The sonic analog of Hawking radiation can now be experimentally recreated in Bose-Einstein condensates that contain an acoustic black hole. In these experiments the signal strength and approximate analog Hawking temperature increase for denser condensates, which however also suffer increased atom losses from inelastic collisions. To determine how these affect analog Hawking radiation, we numerically simulate creation of the latter in a Bose-Einstein condensate in the presence of atomic losses, including nonunitary quantum field dynamics using the truncated Wigner approximation. In particular we explore modifications of density-density correlations through which the radiation has been analyzed so far. We find no evidence that losses directly alter the basic picture of the analog Hawking effect; instead all consequences that we find are indirect: Losses increase the contrast of the correlation signal, which we attribute to condensate heating by the losses, in turn leading to a component of stimulated radiation in addition to the spontaneous one. Other indirect consequences are the modification of the white-hole instability pattern and a change of slope of the Hawking tongue.