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. 2022 Apr;23(4):417-425.
doi: 10.1111/hiv.13255. Epub 2022 Feb 22.

Women with HIV transitioning through menopause: Insights from the Swiss HIV Cohort Study (SHCS)

Anna Hachfeld  1 , Andrew Atkinson  1 , Petra Stute  2 , Alexandra Calmy  3 , Philip E Tarr  4 , Katharine Darling  5 , Baharak Babouee Flury  6 , Christian Polli  7 , Leila Sultan-Beyer  8 , Irene A Abela  9 , Karoline Aebi-Popp  1 ; Swiss HIV Cohort Study (SHCS)
Collaborators, Affiliations

Women with HIV transitioning through menopause: Insights from the Swiss HIV Cohort Study (SHCS)

Anna Hachfeld et al. HIV Med. 2022 Apr.

Abstract

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.

Keywords: HIV; bone mineral density; early menopause; hormone replacement therapy; menopause.

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Conflict of interest statement

None of the authors has declared a possible conflict of interest related to this study. AH’s institution has received travel grants, congress and advisory fees from MSD, Viiv and Gilead, unrelated to this work. BBF has undertaken Advisory Boards or ad hoc consultancy for Merck/MSD, Melinta/Menarini, Shionogi and Pfizer, unrelated to this work. KD's institution has received sponsorship for specialist meetings from MSD, outside the scope of this work, and additional research funding unrelated to this publication from Gilead. PET's institution has received grants and advisory fees from Gilead and ViiV, outside the submitted work. KA‐P’s institution has received travel grants and advisory fees from MSD, Gilead and ViiV Healthcare.

Figures

FIGURE 1
FIGURE 1
Demographic shift of women participating in the Swiss HIV Cohort Study (SHCS) between 2010 and 2018. (a) Proportion of postmenopausal women over time. (b) Age histogram of women participating in the SHCS in 2018
FIGURE 2
FIGURE 2
Uni‐ and multivariate logistic regression of risk factors for an early menopause
See this image and copyright information in PMC

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