HIV Infection, Drug Use, and Onset of Natural Menopause

Schoenbaum, Ellie E.; Hartel, Diana; Lo, Yungtai; Howard, Andrea A.; Floris-Moore, Michelle; Arnsten, Julia H.; Santoro, Nanette

doi:10.1086/497270

Cited by 149 publications

(186 citation statements)

References 40 publications

(48 reference statements)

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“…As previously described, women 35 years of age and older were recruited from methadone maintenance clinics, primary care clinics, and community flyers and by word-of-mouth between September 2001 and January 2003. 3 Study enrollment was directed so that half of the participants were infected with HIV and half were uninfected, and so that 50% of the women within each of these groups were drug users. The study was approved by the institutional review boards at the Albert Einstein College of Medicine and Montefiore Medical Center.…”

Section: Methodsmentioning

confidence: 99%

“…Recent data suggest that an earlier onset of natural menopause may be associated with opioid use 3 and HIV. 3,4 However, information about menopause in this population is very limited.…”

Section: Introductionmentioning

confidence: 99%

“…18 Data from this prospective cohort (the Ms. Study) and the Women's Interagency HIV Study indicate that HIV is associated with an earlier age at natural onset of menopause (ie, 47-48 y). 3,4 Given this earlier age at onset, symptoms may begin many years before the final menstrual period, which may explain why the women in our sample did not know why they were experiencing these symptoms.It is quite striking that more than 70% of the women did not attribute vaginal dryness to menopause and that 37% of the women did not know why they had the symptom. Studies on access to menopause information are extremely scarce; one study published in 2000 reported that 100% (n = 12) of high school-educated African American women had no source of menopause information compared with 47% (n = 15) of high school-educated white women.…”

mentioning

confidence: 98%

“…Recent data suggest that an earlier onset of natural menopause may be associated with opioid use 3 and HIV. 3,4 However, information about menopause in this population is very limited.Menopause is associated with many symptoms including vasomotor symptoms, vaginal dryness, sleep disturbances, and psychological and cognitive problems. 5 However, hot flashes and vaginal dryness are the two symptoms most conclusively associated with a hypoestrogenic state.…”

mentioning

confidence: 99%

“…[8][9][10] Studies also suggest that women infected with HIV experience a greater number of menopausal symptoms than HIV-uninfected women. 11,12 Because menopause symptoms may come at an earlier age in HIV-infected and drug-using women, 3,4 it is possible that the women may not be aware of the reason for the symptoms.Thus, we performed a cross-sectional study to determine to what peri-and postmenopausal women with and at risk of HIV attribute menopausal symptoms. …”

mentioning

confidence: 99%

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Attribution of menopause symptoms in human immunodeficiency virus-infected or at-risk drug-using women

