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Background <p>Women have reported abnormal uterine bleeding (AUB) during the COVID-19 pandemic. Evaluating AUB among women living with HIV (WWH) and women without HIV (WWoH) during the COVID-19 pandemic is key to understanding reproductive health in the setting of viral co-infections.</p> Methods <p>From 2021 to 2023, the Study of Treatment and Reproductive Outcomes (STAR) collected cross-sectional data from WWH and WWoH 18–45 years-of-age across the southern United States without conditions known to interfere with menses. Women completed surveys on COVID-19 testing, COVID-19 vaccination, AUB (spotting, missed periods, early/late periods), stress, and demographics. We tested plasma from participants at two study sites for COVID-19 antibodies. We defined “prior SARS-CoV-2 infection” as having detectable anti-nucleocapsid antibodies or a self-reported positive COVID-19 test. We examined AUB in association with COVID-19 vaccination and infection stratified by HIV status.</p> Results <p>Among 188 eligible women, 61% were living with HIV, 49% had AUB, and 58% were vaccinated for COVID-19. When assessed via combined self-report and antibody tests (<i>n</i> = 86), 69% of women had prior SARS-CoV-2 infection. There were no differences in AUB, COVID-19 vaccination, or SARS-CoV-2 infection by HIV status. Among the entire sample of WWoH (<i>n</i> = 73), AUB was associated with lower age (32 vs. 35, <i>p</i> = 0.04) and higher perceived stress (17 vs. 13, <i>p</i> = 0.04), and AUB was more common in WWoH who self-reported a positive COVID-19 test versus WWoH without (70% vs. 43%, <i>p</i> = 0.03). AUB was not associated with COVID-19 vaccination, body mass index, race, or ethnicity. In WWoH with antibody testing (<i>n</i> = 42), AUB remained more common among WWoH with prior SARS-CoV-2 infection versus WWoH without (61% vs. 27%, <i>p</i> = 0.05). Among WWH, no variables were associated with AUB.</p> Conclusions <p>In this hypothesis-generating, descriptive study, AUB was associated with SARS-CoV-2 infection, stress, and age among WWoH, but not among WWH. There was no association between AUB and COVID-19 vaccination.</p>

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Abnormal uterine bleeding during the COVID-19 pandemic among reproductive-age women with and without HIV

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月21日

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  • Emily M. Cherenack,
  • Suresh Pallikkuth,
  • Patricia Racchamarich,
  • Nicholas F. Nogueira,
  • Daniel Westreich,
  • Elizabeth F. Topper,
  • Deborah Konkle-Parker,
  • Aadia I. Rana,
  • Seble G. Kassaye,
  • Anandi N. Sheth,
  • Deborah L. Jones,
  • Maria L. Alcaide

摘要

Background

Women have reported abnormal uterine bleeding (AUB) during the COVID-19 pandemic. Evaluating AUB among women living with HIV (WWH) and women without HIV (WWoH) during the COVID-19 pandemic is key to understanding reproductive health in the setting of viral co-infections.

Methods

From 2021 to 2023, the Study of Treatment and Reproductive Outcomes (STAR) collected cross-sectional data from WWH and WWoH 18–45 years-of-age across the southern United States without conditions known to interfere with menses. Women completed surveys on COVID-19 testing, COVID-19 vaccination, AUB (spotting, missed periods, early/late periods), stress, and demographics. We tested plasma from participants at two study sites for COVID-19 antibodies. We defined “prior SARS-CoV-2 infection” as having detectable anti-nucleocapsid antibodies or a self-reported positive COVID-19 test. We examined AUB in association with COVID-19 vaccination and infection stratified by HIV status.

Results

Among 188 eligible women, 61% were living with HIV, 49% had AUB, and 58% were vaccinated for COVID-19. When assessed via combined self-report and antibody tests (n = 86), 69% of women had prior SARS-CoV-2 infection. There were no differences in AUB, COVID-19 vaccination, or SARS-CoV-2 infection by HIV status. Among the entire sample of WWoH (n = 73), AUB was associated with lower age (32 vs. 35, p = 0.04) and higher perceived stress (17 vs. 13, p = 0.04), and AUB was more common in WWoH who self-reported a positive COVID-19 test versus WWoH without (70% vs. 43%, p = 0.03). AUB was not associated with COVID-19 vaccination, body mass index, race, or ethnicity. In WWoH with antibody testing (n = 42), AUB remained more common among WWoH with prior SARS-CoV-2 infection versus WWoH without (61% vs. 27%, p = 0.05). Among WWH, no variables were associated with AUB.

Conclusions

In this hypothesis-generating, descriptive study, AUB was associated with SARS-CoV-2 infection, stress, and age among WWoH, but not among WWH. There was no association between AUB and COVID-19 vaccination.