For HIV+ people, is there any real benefit from taking regular doses of testosterone and/or steroids? Any side effects? Your advice please.

Well - first question. What is the goal of taking these meds?

One approach is to use testosterone as a replacement since enough men who have HIV infection have noted that there is a decrease in the body's ability to make testosterone. When these levels are low - we might feel it - as low energy, fatigue, decreased libido/sex drive. And a few studies have replaced the missing testosterone with supplements - which can be done either as a shot in the muscle, or as a patch, or in the next few months a new method will be available, providing testosterone as a gel which is rubbed into the skin. The dose can be individualized - meaning we can start with some standard dose and check the levels to see what happens. The studies that have been done do confirm that there are benefits to using these meds - there is increased muscle mass, and improved energy and mood. It is safe to use at least in the short term.

But some will also use testosterone supplementation, or other androgenic steroids like nandrolone or oxandrin or anadrol, to use in addition to whatever amount the body is already making. This is most often as a way to increase muscle mass, especially in those already doing some muscle building exercises. The use for this purpose is much more controversial - in part because there can be some side effects with these meds - which can include liver damage which can be serious, skin problems (acne), and mood changes (irritability). Sometimes there is a problem that we are trying to fix - like muscle loss from HIV infection and related problems, and the use of these approaches might be reasonable. But sometimes it is purely for cosmetic reasons - and this use is where there can be controversy, since these medications are controlled and not supposed to be used for these latter purposes.

Clinicians have very different understandings about how to approach the use of steroids, including what tests to use to decide when to use them, and what doses to use and for how long to use them. And any use of these meds must be monitored to ensure there are no side effects happening. So there must be a partnership with a provider.

Hope that helps. CC