Menopausal symptoms by HIV status and association with health-related quality of life among women in Zimbabwe: a cross-sectional study
Abstract Background The scale-up of antiretroviral therapy programmes has resulted in increased life expectancy of people with HIV in Africa. Little is known of the menopausal experiences of African women, including those living with HIV. We aimed to determine the prevalence and severity of self-rep...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Women's Health |
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| Online Access: | https://doi.org/10.1186/s12905-023-02466-1 |
| _version_ | 1797789536162414592 |
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| author | Tafadzwa Madanhire Samuel Hawley Ethel Dauya Tsitsi Bandason Ruramayi Rukuni Rashida A Ferrand Celia L Gregson |
| author_facet | Tafadzwa Madanhire Samuel Hawley Ethel Dauya Tsitsi Bandason Ruramayi Rukuni Rashida A Ferrand Celia L Gregson |
| author_sort | Tafadzwa Madanhire |
| collection | DOAJ |
| description | Abstract Background The scale-up of antiretroviral therapy programmes has resulted in increased life expectancy of people with HIV in Africa. Little is known of the menopausal experiences of African women, including those living with HIV. We aimed to determine the prevalence and severity of self-reported menopause symptoms in women at different stages of menopause transition, by HIV status, and evaluate how symptoms are related to health-related quality of life (HRQoL). We further sought to understand factors associated with menopause symptoms. Methods A cross-sectional study recruited women resident in Harare, Zimbabwe, sampled by age group (40–44/45–49/50–54/55–60 years) and HIV status. Women recruited from public-sector HIV clinics identified two similarly aged female friends (irrespective of HIV status) with phone access. Socio-demographic and medical details were recorded and women staged as pre-, peri- or post-menopause. The Menopausal Rating Scale II (MRS), which classified symptom severity, was compared between those with and without HIV. Linear and logistic regression determined factors associated with menopause symptoms, and associations between symptoms and HRQoL. Results The 378 women recruited (193[51.1%] with HIV), had a mean (SD) age of 49.3 (5.7) years; 173 (45.8%), 51 (13.5%) and 154 (40.7%) were pre-, peri and post-menopausal respectively. Women with HIV reported more moderate (24.9% vs. 18.1%) and severe (9.7% vs. 2.6%) menopause symptoms than women without HIV. Peri-menopausal women with HIV reported higher MRS scores than those pre- and post-menopausal, whereas in HIV negative women menopausal stage was not associated with MRS score (interaction p-value = 0.014). With increasing severity of menopause symptoms, lower mean HRQoL scores were observed. HIV (OR 2.02[95% CI 1.28, 3.21]), mood disorders (8.80[2.77, 28.0]), ≥ 2 falls/year (4.29[1.18, 15.6]), early menarche (2.33[1.22, 4.48]), alcohol consumption (2.16[1.01, 4.62]), food insecurity (1.93[1.14, 3.26]) and unemployment (1.56[0.99, 2.46]), were all associated with moderate/severe menopause symptoms. No woman reported use of menopausal hormone therapy. Conclusions Menopausal symptoms are common and negatively impact HRQoL. HIV infection is associated with more severe menopause symptoms, as are several modifiable factors, including unemployment, alcohol consumption, and food insecurity. Findings highlight an unmet health need in ageing women in Zimbabwean, especially among those living with HIV. |
| first_indexed | 2024-03-13T01:52:08Z |
| format | Article |
| id | doaj.art-022fd122419c42e6b0f516b20d91f892 |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-03-13T01:52:08Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-022fd122419c42e6b0f516b20d91f8922023-07-02T11:25:55ZengBMCBMC Women's Health1472-68742023-06-0123111310.1186/s12905-023-02466-1Menopausal symptoms by HIV status and association with health-related quality of life among women in Zimbabwe: a cross-sectional studyTafadzwa Madanhire0Samuel Hawley1Ethel Dauya2Tsitsi Bandason3Ruramayi Rukuni4Rashida A Ferrand5Celia L Gregson6The Health Research Unit Zimbabwe, Biomedical Research and Training InstituteGlobal Musculoskeletal Research Group, Musculoskeletal Research Unit, Bristol Medical School, University of BristolThe Health Research Unit Zimbabwe, Biomedical Research and Training InstituteThe