Children growing up with HIV infection have concerning deficits in skeletal strength which become more apparent towards the end of pubertal growth, finds the largest study to date to investigate the link between HIV and skeletal health in children. The study, conducted in Zimbabwe and published in The Lancet Child and Adolescent Health, identifies a link between these skeletal deficits and the first-line antiretroviral-HIV drug, tenofovir disproxil fumarate (TDF), which is widely used across sub-Saharan Africa.