title: Attribution of menopause symptoms in human immunodeficiency virus-infected or at-risk drug-using women.
abstract: OBJECTIVE
  To examine the relationship of human immunodeficiency virus (HIV) and attribution of menopausal symptoms.
  
  
  METHODS
  Peri- and postmenopausal women participating in a prospective study of HIV-infected and at-risk midlife women (the Ms. Study) were interviewed to determine whether they experienced hot flashes and/or vaginal dryness and to what they attributed these symptoms.
  
  
  RESULTS
  Of 278 women, 70% were perimenopausal; 54% were HIV-infected; and 52% had used crack, cocaine, heroin, and/or methadone within the past 5 years. Hot flashes were reported by 189 women and vaginal dryness was reported by 101 women. Overall, 69.8% attributed hot flashes to menopause and 28.7% attributed vaginal dryness to menopause. In bivariate analyses, age 45 years and older was associated with attributing hot flashes and vaginal dryness to menopause, and postmenopausal status and at least 12 years of education were associated with attributing vaginal dryness to menopause, but HIV status was not associated with attribution to menopause. In multivariate analysis, significant interactions between age and menopause status were found for both attribution of hot flashes (P=0.019) and vaginal dryness (P=0.029). Among perimenopausal women, older age was independently associated with attribution to menopause for hot flashes (adjusted odds ratio=1.2, 95% CI: 1.1-1.4, P=0.001) and vaginal dryness (adjusted odds ratio=1.3, 95% CI: 1.1-1.6, P=0.011). None of the tested factors were independently associated with attribution to menopause among postmenopausal women.
  
  
  CONCLUSIONS
  Tailored health education programs may be beneficial in increasing the knowledge about menopause among HIV-infected and drug-using women, particularly those who are perimenopausal.
authors.affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA.
authors.forename: Tonya M
authors.initials: TM
authors.lastname: Johnson
authors.forename: Hillel W
authors.initials: HW
authors.lastname: Cohen
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Howard
authors.forename: Nanette
authors.initials: N
authors.lastname: Santoro
authors.forename: Michelle
authors.initials: M
authors.lastname: Floris-Moore
authors.forename: Julia H
authors.initials: JH
authors.lastname: Arnsten
authors.forename: Diana M
authors.initials: DM
authors.lastname: Hartel
authors.forename: Ellie E
authors.initials: EE
authors.lastname: Schoenbaum
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D019584:Hot Flashes / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D047648:Perimenopause / Q000523:psychology*; D017698:Postmenopause / Q000523:psychology*; D015819:Substance Abuse, Intravenous