Subclinical atherosclerosis across the menopausal transition in women with and without HIV.

The menopausal transition is a pivotal time of cardiovascular risk, but knowledge is limited in HIV. We studied longitudinal carotid artery intima-media thickness (CIMT) in the Women's Interagency HIV Study (2004-2019; 979 women/3247 person-visits; 72% living with HIV). Among women with HIV only, those who transitioned had greater age-related CIMT progression compared to those remaining pre-menopausal (difference in slope=1.64 µm/year, p=0.002); and CIMT increased over time in the pre-transition (3.47 µm/year, p=0.002) and during the menopausal transition (9.41 µm/year, p<0.0001), but not post-transition (2.9 µm/year, p=0.19). In women with HIV, menopause may accelerate subclinical atherosclerosis as measured by CIMT.