"Menopause! Please! We are here!" - Exploring factors influencing a supported menopause transition for women living...

BackgroundOwing to a longer life expectancy, the first large cohort of women living with HIV are experiencing menopause. While the biological and social impacts of menopause have been well documented, research regarding medical and personal support systems to help navigate the menopause transition, especially in the setting of HIV, is scarce.ObjectivesThis study explored factors influencing a supported menopause transition for women living with HIV.DesignWe conducted a qualitative study examining factors influencing menopause support for women living with HIV guided by the socio-ecological model of health and an intersectional framework.MethodsWomen living with HIV who self-identified as perimenopausal or postmenopausal at time of the study were recruited through purposive and snowball sampling across British Columbia (BC) and Ontario (January to August 2023). Seven focus groups (n=40) were conducted in-person (n=4) and virtually (n=3) to explore women's menopause experiences. Reflexive thematic analysis was conducted using NVivo.ResultsParticipants had a median age of 52 years (interquartile range 47-58). Forty four percent (44%) identified as African/Caribbean/Black, 31% White, 18% Indigenous and 8% South Asian/multiracial. Participants highlighted the need for increased menopause awareness among women and providers, destigmatization, and holistic support that acknowledges diverse cultural contexts. Living with HIV influenced women's support-seeking behaviors, shaped by positive and negative impacts of long-term healthcare engagement and experience of intersecting stigmas related to HIV, menopause, and ageism. Women underscored the importance of peer and experiential support, as well as timely menopause education, particularly before and during midlife clinical visits.ConclusionFindings underscore the need for holistic menopause support by, with, and for women living with HIV. Many women felt inadequately supported, emphasizing the importance of expanding educational resources for women and healthcare providers, adopting a person-centered approach that prioritizes peer-led initiatives, and integrating culturally safe practices into menopause care.