Menopausal symptoms are associated with non-adherence to highly active antiretroviral therapy in human immunodeficiency virus-infected middle-aged women

Abstract

Objective: This study aimed to evaluate the association between the intensity of menopausal symptoms and highly active antiretroviral therapy (HAART) adherence in middle-aged women with human immunodeficiency virus (HIV) infection.

Methods: In this cross-sectional study, 313 Peruvian women with HIV infection (age 40-59 years) were surveyed and classified as adherent or non-adherent to HAART based on the Antiretroviral Treatment Adherence Evaluation Questionnaire. The intensity of menopausal symptoms was assessed with the Menopause Rating Scale, and categorized as none, mild, moderate, and/or severe. Age, sexual orientation, used HAART scheme, time since HIV diagnosis, menopausal status, risk of depression, and presence of comorbidities were also assessed. Poisson generalized linear models with robust variance were performed in order to estimate crude prevalence ratios (PRs) and adjusted PRs using statistical (a₁PR) and epidemiological criteria (a₂PR).

Results: A total of 19.9%, 32.6%, and 15.0% of all women presented mild, moderate, and severe menopausal symptoms, respectively. Overall, 70.6% women were non-adherent to HAART. The probability of non-adherence was higher in women with mild, moderate, and severe symptoms as compared to asymptomatic women in the non-adjusted model (PR: 1.79, 95% confidence interval [CI]: 1.39–2.29; PR: 1.76, 95% CI: 1.38–2.23; and PR: 2.07, 95% CI: 1.64–2.61, respectively) and the adjusted model.

Conclusion: The severity of menopausal symptoms was associated with HAART non-adherence in HIV-infected middle-aged women.

摘要

目的：评估人类免疫缺陷病毒（HIV）感染的中年女性更年期症状强度与高效抗逆转录病毒治疗（HAART）依从性的关系。

方法：此项横断面研究中, 对313名40∼59岁的感染HIV的秘鲁女性进行了调查, 并根据抗逆转录病毒治疗依从性评估问卷将其分为HAART依从者和不依从者。更年期症状的强度用更年期评定量表进行评估, 并将其分为无、轻度、中度和/或重度, 还评估了年龄、性取向、采用的HAART方案、自HIV诊断以来的时间、绝经状态、抑郁风险和是否存在合并症。采用具有稳健方差的Poisson广义线性模型, 采用统计学（A₁PR）和流行病学标准（A₂PR）评估粗患病率（PRs）和调整后的PRs。

结果：分别共有19.9%、32.6%和15.0%的女性出现轻度、中度和重度更年期症状。总体而言, 70.6%的女性不依从HAART。在未经调整的模型和经过调整的模型中, 轻度、中度和重度更年期症状的女性与无症状女性相比, 不依从的可能性更高（分别为PR：1.79, 95%CI：1.39-2.29；PR：1.76, 95%CI：1.38-2.23；PR：2.07, 95%CI：1.64-2.61）。

结论：在HIV感染的中年女性中, 更年期症状的严重程度与HAART的不依从性有关。

Keywords:

• Human immunodeficiency virus
• menopause symptoms
• treatment adherence
• highly active antiretroviral therapy

Acknowledgement

To Wendy Guevara-Condorhuaman for her support in data collection.

Potential conflict of interest

The authors declare no conflicts of interest.

Source of funding

This research did not receive any specific grant or was funded by any commercial or non-profit organization or public agency.