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Medical Care for Menopausal and Older Women With HIV Infection
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Posted March 2008
New York State Department of Health AIDS Institute: http://www.hivguidelines.org

Medical Care for Menopausal and Older Women With HIV Infection http://www.hivguidelines.org/clinical-guidelines/womens-health/medical-care-for-menopausal-and-older-women-with-hiv-infection/
Information about HIV-infected women over the age of 50 and their treatment is limited because few studies have targeted this gender and age group. However, some generalizations have been observed in clinical studies, including the following:

· Before the use of antiretroviral therapy (ART), older age was a predictor for an increased rate of disease progression to AIDS and death.1,2 The age factor can be mitigated by appropriate treatment with ART.3,4
· HIV-related symptoms and side effects of HIV-related medications may be difficult to distinguish from common age-related comorbidities, such as anemia, wasting, dyspnea on exertion, rheumatologic disorders,5 dementia, osteoporosis, lipid abnormalities, and insulin resistance.
· Because of the increased incidence of malignancy in HIV-infected adults6 and the increased incidence and association of some malignancies with aging, clinicians need to be vigilant for vulvar and cervical neoplasia (see Anogenital Neoplasia) and ovarian, breast, and uterine cancer in older women.
This chapter discusses prevalence and identification of HIV in women over the age of 50, primary health care for HIV-infected older women, the implications of initiating ART and/or hormone replacement therapy (HRT), and the psychosocial issues that may affect older women living with HIV infection. The medical care for HIV-infected menopausal women and women over the age of 50 also includes the same elements of routine medical care that are appropriate for HIV-infected persons in general (see the Adult Treatment guidelines).