ABSTRACT
Background: Women have reported increased menstrual irregularities during the COVID-19 pandemic. It is unknown if this is due to biological (i.e., the effect of SARS-CoV-2 infection or vaccination) and/or psychosocial factors. This study examined menstrual irregularities during the COVID-19 pandemic and the association of abnormal menses with the presence of SARS-CoV-2 antibodies, stress, and mental health among reproductive age women. Methods: A cross-sectional study of 182 HIV-negative, sexually active, 18-to 45-year-old cisgender women was conducted on biobehavioral factors influencing HIV risk. From January 2019 to September 2021, participants completed a survey of menstrual irregularities over the previous three months, previous month condomless vaginal intercourse, and plans to conceive. Starting October 2020, SARS-CoV-2 IgG antibodies were measured using an FDA EUA rapid test assay using whole blood, and participants completed the Centers for Epidemiological Studies Depression Scale, the Loneliness Brief Form, the Perceived Stress Scale. History of COVID-19 vaccination was self-reported. Menstrual irregularities were compared by recruitment date (pre-pandemic vs. during pandemic/after April 2020) and by IgG antibody status. Logistic regression models tested if the presence of antibodies was associated with menstrual irregularities when controlling for age (in all models) and stress, depression, and loneliness in separate models. Results: Key variables are illustrated in Table 1. Menstrual irregularities did not differ by enrollment date. About half of women (n=36) had detectable IgG;5 had been vaccinated. Controlling for age, women with detectable IgG had 7.3, 95% CI [1.5, 36.5], times the odds of menstrual irregularities. Neither age, stress, nor mental health were associated with irregular menstruation. Among unvaccinated women (n=31), 35% with IgG antibodies had irregular menstruation compared to 0% without IgG antibodies. Among women with no plans to conceive, 74% had condomless intercourse, of whom 11% had irregular menstruation. Conclusion: Findings suggest a relationship between SARS-CoV-2 infection and irregular menstruation that was not accounted for by stress or mental health. During the COVID-19 pandemic, increased condom use and routine pregnancy testing may be merited among women not intending to conceive.
ABSTRACT
Background: As the COronaVIrus Disease 2019 (COVID-19) continues to unfold, drastic changes in daily life pose significant challenges on mental and clinical health. While public health interventions such as national lockdowns and social distancing are enforced to reduce the spread of COVID-19, the psychosocial and physical consequences have yet to be determined that may disproportionately affect people living with HIV (PLWH). Methods: To evaluate the impact of COVID-related stress on mental and clinical health, we conducted a 20-minute questionnaire eliciting sociodemographic information, clinical and psychological factors from people living in Miami, Fl. All individuals >18 years with or without a history of COVID-19 were included. Participating PLWH were recruited from an existing HIV registry and HIV uninfected participants from community flyers and word of mouth. Results: A total of 135 participants were recruited from 05/2020-06/2020. The mean age was 50 years old, 73/135 (54%) were female, and 102/135 (75%) were PLWH. Among participating PLWH, 60/102 (58.8%) self-identified as African American, and 9/102 (8.8%) were positive for COVID-19 by a commercially approved test. Among HIV-negative participants, 15/33 (45.5%) self-identified as White and 11/33 (33%) were positive for COVID-19. Both PLWH and HIVnegative participants described significant disruptions in health care access (47%), difficulty paying basic needs (41%), and feelings of anxiety and depression (48%);there was no statistically significant difference by HIV status. However, HIV negative participants were less likely to experience job loss and income disruption compared to PLWH during the pandemic (70% for HIV-negative vs 48% for PLWH;OR 0.40, p=0.03). Conclusion: The impact of COVID-19 on emotional and clinical health is significant in both PLWH and HIV-negative groups. These findings highlight the need for providing mental and physical health care during the pandemic, especially for coping with stress and anxiety during these difficult times and ensuring adequate access to health care.