Role of Menopause-Related Factors and Depression in Cardiovascular Disease Risk and Bone Loss in Postmenopausal Minority Women with HIV: A Secondary Analysis

Abstract

Role of Menopause-Related Factors and Depression in Cardiovascular Disease Risk and Bone Loss in Postmenopausal Minority Women with HIV: A Secondary Analysis Yamnia I. Cortes An aging HIV population carries a magnified risk of degenerative conditions such as cardiovascular disease (CVD) and osteoporosis. Recent studies have demonstrated that the growing population of older HIV-infected women is at special risk for these complications. To what extent the metabolic consequences of menopause or other related disease predictors such as depression influence this gender disparity is not known. The overall goal of this dissertation is to better characterize the etiology of low bone density and accelerated CVD in HIV-infected postmenopausal women. Current gaps in knowledge surrounding women aging with HIV, particularly as it relates to CVD and bone loss, are discussed in Chapter One. Chapter Two reports findings from a systematic review of low bone density and fractures in HIV-infected postmenopausal women. To gain a better understanding of CVD risk in HIV-infected postmenopausal minority women, a cross-sectional study was conducted and is presented in Chapter Three. Quantitative findings from a longitudinal analysis of bone density in postmenopausal minority women with HIV are reported in Chapter Four. Finally, in Chapter Five, findings from the previous chapters are summarized and synthesized into a concluding chapter; implications and future recommendations are also discussed. This dissertation was written following the format of the publication option, which includes versions of three full-length articles that have been submitted or will be submitted to peer reviewed journals for publication; two of the papers are data-based manuscripts and the third is a systematic review. The current status of these papers is as follows: 1. Chapter 2, (Paper #1) Cortes, Y.I., Yin, M.T., Reame, N.K. Low bone mineral density and fractures in postmenopausal HIV-infected women: A systematic review. Journal of the Association of Nurses in AIDS Care. Published online: April 3, 2015. Doi: 10.1016/j.jana.2015.03.005. 2. Chapter 3, (Paper #2) Cortes, Y.I., Reame, N.K., Zeana, C., Jia, H., Shane, E., Yin, M.T. Cardiovascular disease in HIV-infected postmenopausal women: Characterizing risk and use of the Framingham Risk Score. Prepared for submission to Menopause. 3. Chapter 4, (Paper #3) Cortes, Y.I., Reame, N.K., Shane, E., Yin, M.T. Determinants of bone loss change in HIVinfected postmenopausal women: A secondary analysis of reproductive history and depression-related factors. Prepared for submission to Calcified Tissue International.