A new study from the San Francisco Bay Area reveals a critical gap in HIV menopause care. Researchers interviewed 15 HIV care providers between May and September 2024, finding that most clinicians lacked formal training on menopause, let alone its intersection with HIV. Many described their competence as shaped more by personal experience than education.
Menopause discussions were typically started by patients, not providers. Symptoms like hot flashes, sleep issues, and mood changes often went unrecognized. Trust was key, but providers noted that trauma histories made some patients hesitant to speak up. The authors recommend routine, trauma-informed menopause conversations for all women with HIV over 35.
Treatment decisions also remain complex. While most prescribing clinicians are comfortable offering hormone therapy, shifting evidence and outdated warnings create confusion. Team-based care and better specialist referrals are helping, but the study calls for improved continuing education and tailored assessment tools to reduce the burden on patients.