Menopause experiences among women living with HIV (WLHIV) in Sub-Saharan Africa: a scoping review

Themba, Nokwanda

Menopause experiences among women living with HIV (WLHIV) in Sub-Saharan Africa: a scoping review

Thesis / Dissertation

2026

Publisher

University of Cape Town

Department

Department of Public Health and Family Medicine

Faculty

Faculty of Health Sciences

Abstract

Menopause is a significant biological transition for women living with HIV (WLHIV) in Sub-Saharan Africa (SSA), presenting unique challenges such as increased risks for bone loss and more severe symptoms. With increasing life expectancy due to effective antiretroviral therapy (ART), the population of ageing WLHIV continues to grow, requiring tailored HIV services. However, research on the complex association between HIV and menopause remains limited. Objectives: This scoping review aims to provide a comprehensive overview of current knowledge on menopause among WLHIV in Sub-Saharan Africa, identify gaps in existing literature, and provide insights for future research and interventions. Methods: A scoping review was conducted following the JBI framework and PRISMA-ScR guidelines. Databases PubMed, Science Direct and Google Scholar were searched for studies published in English up to October 2023. Eligible studies included perimenopausal and postmenopausal WLHIV in Sub-Saharan Africa. Data were extracted and summarised based on study characteristics, methodology, menopause definitions, symptoms, and health outcomes. Results: A total of 138 articles were identified and screened for eligibility based on titles and abstracts; 72 articles were assessed for full-text eligibility, and 65 articles were excluded. Seven studies in South Africa, Nigeria, and Zimbabwe met the final inclusion criteria. Studies found a higher prevalence of early menopause, decreased bone mineral density, and more severe menopausal symptoms among WLHIV compared to women living without HIV. Furthermore, several studies reported a high BMI was strongly associated with symptom severity. Conclusion: Our scoping review highlights a significant association between HIV and menopause among WLHIV in Sub-Saharan Africa. WLHIV experience severe menopausal symptoms, earlier menopause, and lower bone mineral density compared to women without HIV. However, research is limited, and findings are inconsistent. Future longitudinal studies are required to understand the complex relationship between menopause and HIV for the development of effective interventions. Integrating menopause care into HIV services is crucial for improving health outcomes and quality of life among WLHIV in this region.