Metabolic and Psychosocial Changes Associated with Menopause among Women with HIV

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DESCRIPTION (provided by applicant): Significant changes are seen across the menopause transition among women without HIV including increased visceral fat and waist circumference, reduced muscle mass, and changes in lipids, glucose metabolism and bone density. HIV and potentially antiretroviral therapy 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. Menopause has also been associated with changes in mood state, decreased quality of life, and presence of vasomotor symptoms among women without HIV. Similar psychosocial indices are common among women with HIV, and may manifest or worsen during the menopause transition. The proposed study will investigate the prevalence and extent of both metabolic and psychosocial changes associated with the menopause transition at baseline and over one year among women with HIV compared to women without HIV of similar age, weight, menstrual status, and ethnic background. Specifically, it is hypothesized that HIV positive women in the menopause transition will demonstrate: 1) increased visceral adipose tissue, reduced lean body mass, dyslipidemia, and alterations in glucose metabolism, 2) a greater degree of bone loss and an accelerated pattern of bone loss over time, 3) increased symptomatology related to depression, reduced quality of life, and increased severity of vasomotor symptoms. Findings from this novel investigation will generate important data that will benefit both the physical and psychosocial health of women with HIV during the menopause transition. To achieve these aims, the candidate will participate in a combination of didactic coursework, research, mentorship and advisement activities, in addition to scientific symposia and conferences. The candidate's institutional support provides an environment that is conducive to conducting patient-oriented clinical research under the mentorship of a world renowned expert in the area of HIV-related metabolics and endocrinology. The assistance of the K23 career development award will help the candidate fulfill her goal of becoming an independent nurse scientist, and establish a program of clinical research that will focus on metabolic and psychosocial indices associated with the menopause transition among women with HIV. PUBLIC HEALTH RELEVANCE: Significant changes in both metabolic and psychosocial parameters are seen across the menopause transition among women without HIV. HIV, and potentially antiretroviral therapy use have been associated with similar metabolic and psychological manifestations, though little is known regarding how the virus may influence or exacerbate such changes across the menopausal transition. This cross-sectional and longitudinal investigation will evaluate metabolic and psychosocial indices associated with the menopause transition at baseline and over one year among women with HIV compared to women without HIV who are similar in age, race/ethnicity, weight and menstrual status.