Let me quickly review a few of the common causes as well as address your specific situation. Rest, diet and exercise can play a significant role. With busy schedules it's often quite difficult to find time for exercise, eating well-balanced meals or even getting adequate amounts of sleep. Virtually all of us who are HIV positive have periods of feeling upset, worried, anxious or depressed. Fatigued individuals should pay close attention to any concurrent symptoms such as fever, cough, headaches etc.
Hormonal imbalances can cause significant fatigue.
Decreased testosterone levels are a very common occurrence in HIV positive men and can be associated with fatigue, decreased libido and other symptoms. Other factors could include increased levels of cortisol an adrenal hormone that is produced in abundance during chronic infections as a normal body defense against stress. Low levels of thyroid hormone can also be associated with fatigue. Medications whether HIV related or not can often have fatigue as a potential side effect. Anemia, a decrease in red blood cells is one of the most common causes for fatigue in HIV infection.