AEGiS-15IAC: Assessment of menopausal status among women in the Women's Interagency HIV Study (WIHS).

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Assessment of menopausal status among women in the Women's Interagency HIV Study (WIHS).

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. MoOrD1096)

Cejtin HE, Kim S, Taylor R, Watts DH
John H. Stroger Hospital of Cook County, Chicago, United States

BACKGROUND: It is often difficult in the HIV-infected woman to distinguish menopause from amenorrhea from other causes. The purpose of this study is to determine the accuracy of both women and their providers in assessing menopausal status.

METHODS: The WIHS is a prospective cohort study of the natural history of HIV infection in women. The women were asked to assess their menopausal status, and so were their providers after performing a gynecologic exam. Their answers were compared to the women's follicle stimulating hormone (FSH) levels. Menopause was defined as FSH≥40mIU/ml, premenopause as FSH<25mIU/ml. Kappa statistics were performed.

RESULTS: There were 1335 women, 1063 HIV-positive and 272 HIV-negative. The median age was 38.6 years. Overall, premenopausal women were correctly identified 94.8% of the time by themselves, and 98.2% of the time by their providers. Menopausal HIV-negative women were correctly identified by themselves 69.2% of the time, and by their providers 50.0% of the time. Menopausal HIV-positive women were correctly identified by themselves 57.7% of thew time, and by their providers only 37.0% of the time. Agreement with laboratory values was highest for provider assessment of HIV-negative women, with a kappa of.59 (95% CI,.34-.84), and lowest for provider assessment of HIV-positive women, with a kappa of.42 (95% CI,.28-.56), mostly because of provider underreporting of menopause in seropositive women.

CONCLUSIONS: Menopausal women are more likely to correctly assess their menopausal status than are their providers, especially if they are HIV-positive. Providers may be attributing amenorrhea in their HIV-positive patients to causes other than menopause.

Keywords: AEGIS, HIV, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Menopause, HIV Infections, HIV Seronegativity, Premenopause, Cohort Studies, Prospective Studies, Follicle Stimulating Hormone, Humans, Female, immunology, methods

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MoOrD1096