I know next to nothing about HIV but my understanding from Nelson's comments and discussion of his book on the topic (Built to Survive) is that Nandrolone has been the go-to anti-wasting drug since the early 90's, often on doses much higher that what are discussed here. That seems like a good experience pool that would apply regardless of the last few years. As Nelson has acknowledged, issues can eventually arise, however much of medicine is about buying time until better approaches are available. I do have experience working with people who have extreme fragility, poor margin of strength safety, and debilitating pain, and the risk reward from sensible Nandrolone use in combination with other modalities seems overwhelmingly on the reward side.