Metabolic and Psychological Changes Associated With Menopause Among Women With HIV

• Bone Mineral Density [ Time Frame: baseline to 12 months ] [ Designated as safety issue: No ]
  Measurement of bone density at the toal body, lumbar spine and total hip
  
  

• Body Composition [ Time Frame: baseline to 12 months ] [ Designated as safety issue: No ]
  Total body fat and abdominal fat measurement, and total lean mass measurement
  
  
• Lipid Levels [ Time Frame: baseline to 12 months ] [ Designated as safety issue: No ]
  Lipid levels include total cholesterol, low density lipoprotein, high density lipoprotein, and triglyceride levels
  
  
• Glucose Metabolism [ Time Frame: baseline to 12 months ] [ Designated as safety issue: No ]
  Includes fasting glucose and insulin levels
  
  
• Depression [ Time Frame: baseline to 12 months ] [ Designated as safety issue: No ]
  Depressive symptoms assessed by the Centers for Epidemiologic Studies Depression Scale (CES-D)
  
  
• Quality of Life [ Time Frame: baseline to 12 months ] [ Designated as safety issue: No ]
  Assessed by the Utian Quality of Life Scale
  
  
• Vasomotor Symptoms [ Time Frame: Baseline to 12 months ] [ Designated as safety issue: No ]
  Assessed by the Menopause Rating Scale, includes hot flashes, mood, sleep, genitourinary symptoms, and sexual function
  
  
• Systemic Inflammation (as it relates to cardiovascular risk/body composition changes) [ Time Frame: Baseline to 12 months ] [ Designated as safety issue: No ]
  Assessment of inflammatory biomarkers and cytokines including CRP,IL-6, TNF-α, and PAI-1, as well as adiponectin.
  
  

Treatment with combination antiretroviral therapy (ART) has resulted in substantial improvement in survival among women living with HIV in the United States, many of whom have entered or will soon enter the menopause transition. Significant changes are seen across the menopause transition among women without HIV including increased abdominal fat and waist circumference, reduced muscle mass, and changes in lipids, glucose metabolism and bone density. HIV and potentially ART use have been associated with similar manifestations such as reduced bone density, changes in lipid and glucose metabolism, and body composition, though little is known regarding how the virus may influence or exacerbate such changes across the menopause transition. In addition to metabolic factors, menopause has been associated with changes in mood state, decreased quality of life, and presence of vasomotor symptoms among women without HIV. Psychosocial indices, such as depression and decreased quality of life are common among women with HIV, and may manifest or worsen during the menopause transition. However, research investigating the presence and acuity of these symptoms among women with HIV during menopause is limited.