Exploring the Interplay Between Menopause Symptoms and HIV Management in Sub-Saharan Africa: A Narrative Literature Review

The intersection of menopause and HIV management represents a critical concern in women’s health in Sub-Saharan Africa, as a growing population of women ages while receiving lifelong antiretroviral therapy (ART). The physiological transition of menopause generates symptoms that frequently overlap with HIV-related pathology, ART side effects, mental health disorders, and age-associated comorbidities. This overlapping symptomatology creates substantial challenges for accurate diagnosis and comprehensive care. This narrative literature review systematically examines the relationship between menopausal symptoms and HIV management among women living with HIV (WLHIV) in Sub-Saharan Africa. Through thematic synthesis of literature from major academic databases, the review evaluates key dimensions including symptom overlap, treatment adherence, quality of life, psycho-sexual health, socio-cultural influences, and systemic healthcare responses. Synthesized evidence indicates that unmanaged menopausal symptoms significantly compromise overall well-being and engagement with HIV services. Provider-level training deficits, persistent social stigma, and fragmented health infrastructure continue to hinder the identification and clinical management of these overlapping needs. This review underscores the urgent need for person-centered, culturally responsive, and integrated care models that address menopause and HIV concurrently while accounting for individual symptom profiles. Recommended strategies for integration include implementing routine menopausal screening in HIV clinics, establishing multidisciplinary care teams comprising HIV clinicians and women's health specialists, incorporating menopause symptom assessment tools into regular patient evaluations, and providing joint counseling sessions that address both HIV and menopausal health. Developing clear referral pathways to gynecological services for complex cases may further enhance care coordination. Future research should prioritize developing and empirically evaluating integrated healthcare models tailored to the diverse contexts of Sub-Saharan Africa.