CTNPT 050: Perception of menopausal hormone therapy among women living with HIV

About The Study

This pilot study is assessing the beliefs and attitudes of women living with HIV towards menopausal hormone treatment. The goal is to understand the factors behind low treatment uptake in this group and to provide important background information for the design of a clinical trial to evaluate menopausal hormone treatment in women living with HIV.

Background

Thanks to the effectiveness of modern antiretroviral therapies, many women living with HIV are now living long enough to experience menopause. In fact, about one-third of women living with HIV in Canada are currently of menopausal age and that proportion is expected to double over the next ten years.

Women living with HIV tend to experience severe symptoms related to menopause, as well as other age-related challenges like bone mineral loss and heart disease. These symptoms are typically treated with menopausal hormone therapy, which supplements the declining levels of natural hormones that occurs during menopause. This therapy also has secondary benefits for heart disease and bone health. Despite the effectiveness of this treatment, and the significant potential benefit for women living with HIV, there is limited knowledge about hormone therapy in this group, and women living with HIV are three times less likely to start this treatment compared to their HIV-negative peers.

Study Approach

The study will consist of two parts: i) a qualitative assessment of menopause, menopausal symptoms and treatments; and ii) a larger survey assessment of menopause treatments in women living with and without HIV. For the qualitative assessment, participants will be recruited from British Columbia and Ontario. In British Columbia, recruitment will be through the ongoing BC CARMA–CHIWOS Collaboration (BCC3; CTN 335), a study of healthy aging for women living with HIV that recruits from several sites across the province (Vancouver, Prince George, Victoria, Kelowna). In Ontario, recruitment will be through word of mouth and postings in community centers and HIV clinics in Toronto, Ottawa, and Hamilton. In both provinces, focus groups will be conducted by a study team member and community research associate to identify beliefs, attitudes, and preferences towards hormone therapy. A total of six focus groups will be held with five to six participants per group (~30 total participants). This content will be used to draft and finalize a questionnaire that will be administered to 100 women living with HIV, as well as 100 women not living with HIV. This survey will gather information about women’s perspectives on hormone therapy and understand how they differ between those living with and without HIV.