Objective-To examine the relationship of human immunodeficiency virus (HIV) and attribution of menopausal symptoms.Design-Peri-and postmenopausal women participating in a prospective study of HIV-infected and at-risk midlife women (the Ms. Study) were interviewed to determine whether they experienced hot flashes and/or vaginal dryness and to what they attributed these symptoms.Results-Of 278 women, 70% were perimenopausal; 54% were HIV-infected; and 52% had used crack, cocaine, heroin, and/or methadone within the past 5 years. Hot flashes were reported by 189 women and vaginal dryness was reported by 101 women. Overall, 69.8% attributed hot flashes to menopause and 28.7% attributed vaginal dryness to menopause. In bivariate analyses, age 45 years and older was associated with attributing hot flashes and vaginal dryness to menopause, and postmenopausal status and at least 12 years of education were associated with attributing vaginal dryness to menopause, but HIV status was not associated with attribution to menopause. In multivariate analysis, significant interactions between age and menopause status were found for both attribution of hot flashes (P = 0.019) and vaginal dryness (P = 0.029). Among perimenopausal women, older age was independently associated with attribution to menopause for hot flashes (adjusted odds ratio = 1.2, 95% CI: 1.1-1.4, P = 0.001) and vaginal dryness (adjusted odds ratio = 1.3, 95% CI: 1.1-1.6, P = 0.011). None of the tested factors were independently associated with attribution to menopause among postmenopausal women.Address correspondence to: Ellie E. Schoenbaum, MD, Belfer Building, Room 1312, 1300 Morris Park Avenue, Bronx, NY 10461. schoenba@aecom.yu.edu. Financial disclosure: None reported. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptConclusion-Tailored health education programs may be beneficial in increasing the knowledge about menopause among HIV-infected and drug-using women, particularly those who are perimenopausal. KeywordsMenopause; HIV; Menopause symptoms; Attribution; Drug useAs the human immunodeficiency virus (HIV)/acquired immunodeficiency virus (AIDS) epidemic evolves, more women are becoming affected, and in 2005, an estimated 23% of the people living with AIDS in the United States were women, 1 compared with 10% in 1990. 2 As people with HIV are living longer and healthier lives, HIV infection is increasingly viewed as a chronic disease. As a result, many of these women will traverse menopause. Recent data suggest that an earlier onset of natural menopause may be associated with opioid use 3 and HIV. 3,4 However, information about menopause in this population is very limited.Menopause is associated with many symptoms including vasomotor symptoms, vaginal dryness, sleep disturbances, and psychological and cognitive problems. 5 However, hot flashes and vaginal dryness are the two symptoms most conclusively associated with a hypoestrogenic state. 6,7 Studies in middle class and educated women found that hot flashes ...

Falls with injury are a persistent patient safety challenge in the acute care setting. This article describes the creation and implementation of a Certified Falls Prevention Advocate (CFPA) program on a medical-surgical unit. The program created standardization of nursing support staff involvement in falls prevention and engaged them as members of the interdisciplinary team. The CFPA program was an important element in the unit's improvement in falls with injury rates. The mean falls with injury rate decreased from 1.115 to 0.178 per 1000 patient-days over a 1-year period.