Menopausal symptoms are associated with non-adherence to highly active antiretroviral therapy in human immunodeficiency virus-infected middle-aged women

Cutimanco-Pacheco, Víctor; Arriola-Montenegro, José; Mezones‐Holguín, Edward; Niño-García, Roberto; Bonifacio-Morales, N.; Lucchetti-Rodríguez, Aldo; Ticona, Eduardo; Blümel, Juan E.; Pérez‐López, Faustino R.; Chedraui, Peter

doi:10.1080/13697137.2019.1664457

Cited by 9 publications

(11 citation statements)

References 41 publications

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“…3 Only a few studies have specifically examined the association between menopausal symptoms and adherence to antiretroviral therapy (ART). [4][5][6][7] A recent analysis of the Positive Transitions through the Menopause (PRIME) study, a cross-sectional study of women living with HIV in the UK aged 45-60 years, reported a significant association between severe menopausal symptoms and both sub-optimal adherence and HIV clinic attendance. 7 Despite the significant impact of sub-optimal adherence and poor clinic attendance on clinical outcomes, 8,9 there are currently no clear data on whether clinical HIV outcomes change among women as they progress through different stages of the menopause.…”

Section: Introductionmentioning

confidence: 99%

Associations of menopausal age with virological outcomes and engagement in care among women living with HIV in the UK

Tariq

Burns

Gilleece

et al. 2020

HIV Research & Clinical Practice

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Background: Women ageing with HIV undergo sex-specific changes. There is limited evidence available with regards to how the menopause impacts HIV outcomes. Objective: To investigate whether menopausal age is associated with engagement-in-care (EIC), viral load (VL) suppression and rebound among women living with HIV. Methods: Women were grouped by age (<40, 40–50, >50 years), corresponding to pre-, peri- and post-menopausal stages. EIC, HIV VL suppression (VL < 50 copies/mL) within 12 months of antiretroviral therapy initiation and VL rebound (two consecutive VL > 50 copies/mL) after VL suppression were compared across age groups using logistic/Cox proportional hazards regression. Associations were compared to those seen in heterosexual men. Results: Six thousand four hundred and fifty-five (6455) eligible women (median age 36 [interquartile range: 29–42], 64.4% black African, 19.1% white) contributed 44,226 person-years (PYRS) of follow-up; 29,846, 10,980 and 3,399 PYRS in those aged <40, 40–50 and >50, respectively. Women were engaged-in-care for 79.5% of follow-up time, 3,344 (78.0%) experienced VL suppression and 739 (22.1%) VL rebound. After adjustment, women aged >50 years had lower EIC than those aged <40. Women aged 40–50 were more likely to have VL suppression and were less likely to experience VL rebound than those aged <40 years. Trends in heterosexual men were similar for EIC but with no evidence of a higher VL suppression rate in those aged 40–50 years ( p int. 0< .0001) and a stronger protective association between older age and VL rebound ( p int. 0< .0001). Conclusion: Our findings warrant further research into the potential impact of the menopause to support women and clinicians through HIV care.

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Section: Introductionmentioning

confidence: 99%

Associations of menopausal age with virological outcomes and engagement in care among women living with HIV in the UK

Tariq

Burns

Gilleece

et al. 2020

HIV Research & Clinical Practice

View full text Add to dashboard Cite

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“…12,[33][34][35] Recent studies have highlighted the association between menopausal age and/or symptoms and reduced clinic attendance and adherence to ART. [36][37][38][39] Our analysis adds to this emergent literature. We did not find evidence that mental health class membership was associated with undetectable last viral load or CD or CD4 count 200 cells/mm 3 .…”

Section: Haag Et Almentioning

confidence: 88%

Patterns of mental health symptoms among women living with HIV ages 45-60 in England: associations with demographic and clinical factors

et al. 2022

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Objective: We aimed to describe the prevalence of various mental health symptoms according to menopausal status (pre, peri, post) among women living with HIV ages 45-60 in England, and to identify groups of women with similar general and menopause-related mental health symptoms. We then investigated demographic predictors of group-membership and group differences in HIV-related care outcomes (antiretroviral therapy adherence, HIV clinic attendance, CD4-count, and last HIV viral load).Methods: An analysis of cross-sectional data from the Positive Transitions through Menopause study, an observational study of the health and well-being impacts of menopause on 869 women with HIV aged 45-60 years. Self-reported data on eight mental health indicators were collected from women in pre-, peri-and post-menopausal state using validated measures. Groups (termed ''classes'') of women with similar mental health symptoms were derived via latent class analysis. Class membership was linked to demographic factors using nominal logistic regression, and to clinical outcomes using Wald tests.Results: We identified five classes: 1) few mental health symptoms (n ¼ 501, 57.8%); 2) high current anxiety/ depression (n ¼ 120, 13.8%); 3) history of depression, with elevated current substance use (n ¼ 40, 4.6%); 4) history of depression with current psychological menopause symptoms (n ¼ 81, 9.3%); and 5) high previous and concurrent mental health problems (n ¼ 125, 14.4%). University attendance, ethnicity, and longer time since HIV diagnosis predicted class membership. Antiretroviral therapy adherence was lower in classes 3 (11%), 4 (19%) and 5 (24%) compared to class 1 (4%; all P < 0.001). Members of class 5 were more likely to have missed !1 HIV clinic appointment in the past year than those in class 1 (34% vs 17%, P ¼ 0.005).Conclusions: Women with a history of depression, current anxiety/depression, and current menopause-related mental health symptoms were more likely to have poorer clinical outcomes. Although we cannot comment on causality, our findings highlight the importance of assessing and managing menopausal symptoms and mental health to improve well-being and engagement in HIV care.

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“…Three recent studies indicated that women with severe menopausal symptoms are less likely to engage in medical care and to take their ART. [26][27][28] Data on its effect on virological control are only provided in one study, which found a nonsignificant trend toward lower viral suppression rates in women with severe menopausal symptoms. 26 Unfortunately, information on menopause symptoms in our patients are lacking, and we are not able to determine whether adverse virologic events occur more often in this subset of patients.…”

Section: Viral Suppression and Adherence During Menopause Transitionmentioning

confidence: 99%

Brief Report: Does Menopause Transition Influence Viral Suppression and Adherence in Women Living With HIV?

Hachfeld

Atkinson

Stute

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Increasing numbers of women living with HIV transition through menopause. It is unclear whether this transition has an impact on treatment adherence, viral suppression, psychiatric comorbidities, or drug use. We aimed at examining adherence and viral suppression during the perimenopausal period and explored the influence of psychiatric comorbidities and active injection drug use (IDU).

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Menopausal symptoms are associated with non-adherence to highly active antiretroviral therapy in human immunodeficiency virus-infected middle-aged women

Cited by 9 publications

References 41 publications

Associations of menopausal age with virological outcomes and engagement in care among women living with HIV in the UK

Associations of menopausal age with virological outcomes and engagement in care among women living with HIV in the UK

Patterns of mental health symptoms among women living with HIV ages 45-60 in England: associations with demographic and clinical factors

Brief Report: Does Menopause Transition Influence Viral Suppression and Adherence in Women Living With HIV?

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