Resilience and psychosocial factors linked to symptom experience during the menopause transition for women living with HIV*

Abstract

Objective: Women living with HIV (WLWH) are commonly symptomatic during perimenopause and menopause (!1 y without menstruation), however, little is known of risks for symptoms and their timing. We analyzed these unwanted experiences to inform care.Methods: WLWH (!40 y) in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study rated midlife experiences for seven symptoms and a symptom composite (from 0 to 21). Timing was categorized into four phases: i) perimenopause (flow in the last year), ii) 1-2 years from final menstrual period (FMP), iii) 2-5 years post-FMP; and iv) >5 years post-FMP. Resilience (standardized out of 100) was assessed based on Wagnild's Resilience Scale. Univariable/multivariable mixed effects linear regression assessed correlates of symptom intensity by composite score.Results: Among 457 peri-/menopausal women mean age 54.7 (AE6.6) over two time points (703 observations), 88% experienced !1 mild symptom; 75% were of moderate and 55% severe intensity. The most frequently reported symptoms were joint/muscle stiffness (67%), depressed mood (67%), and hot flashes (57%). After adjusting for reproductive phase, we found that women with greater resilience had fewer/lower intensity symptoms (symptom score 1.37 [2.30 to 0.44] lower; P ¼ 0.004); those with depressive symptoms and recreational drug use (respectively) had more/higher intensity symptoms (scores 1.71 [0.61 to 2.82] [P ¼ 0.002]; 2.89 [2.09 to 3.77] [P < 0.001] higher). Symptoms were most intense in perimenopause and declined with increasing menopausal years (P ¼ 0.03).Conclusions: WLWH experiences a high burden of midlife symptoms, decreased by resilience and most intense during perimenopause. Unwanted experiences were linked to psychosocial and behavioral factors. These data encourage HIV providers to adopt a bio-psychosocial approach to midlife management.

Sexual Satisfaction of Midlife Women Living With HIV in Canada: A Prospective Cohort Analysis

“…58 Reasons behind this lack of association between physical health and sexual satisfaction warrant further exploration. One influencing factor may be the high degree of resilience observed in cohorts of women with HIV, [59][60][61] whereby resilient behaviors may be allowing this group to develop strong coping strategies to deal with physical health limitations. Other explanations for this finding should be explored in future research.…”