Objectives We aimed to assess prevalence and age at menopause, identify factors associated with early menopause and explore the provision and utilization of healthcare in women living with HIV in Switzerland. Methods This was a retrospective Swiss HIV Cohort Study analysis from January 2010 to December 2018. Descriptive statistics to characterise the population and menopause onset. Logistic regression analysis to identify risk factors for early menopause. Results Of all women in the SHCS, the proportion of postmenopausal women tripled from 11.5% (n = 274) in 2010 to 36.1% (n = 961) in 2018. The median age at menopause was 50 years. Early menopause (< 45 years) occurred in 115 (10.2%) women and premature ovarian insufficiency (POI) (< 40 years) in 23 (2%) women. Early menopause was associated with black ethnicity (52.2% vs. 21.6%, p < 0.001), but not with HIV acquisition mode, CDC stage, viral suppression, CD4 cell count, hepatitis C, smoking or active drug use. While 92% of the postmenopausal women underwent a gynaecological examination during the 36 months before menopause documentation, only 27% received a bone mineral density measurement within 36 months after the last bleed and 11% were on hormone replacement therapy at the time of menopause documentation. Conclusions The median age of women living with HIV at menopause is around 2 years lower than that reported for HIV‐negative women in Switzerland. HIV care providers need to adapt their services to the requirements of the increasing number of women living with HIV transitioning through menopause. They should be able to recognize menopause‐associated symptoms and improve access to bone mineral density measurement as well as hormone replacement therapy.

To investigate the association between country incidence of type 1 diabetes and mortality from infectious disease and antibiotic susceptibility. An ecological study to explore the relationship at a country level of the reported incidence of type 1 diabetes (DiaMond) to infectious disease mortality (World Health Organisation) and to antibiotic susceptibility (Alexander Project). There were significant negative correlations between the incidence of type 1 diabetes and mortality for all infectious diseases studied. There were also significant positive correlations between the incidence of type 1 diabetes and antibiotic susceptibilities of Strep. pneumoniae, but not to those of Haem. influenzae. Since infectious disease mortality and antibiotic susceptibility are surrogate markers for bacterial exposure, our results provide support for a negative association between bacterial exposure in a community and its incidence of type 1 diabetes. The consistency of our results as well as the highly statistically significant results of most of the associations studied reinforces the validity of our findings.

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