By Kudakwashe Pembere
RESEARCHERS from Zimbabwe, South Africa and the United Kingdom want to do a study to understand the impact of HIV and Antiretroviral Treatment among women going on menopause.
Leading researchers in Zimbabwe is Professor Rashida Ferrand from the Biomedical Research and Training Institute (BRTI) ,in the UK there is Prof Celia Gregson from MRC Lifecourse Epidemiology Unit University of Southampton with South Africa being led by Prof Micklesfield from the University of the Witwatersrand.
“The scale-up of antiretroviral treatment has dramatically improved survival, such that across Africa, increasing numbers of women with chronic HIV are now reaching the menopause and beyond. The menopause is a period of metabolic change with effects on the skeleton associated with increased fracture risk. Research has seldom focused on African woman at this stage of life. This is a mixed-methods study,” read a post on the London School of Hygiene & Tropical Medicine (LSHTM)web page.
The research is an investigation on the impact of HIV medication on women headed towards menopause.
“We are investigating whether HIV infection and its treatments worsen menopausal bone loss, and whether good viral suppression, achieved through antiretroviral treatment (ART), attenuates this HIV effect. We are examining whether certain ARTs, eg. tenofovir, may have more detrimental effects on bone mass and architecture, and if HIV infection is associated with earlier menopause. We further wish to understand women’s opinions about menopause and their experiences of menopause and associated health, and to identify unmet needs, for example in knowledge, understanding and/or health care provision. Understanding both patterns of bone loss and women’s opinions about menopause in the context of HIV infection will help inform future interventions and guidelines,” added LSHTM.
Workpackage 1: Qualitative Study in Harare and Soweto
We will interview women at different stages of menopause to understand country-specific contexts and women’s priorities at this stage in life.
Workpackage 2: Longitudinal analysis
We will analyse data already collected from 450 women followed-up over a 4-year period in Soweto, Johannesburg, to determine changes in bone density through menopausal transition and how this is influenced by the presence of HIV infection.
Workpackage 3: Cross-sectional study
We will collect new data from 380 pre-, peri- and post-menopausal women living in Harare. Each will complete detailed questionnaires and undergo musculoskeletal evaluation by DXA and pQCT measurement of bone and muscle mass, as well as assessment of muscle function and physical performance.
This body of work will involve team training and build musculoskeletal research capability in these areas, and expand the Sub-Saharan African MuSculOskeletal Network (SAMSON).