Abstract [Objective] To investigate the incidence of subclinical vertebral fractures in young male AIDS patients after HAART, and to explore the risk factors. [Methods] From January 2018 to January 2019, 223 young male HIV-positive patients (aged 20-55 years) who visited the beijing ditan hospital affiliated to Capital Medical University were selected as the study group. All subjects were required to take T4-L4 standard lateral radiographs, record the fracture degree of each vertebral body in a semi-quantitative way, and calculate SDI index The bone mineral density of patients was measured by dual-energy X-ray bone densitometer, and the indexes such as age, height, weight, body mass index (BMI), CD4+T cell level, HIV infection time and HIV virus load were recorded, and the data were statistically analyzed. [Results] The incidence of subclinical vertebral fractures in the study group was 23.3%, 35.4% and 42.6% at 3 months, 6 months and 12 months after antiviral treatment, respectively. The duration of antiviral treatment, HIV load level and vertebral bone density are the risk factors of subclinical vertebral fractures in young and middle-aged male AIDS patients (P<0.05). [Conclusion] Spinal osteoporosis often occurs in young and middle-aged AIDS patients after antiviral treatment, and the incidence increases with the increase of antiviral treatment time. It is suggested that these people should have regular X-ray and bone mineral density examination. Key words: AIDS; Subclinical fracture of vertebral body; SDI index; Bone mineral density; Risk factor