Health Research Unit Zimbabwe, Biomedical Research and Training InstituteThe Health Research Unit Zimbabwe, Biomedical Research and Training InstituteThe Health Research Unit Zimbabwe, Biomedical Research and Training InstituteSAMRC/Wits Developmental Pathways for Health Research Unit, School of Clinical Medicine, Faculty of Health Sciences, University of the WitwatersrandAbstract Background The scale-up of antiretroviral therapy programmes has resulted in increased life expectancy of people with HIV in Africa. Little is known of the menopausal experiences of African women, including those living with HIV. We aimed to determine the prevalence and severity of self-reported menopause symptoms in women at different stages of menopause transition, by HIV status, and evaluate how symptoms are related to health-related quality of life (HRQoL). We further sought to understand factors associated with menopause symptoms. Methods A cross-sectional study recruited women resident in Harare, Zimbabwe, sampled by age group (40–44/45–49/50–54/55–60 years) and HIV status. Women recruited from public-sector HIV clinics identified two similarly aged female friends (irrespective of HIV status) with phone access. Socio-demographic and medical details were recorded and women staged as pre-, peri- or post-menopause. The Menopausal Rating Scale II (MRS), which classified symptom severity, was compared between those with and without HIV. Linear and logistic regression determined factors associated with menopause symptoms, and associations between symptoms and HRQoL. Results The 378 women recruited (193[51.1%] with HIV), had a mean (SD) age of 49.3 (5.7) years; 173 (45.8%), 51 (13.5%) and 154 (40.7%) were pre-, peri and post-menopausal respectively. Women with HIV reported more moderate (24.9% vs. 18.1%) and severe (9.7% vs. 2.6%) menopause symptoms than women without HIV. Peri-menopausal women with HIV reported higher MRS scores than those pre- and post-menopausal, whereas in HIV negative women menopausal stage was not associated with MRS score (interaction p-value = 0.014). With increasing severity of menopause symptoms, lower mean HRQoL scores were observed. HIV (OR 2.02[95% CI 1.28, 3.21]), mood disorders (8.80[2.77, 28.0]), ≥ 2 falls/year (4.29[1.18, 15.6]), early menarche (2.33[1.22, 4.48]), alcohol consumption (2.16[1.01, 4.62]), food insecurity (1.93[1.14, 3.26]) and unemployment (1.56[0.99, 2.46]), were all associated with moderate/severe menopause symptoms. No woman reported use of menopausal hormone therapy. Conclusions Menopausal symptoms are common and negatively impact HRQoL. HIV infection is associated with more severe menopause symptoms, as are several modifiable factors, including unemployment, alcohol consumption, and food insecurity. Findings highlight an unmet health need in ageing women in Zimbabwean, especially among those living with HIV.https://doi.org/10.1186/s12905-023-02466-1HIVMenopauseMenopausal symptomsQuality of lifeAfricaAgeing |
| spellingShingle | Tafadzwa Madanhire Samuel Hawley Ethel Dauya Tsitsi Bandason Ruramayi Rukuni Rashida A Ferrand Celia L Gregson Menopausal symptoms by HIV status and association with health-related quality of life among women in Zimbabwe: a cross-sectional study BMC Women's Health HIV Menopause Menopausal symptoms Quality of life Africa Ageing |
| title | Menopausal symptoms by HIV status and association with health-related quality of life among women in Zimbabwe: a cross-sectional study |
| title_full | Menopausal symptoms by HIV status and association with health-related quality of life among women in Zimbabwe: a cross-sectional study |
| title_fullStr | Menopausal symptoms by HIV status and association with health-related quality of life among women in Zimbabwe: a cross-sectional study |
| title_full_unstemmed | Menopausal symptoms by HIV status and association with health-related quality of life among women in Zimbabwe: a cross-sectional study |
| title_short | Menopausal symptoms by HIV status and association with health-related quality of life among women in Zimbabwe: a cross-sectional study |
| title_sort | menopausal symptoms by hiv status and association with health related quality of life among women in zimbabwe a cross sectional study |
| topic | HIV Menopause Menopausal symptoms Quality of life Africa Ageing |
| url | https://doi.org/10.1186/s12905-023-02466-1 |
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