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Swann, Shayda

University of British Columbia

Background: Women living with HIV experience accelerated aging and a higher burden of age-related health conditions compared to HIV-negative women, however the reasons for this are poorly understood. States of hormone insufficiency, such as amenorrhea and early menopause, can drive disease progression in women. Thus, we investigated whether women living with HIV were more likely to experience amenorrhea, early menopause, and hormone dysregulation compared to HIV-negative women and whether these were associated with age-related health conditions. Methods: This thesis largely drew upon data from the British Columbia CARMA-CHIWOS Collaboration study and the as well as the Children and Women: AntiRetroviral Therapy and Makers of Aging (CARMA), which both enrolled women living with HIV and HIV-negative women in British Columbia. Prevalences of amenorrhea, age at menopause, and hormone levels (estrone, estradiol, progesterone, testosterone, and cortisol), were compared between groups. Associations between amenorrhea and bone health, as well as estradiol levels and number of health outcomes, were assessed by multivariable regression modelling, controlling for clinical and socio-structural confounders. Results: Women living with HIV were more likely to have ever experienced one year of amenorrhea compared to HIV-negative women. There was no difference in age at menopause between women living with HIV and HIV-negative women. Women living with HIV had similar hormone levels compared to HIV-negative women. Amenorrhea was associated with having lower baseline bone mineral density, but not rate of bone density loss. There was no association between estradiol levels and number of age-related health conditions, particularly after controlling for confounders like substance use. Conclusions: These findings suggest that, in the modern era of efficacious HIV therapies, women living with HIV do not experience ongoing hormone dysregulation and that this does not drive development of age-related conditions. Factors outside of HIV infection, such as socio-structural conditions, may play a more important role in healthy aging for women living with HIV.

Text

2025-06-30

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/88497

Experimental Medicine

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/