Effects of HIV infection and its treatment on self-reported menstrual abnormalities in women.
OBJECTIVE
To describe menstrual abnormalities among women with HIV.


METHODS
Women in a multicenter prospective cohort study of HIV natural history reported menstrual abnormalities every 6-months between October 1994 and September 2002. Logistic regression and Cox proportional-hazards models were applied.


RESULTS
The prevalence and incidence of menstrual abnormalities were <20%. HIV serostatus was not associated with prevalent menstrual abnormalities, but in HIV-seropositive women, higher CD4 counts were associated with fewer problems: compared with women with CD4 counts <200/mm3, in women with counts 200-500/mm3, odds ratio (OR) for amenorrhea was 0.55, p = 0.02, and for oligomenorrhea was 0.54, p = 0.0003; for women with counts >500/mm3, OR for amenorrhea was 0.67, p = 0.14, and for oligomenorrhea was 0.55, p = 0.001. HIV serostatus was not associated with incident abnormalities. Highly active anti-retroviral therapy (HAART) use was not associated with prevalent abnormalities, but both HAART use and higher CD4 counts were linked to lower rates of incident menstrual problems.


CONCLUSIONS
Compared with seronegative women, HIV-seropositive women are at increased risk for some menstrual changes, although the absolute frequency of most abnormalities is low. Higher CD4 counts and HAART protect against incident abnormalities.
Massad
L Stewart
LS
Southern Illinois University School of Medicine, Springfield, Illinois 62794-9640, USA. LSMASSAD@ameritech.net
Evans
Charlesnika T
CT
Minkoff
Howard
H
Watts
D Heather
DH
Greenblatt
Ruth M
RM
Levine
Alexandra M
AM
Anastos
Kathryn
K
Young
Mary
M
Seifer
David B
DB
Golub
Elizabeth
E
Cohen
Mardge
M
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology*; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008599:Menstruation Disturbances / Q000453:epidemiology*; D015337:Multicenter Studies as Topic; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016387:Women's Health