D in milk products, fatty fish (like tuna), eggs and nuts. Calcium lurks in dairy foods, tofu, broccoli and kale and canned fish with bones (like sardines). Consult your doctor about how much you need. If your diet doesn’t supply enough, add a supplement that is not made from bonemeal or oyster shells, which can harbor unwanted metals (try carbonate or citrate). Bone voyage.