World Menopause Day: Insights from the Positive Transitions Through the Menopause (PRIME) Study

By Hajra Okhai

Menopause, although natural, can be a challenging time for many women. No matter how much someone can tell you ‘this is normal’, women experience a whole host of changes which can impact their quality-of-life. With great successes in HIV treatment, we now have a group of women who are ageing with HIV and experiencing menopause. There has been some evidence suggesting women with HIV experience more severe symptoms of menopause. This could mean that this group of women, might be at risk of greater impact on their quality-of-life.

Using data from one of the largest studies assessing women aged 45-60 living with HIV (the PRIME study), we wanted to find out if experiencing menopause impacted the quality-of-life of these women more than women aged 45–59 in England (using data from the Health Survey for England). Both studies measured quality-of-life using the Euroqol questionnaire which allowed us to score quality-of-life after assessing five factors: mobility, self-care, ability to do usual activities, pain/discomfort and anxiety/depression. In this study, we found that quality-of-life scores for menopausal aged women with HIV were similar to women of the same age in England.

We went on to assess whether severity of menopausal symptoms among PRIME women was linked to poorer quality-of-life. Overall, sub-optimal/poor health (defined by lower quality-of-life scores) dramatically increased as the severity of symptoms increased. This strong relationship between lower quality-of-life scores and moderate and severe menopausal symptoms remained after accounting for demographic, socioeconomic, lifestyle and clinical HIV characteristics.

Our research found, there were no differences in quality-of-life between menopausal aged women with HIV from the PRIME study and women from England in the Health Survey for England. This suggests that the average quality-of-life score is less than optimal health for both groups of women, regardless of HIV status, and may be a result of ageing. For women with HIV, quality-of-life was reduced in those with increasingly severe menopausal symptoms highlighting the importance of proactive assessment of menopausal symptoms in this population to ensure appropriate support and management are provided. This is crucial if we are to help women living with HIV to optimize their health as they reach mid-life and beyond.

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Article Details
Association between health-related quality of life and menopausal status and symptoms in women living with HIV aged 45–60 years in England: An analysis of the PRIME study
Hajra Okhai, Livia Dragomir, Erica RM Pool, Caroline A Sabin, Alec Miners, Lorraine Sherr, Katharina Haag, Rageshri Dhairyawan, Nina Vora, Binta Sultan, Richard Gilson, Fiona Burns, Yvonne Gilleece, Rachael Jones, Frank Post, Jonathan Ross, Andrew Ustianowski, and Shema Tariq
First Published January 13 2022
DOI: 10.1177/17455065211068722
Women’s Health

About the Author

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Hajra is a Research Statistician based at the Institute for Global Health, University College London since 2018. She has collaborated on designing, analysing and publishing a range of research projects exploring HIV outcomes and co-infections using large, representative, longitudinal datasets of people living with HIV in the UK.