Johnson¹,

Cohen

Howard

et al. 2008

Menopause

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Objective-To examine the relationship of human immunodeficiency virus (HIV) and attribution of menopausal symptoms.Design-Peri-and postmenopausal women participating in a prospective study of HIV-infected and at-risk midlife women (the Ms. Study) were interviewed to determine whether they experienced hot flashes and/or vaginal dryness and to what they attributed these symptoms.Results-Of 278 women, 70% were perimenopausal; 54% were HIV-infected; and 52% had used crack, cocaine, heroin, and/or methadone within the past 5 years. Hot flashes were reported by 189 women and vaginal dryness was reported by 101 women. Overall, 69.8% attributed hot flashes to menopause and 28.7% attributed vaginal dryness to menopause. In bivariate analyses, age 45 years and older was associated with attributing hot flashes and vaginal dryness to menopause, and postmenopausal status and at least 12 years of education were associated with attributing vaginal dryness to menopause, but HIV status was not associated with attribution to menopause. In multivariate analysis, significant interactions between age and menopause status were found for both attribution of hot flashes (P = 0.019) and vaginal dryness (P = 0.029). Among perimenopausal women, older age was independently associated with attribution to menopause for hot flashes (adjusted odds ratio = 1.2, 95% CI: 1.1-1.4, P = 0.001) and vaginal dryness (adjusted odds ratio = 1.3, 95% CI: 1.1-1.6, P = 0.011). None of the tested factors were independently associated with attribution to menopause among postmenopausal women.Address correspondence to: Ellie E. Schoenbaum, MD, Belfer Building, Room 1312, 1300 Morris Park Avenue, Bronx, NY 10461. schoenba@aecom.yu.edu. Financial disclosure: None reported. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptConclusion-Tailored health education programs may be beneficial in increasing the knowledge about menopause among HIV-infected and drug-using women, particularly those who are perimenopausal. KeywordsMenopause; HIV; Menopause symptoms; Attribution; Drug useAs the human immunodeficiency virus (HIV)/acquired immunodeficiency virus (AIDS) epidemic evolves, more women are becoming affected, and in 2005, an estimated 23% of the people living with AIDS in the United States were women, 1 compared with 10% in 1990. 2 As people with HIV are living longer and healthier lives, HIV infection is increasingly viewed as a chronic disease. As a result, many of these women will traverse menopause. Recent data suggest that an earlier onset of natural menopause may be associated with opioid use 3 and HIV. 3,4 However, information about menopause in this population is very limited.Menopause is associated with many symptoms including vasomotor symptoms, vaginal dryness, sleep disturbances, and psychological and cognitive problems. 5 However, hot flashes and vaginal dryness are the two symptoms most conclusively associated with a hypoestrogenic state. 6,7 Studies in middle class and educated women found that hot flashes ...

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Section: Methodsmentioning

confidence: 99%

“…Recent data suggest that an earlier onset of natural menopause may be associated with opioid use 3 and HIV. 3,4 However, information about menopause in this population is very limited.…”

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 98%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Attribution of menopause symptoms in human immunodeficiency virus-infected or at-risk drug-using women

Johnson¹,

Cohen

Howard

et al. 2008

Menopause

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The HIV‐positive female

Sauer

Dolitsky

2021

Assisted Reproduction Techniques

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Addressing treatment and care needs of older adults living with HIV who use drugs

Chayama

McNeil

2020

J Intern AIDS Soc

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Introduction Older adults living with HIV (OALHIV; ≥50 years) who use drugs face unique needs and challenges that compromise their health and wellbeing due to the structural and environmental barriers they experience, in addition to being disproportionately affected by comorbidities. Nevertheless, research on this population is limited and work is needed to tailor and optimize their care and services. The purpose of this commentary is to address the key research gaps pertaining to OALHIV who use drugs. Discussion We identified four key research gaps specific to OALHIV who use drugs. Gap 1: Increased understanding of how older adults manage HIV alongside comorbidities in the context of substance use is critical to optimize their care management. Gap 2: More information on the geriatric characteristics of OALHIV who use drugs and the need and role of harm reduction in geriatric care is necessary for the provision of appropriate and effective care. Gap 3: Greater knowledge around the adoption of harm reduction and case manager approaches in various care facilities is essential to ensure equitable access to care for OALHIV who use drugs. Gap 4: Improved understanding of barriers to high‐quality palliative care among OALHIV who use drugs is important to enhance quality of life across their life course. Conclusions Addressing the identified gaps in literature will lead to a more fulsome understanding of the issues encountered by OALHIV who use drugs and inform the development and implementation of strategies that address disparities at the intersection of HIV, substance use and ageing.

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HIV Infection, Drug Use, and Onset of Natural Menopause

Cited by 149 publications

References 40 publications

Attribution of menopause symptoms in human immunodeficiency virus-infected or at-risk drug-using women

Attribution of menopause symptoms in human immunodeficiency virus-infected or at-risk drug-using women

The HIV‐positive female

Addressing treatment and care needs of older adults living with HIV who use drugs

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