Table 3.
Summary of studies assessing menopausal symptoms in women with HIV
| Authors | Study design | Location | Population | Findings |
|---|---|---|---|---|
| Clark et al84 | Cross-sectional | USA | 52 HIV-positive women ≥40 years with adequate menopausal information; 50% postmenopausal | In HIV-positive menopausal women, higher CD4 count associated with increased prevalence of hot flashes: 23% in those with CD4 <200 vs 54% in those with CD4 >500 |
| Fantry et al13 | Cross-sectional | USA | 120 HIV-positive women ≥40 years of age; 25% postmenopausal | Postmenopausal HIV-positive woman had higher rates of: Hot flashes (86.7%) Vaginal dryness (53.3%) Menopausal status was associated with development of hot flashes (OR 4.2) |
| Miller et al94 | Cross-sectional | USA | 289 HIV-positive and 247 HIV-negative women | 96% of all women had at least 1 menopausal symptom 88.6% had psychological symptoms 61% had vasomotor symptoms HIV infection independently associated with increased symptoms (OR 1.24) |
| Ferreira et al80 | Cross-sectional | Brazil | 96 HIV-positive and 155 HIV-negative women ≥40 years of age | HIV infection independently associated with menopausal symptoms (OR 1.65) HIV-positive had high prevalence of psychological (97.9%) and vasomotor symptoms (78.1%) No association between menopausal symptoms and CD4 count |
| Boonyanurak et al82 | Cross-sectional | Thailand | 268 HIV-positive women ≥40 years of age; 20.5% women postmenopausal | In HIV-positive women, menopausal status was associated with: Night sweats (P=0.03) Change in sexual desire (P=0.01) versus general Thai population, HIV-positive more likely to have: Hot flashes (47% vs 37%) Night sweats (48% vs 21%) |
| Looby et al97 | Cross-sectional | USA | 33 HIV-positive women and 33 HIV-negative women between ages of 45–52 years |
HIV-positive women had greater severity of hot flashes compared to HIV-negative women (P=0.03) and greater severity of menopausal symptoms (P=0.008) HIV-positive women also had more: Sleep difficulties (P=0.04) Depression (P<0.05) Irritability (P<0.05) Anxiety (P<0.05) In HIV-positive women, severity of hot flashes did not correlate with CD4 count or duration of HIV infection |
| Johnson et al98 | Cross-sectional | USA | 150 HIV-positive women and 128 HIV-negative women |
No difference in prevalence of hot flashes or vaginal dryness based on HIV status HIV-positive women were less likely to know the etiology of their hot flashes or vaginal dryness |
| Lui-Filho et al27 | Cross-sectional | Brazil | 273 HIV-positive and 264 HIV-negative women aged 40–60 years of age | HIV sero-status not associated with menopausal symptoms (either vasomotor or psychological symptoms) Hot flashes and vaginal dryness more likely to occur in women who were perimenopausal or postmenopausal |
| Maki et al102 | Cross-sectional evaluation of data collected from the prospective Women’s Interagency Health Study (WIHS) | USA | 835 HIV-positive and 335 HIV-negative women aged 30–65 years | Prevalence of depressive symptoms did not differ between HIV-positive and HIV-negative women Depressive symptoms did vary with stage of menopause (33% in premenopausal, 47% in early perimenopausal, 42% in late perimenopausal, and 43% in postmenopausal) Early perimenopausal status had higher risk of depression (OR 1.92 in HIV-positive women) Among HIV-positive women: Increased depression if CD4 <200 (OR 2.14) Less depression when adherent to ART (OR 0.67) |
| Rubin et al99 | Cross-sectional | USA | 708 HIV-positive and 278 HIV-negative women aged 30–65 years | No difference in menopausal symptoms between HIV-positive and HIV-negative women (trend to HIV-positive having more sleep disturbances than HIV-negative [P=0.07]) Early perimenopausal women more likely to report depressive symptoms than premenopausal (OR 1.84); postmenopausal women more likely to report sleep disturbances than premenpausal (OR 1.83) HIV-positive women had worse outcomes on tests of cognitive function, but this was not associated with menopausal status; those with depression and/or anxiety also had poorer cognitive function |
| Sorlini et al107 | Cross-sectional | Italy | 20 HIV-positive and 21 HIV-negative women ≥65 years | No difference in depression between HIV-positive and HIV-negative women Among HIV-positive women, depression was associated with having a CD4 count <500 (P=0.02) A greater proportion of HIV-positive women than HIV-negative women had pathological scores on neuropsychological testing |
Abbreviations: OR, odds ratio; ART, antiretroviral therapy.