BACKGROUND Reproductive aging may contribute to cardiometabolic comorbid conditions . We integrated data on gynecologic history with levels of an ovarian reserve marker (anti-müllerian hormone [AMH) ] to interrogate reproductive aging patterns and associated factors among a subset of cisgender women with human immunodeficiency virus (WWH) enrolled in the REPRIEVE trial .
METHODS A total of 1449 WWH were classified as premenopausal (n = 482) (menses within 12 months; AMH level ≥20 pg/mL; group 1), premenopausal with reduced ovarian reserve (n = 224) (menses within 12 months; AMH <20 pg/mL; group 2), or postmenopausal (n = 743) (no menses within12 months; AMH <20 pg/mL; group 3). Proportional odds models, adjusted for chronologic age, were used to investigate associations of cardiometabolic and demographic parameters with reproductive aging milestones (AMH <20 pg/mL or> 12 months of amenorrhea). Excluding WWH with surgical menopause, age at final menstrual period was summarized for postmenopausal WWH (group 3) and estimated among all WWH (groups 1-3) using an accelerated failure-time model .
RESULTS Cardiometabolic and demographic parameters associated with advanced reproductive age (controlling for chronologic age) included waist circumference (> 88 vs ≤88 cm) (odds ratio [OR], 1.38; 95% confidence interval , 1.06-1.80; P = .02), hemoglobin (≥12 vs <12 g/dL) (2.32; 1.71-3.14; P <.01), and region of residence (sub-Saharan Africa [1.50; 1.07-2.11; P = .02] and Latin America and the Caribbean [1.59; 1.08-2.33; P = .02], as compared with World Health Organization Global Burden of Disease high-income regions). The median age (Q1, Q3) at the final menstrual period was 48 (45 , 51) years when described among postmenopausal WWH, and either 49 (46 , 52) or 50 (47 , 53) years when estimated among all WWH, depending on censoring strategy .
CONCLUSIONS Among WWH in the REPRIEVE trial, more advanced reproductive age is associated with metabolic dysregulation and region of residence . Additional research on age at menopause among WWH is needed . CLINICAL TRIALS REGISTRATION NCT0234429.