title: Menopause symptoms in HIV-infected and drug-using women.
abstract: OBJECTIVE
  To examine the association of HIV infection, drug use, and psychosocial stressors with type and frequency of menopause symptoms.
  
  
  METHODS
  In a cross-sectional study, HIV-infected and HIV-uninfected midlife women underwent standardized interviews on menopause status and symptoms, demographic characteristics, depressive symptoms, negative life events, and substance abuse. Body mass index (BMI), HIV serostatus, and CD4 count were measured. Associations between study variables and menopause symptoms were assessed using generalized estimating equations.
  
  
  RESULTS
  Of 536 women not on hormone therapy, 48% were black, 42% were Hispanic, 54% were HIV positive, and 30% recently had used illicit drugs. The mean age was 45 +/- 5 years; 48% of the women were identified as premenopausal, and 37% were perimenopausal. Psychological symptoms were most prevalent (89%), followed by arthralgias (63%) and vasomotor symptoms (61%). Perimenopausal women reported significantly more menopause symptoms than premenopausal women (ORadj 1.34, 95% CI, 1.09-1.65). HIV-infected women were more likely to report menopause symptoms than uninfected women (ORadj 1.24, 95% CI, 1.02-1.51). Among HIV-infected women not on highly active antiretroviral therapy, symptoms decreased as the CD4 count declined. Increased menopause symptoms were significantly associated with depressive symptoms (ie, Center for Epidemiologic Studies Depression scale score > 23, ORadj1.82, 95% CI, 1.46-2.28), and with experiencing more than three negative life events (ORadj 2.08, 95% CI, 1.54-2.81). Increasing BMI (per kg/m) was also associated with more menopause symptoms (ORadj 1.03, 95% CI, 1.02-1.05).
  
  
  CONCLUSIONS
  HIV-infected women reported more menopause symptoms than HIV-uninfected women, but symptoms were less frequent in women with more advanced HIV disease. Depressive symptoms and negative life events were also highly associated with symptoms. Further study of menopause symptoms and HIV-related factors is warranted. Mental health interventions may also have a role in ameliorating menopause symptoms.
authors.affiliation: Albert Einstein College of Medicine at Montefiore Medical Center, Bronx, New York 10467, USA.
authors.forename: Samantha A
authors.initials: SA
authors.lastname: Miller
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.forename: Yungtai
authors.initials: Y
authors.lastname: Lo
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Howard
authors.forename: Julia H
authors.initials: JH
authors.lastname: Arnsten
authors.forename: Michelle
authors.initials: M
authors.lastname: Floris-Moore
authors.forename: Galina
authors.initials: G
authors.lastname: Moskaleva
authors.forename: Ellie E
authors.initials: EE
authors.lastname: Schoenbaum
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008016:Life Change Events; D008593:Menopause / Q000276:immunology / Q000502:physiology* / Q000523:psychology; D008875:Middle Aged; D015999:Multivariate Analysis; D009519:New York City / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*