Infection with the human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) may have adverse effects on any organ system. Because there is no cure for HIV infection, and because of ongoing new infection, the number of patients with HIV infection is still growing, especially in developing countries. Moreover, the advent of highly active antiretroviral therapy in conjunction with improved standard antiviral and antibiotic regimens has dramatically changed the clinical course of HIV infection, resulting in prolonged survival in those with access to it. As the population of HIV-infected individuals grows and ages, diseases of bone and mineral metabolism may become increasingly apparent which may cause considerable mortality, morbidity, and impaired quality of life. In this article we review the spectrum of bone and mineral diseases in HIV infection and AIDS, discuss the mechanisms underlying their pathogenesis, and provide practical guidelines for prevention and treatment.