Menopause and women

Background

We currently know very little about the impact of HIV on the health of older women living with HIV.  It has been speculated that the menopause may occur at an earlier age in women living with HIV, but the evidence to support this hypothesis is weak.   The impact of this on other markers of health in older women living with HIV is unclear.

Study aims

We wish to investigate the changes in health that occur in older women living with the HIV and to compare this with those seen in older HIV-negative women. 

Work to date

We have undertaken two sets of analyses to date.  In the first, we conducted preliminary analyses of the menopause among a sub-set of 37 women living with HIV and 30 HIV-negative control women in POPPY.  Overall, 84% of the women were post-menopausal, with no difference in the proportion of HIV-positive and HIV-negative women who were post-menopausal (87% vs. 80%, respectively).  Among women who were post-menopausal, the median age at last menstrual period was 49 years in the women living with HIV and 51 in the HIV-negative women.  Our analyses, based on a small cohort of women, did not support an association between HIV status and either menopausal status or age at menopause.  In the second analysis, we described the prevalence of cardiovascular disease (CVD) risk factors in the women in POPPY who were aged >50 years.  We found no differences in the prevalence of key CVD risk factors by HIV status, either overall or in women who were post-menopausal.  However, we found that a substantial number of women with high CVD risk and/or hypertension were not receiving medication for these conditions.  Our findings suggest that clinicians should be aware of CVD risk in women aging with HIV and ensure that they are screened and treated in accordance with BHIVA guidelines.  

Next steps

We are conducting a systematic review of CVD in women living with HIV, which we hope to submit for publication later in the year. Through a collaboration with the PRIME Study, we hope to increase the number of women living with HIV who can be included in some of our analyses.  We further hope to build on this collaboration between two large cohort studies to increase the number of HIV-negative control female participants in both studies.

Outputs

Findings have been presented as posters at BHIVA meetings in April 2016 and April 2017 [links to BHIVA poster].

Study group

Shema Tariq (UCL), Caroline Sabin (UCL), Alan Winston (Imperial College London), Paddy Mallon (University College Dublin).   Contact Shema Tariq (s.tariq@ucl.ac.uk).