The link between HIV and reduced bone mineral density, including osteopenia and the more severe osteoporosis, is well established. HIV infection has also been associated with an increased risk of fractures. It is so far unclear whether this is due to HIV itself, resulting inflammatory and metabolic changes, antiretroviral toxicity, or some combination of factors. This topic was the focus of major debate at the 7th IAS Conference held in Kuala Lumpur, Malaysia, in early July 2013.