Comorbidities and menopause assessment in women living with HIV: a survey of healthcare providers across the WHO European region

ABSTRACT

Women living with HIV are reaching older age and experiencing menopause and age-related comorbidities. Data suggest that women living with HIV experience earlier menopause and more menopausal symptoms and age-related comorbidities compared to women without HIV. However, there are no guidelines on the screening for and management of age-related comorbidities and events in women living with HIV. Moreover, little is known about provision of care to this population across Europe. We surveyed 121 HIV healthcare providers in 25 World Health Organization European countries to ascertain screening practices for, and management of, menopause, psychosocial and sexual well-being and age-related comorbidities in women with HIV. Most respondents screened for diabetes, cardiovascular disease (CVD) risk factors and poor mental health at least annually. Low bone mineral density (BMD) was regularly checked but less than once a year. Fewer regularly screened for sexual well-being and intimate partner violence. Menstrual pattern and menopausal symptoms in women aged 45–54 were assessed by 67% and 59% of respondents. 44% stated that they were not confident assessing menopausal status and/or symptoms. CVD, diabetes, low BMD and poor mental health were managed mainly within HIV clinics, whereas menopause care was mainly provided by gynaecology or primary care. Most respondents stated a need for HIV and menopause guidelines. In conclusion, we found that whilst metabolic risk factors and poor mental health are regularly screened for, psychosocial and sexual well-being and menopausal symptoms could be improved. This highlights the need for international recommendations and clinician training to ensure the health of this population.

KEYWORDS:

• HIV
• women
• age-related comorbidities
• menopause
• integrated care
• screening
• menopausal hormone therapy

Acknowledgements

We would like to thank Hilary Curtis (Independent consultant) for her work developing and analysing the survey. We are also grateful to our participants for providing the data this analysis is based on.

Disclosure statement

AH’s institution has received travel grants, congress and advisory fees from MSD, Viiv and Gilead, unrelated to this work. GL received speaker and advisory honoraria from Gilead Sciences, ViiV Healthcare and MSD, unrelated to this publication. NN is an employee of ViiV Healthcare and holds GSK stock and stock options. ST received speaker honoraria and funding for preparation of educational materials from Gilead Sciences. UC received congress and advisory fees from Gilead and Jansen, unrelated to this work. No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by European AIDS Clinical Society.