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Increased hot flash severity and related interference in perimenopausal human immunodeficiency virus–infected women

Looby, Sara E. PhD, MSN1; Shifren, Jan MD2; Corless, Inge PhD, RN3; Rope, Alison BA1; Pedersen, Maria C. BA1; Joffe, Hadine MD, MSc4; Grinspoon, Steven MD1

doi: 10.1097/GME.0b013e31829d4c4c
Original Articles

Objective As women with human immunodeficiency virus (HIV) are living longer, more are entering perimenopause. Prior studies suggest that HIV-infected women are more likely to have hot flashes than non–HIV-infected women. However, little is known regarding hot flash severity and hot flash–related interference with daily function, mood, and quality of life in this population.

Methods Perimenopausal HIV-infected and non–HIV-infected women matched by age, race, and menstrual patterns completed the Menopause Rating Scale (to assess hot flash severity) and the Hot Flash Related Daily Interference Scale (HFRDIS). Menopause Rating Scale and HFRDIS scores and subscores were compared between the groups.

Results Thirty-three HIV-infected women and 33 non–HIV-infected women who were similar in age (median [interquartile range], 47 [45-48] vs 47 [46-49] y), race (64% vs 52% nonwhite, P = 0.32), and menstrual patterns (number of periods in the past year; 5 [4-9] vs 6 [4-10], P = 0.53) were studied. Perimenopausal HIV-infected women reported greater hot flash severity (HIV vs non-HIV: 2 [1-3] vs 1 [0-3], P = 0.03) and hot flash–related interference (HFRDIS total score, 37 [10-60] vs 6 [0-20], P = 0.001).

Conclusions Perimenopausal HIV-infected women experience greater hot flash severity and related interference compared with non–HIV-infected perimenopausal women. Increased distress secondary to hot flashes may reduce quality of life and negatively impact important health-promoting behaviors, including adherence to antiretroviral therapy, in HIV-infected women.

From the 1Massachusetts General Hospital Program in Nutritional Metabolism, Boston, MA; 2Massachusetts General Hospital Vincent Obstetrics and Gynecology, Boston, MA; 3Massachusetts General Hospital Institute of Health Professions, Charlestown, MA; and 4Massachusetts General Hospital Center for Women’s Mental Health, Boston, MA.

Received March 26, 2013; revised and accepted May 23, 2013.

Senior authors H.J. and S.G. contributed equally to this work.

Part of the data were presented at the 22nd annual North American Menopause Society meeting held in September 2011 in Washington, DC, and at the 20th annual Conference on Retroviruses and Opportunistic Infections held in March 2013 in Atlanta, GA.

Funding/support: This project was funded by grant NIH K23 NR011833-01A1 (S.E.L.) and grant P30-DK040561 from the Nutrition Obesity Research Center at Harvard. This work was supported by Harvard Catalyst–The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award 8UL1TR000170-05, and financial contributions from Harvard University and its affiliated academic healthcare centers). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic healthcare centers, or the National Institutes of Health.

Clinical trial registration: NCT01142817.

Financial disclosure/conflicts of interest: H.J. reports board membership at Noven, consultancy (noncompensational) for Sunovion, and current research funding from Cephalon/Teva. The remaining authors declare no conflicts of interest.

Address correspondence to: Sara E. Looby, PhD, MSN, LON5-207, 55 Fruit Street, Boston, MA 02114. E-mail:

© 2014 by The North American Menopause Society.