Abnormal uterine bleeding during the COVID-19 pandemic among reproductive-age women with and without HIV
8 affiliations
- 1Department of Psychiatry and Behavioral Sciences, University of Miami
- 2Division of Infectious Diseases, Department of Medicine, University of Miami
- 3Department of Epidemiology, University of North Carolina at Chapel Hill
- 4Department of Epidemiology, John Hopkins University
- 5Schools of Nursing, Medicine and Population Health, University of Mississippi Medical Center
- 6School of Medicine, University of Alabama at Birmingham Heersink School of Medicine
- 7School of Medicine, Georgetown University
- 8Department of Medicine, Emory University School of Medicine
Abstract
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.
Related
- Prevalence and Pattern of Thyroid Dysfunction Among Women of Reproductive Age With Abnormal Uterine Bleeding: A Prospective Observational Study
- Magnitude of Thyroid Disorders in Patients with Abnormal Uterine Bleeding
- Hypothyroidism Versus Hyperthyroidism in Patients With Abnormal Uterine Bleeding: An Observational Study
- Clinical and Metabolic Predictors of Abnormal Uterine Bleeding in Women With Type 2 Diabetes Mellitus: A Retrospective Cohort Study.
- Diagnostic Yield of Endometrial Sampling by Age in Premenopausal Women with Abnormal Uterine Bleeding: A Retrospective Cross-Sectional Study
BibTeX
@article{cherenack2026abnormal,
title = {{Abnormal uterine bleeding during the COVID-19 pandemic among reproductive-age women with and without HIV}},
author = {Emily M. Cherenack and Suresh Pallikkuth and Patricia Racchamarich and Nicholas F. Nogueira and Daniel Westreich and Elizabeth F. Topper and Deborah Konkle-Parker and Aadia I. Rana and Seble G. Kassaye and Anandi N. Sheth and Deborah L. Jones and Maria L. Alcaide},
journal = {BMC Infectious Diseases},
year = {2026},
month = jul,
doi = {10.1186/s12879-026-14029-4},
url = {https://doi.org/10.1186/s12879-026-14029-4},
note = {CC BY},
}
RIS
TY - JOUR
TI - Abnormal uterine bleeding during the COVID-19 pandemic among reproductive-age women with and without HIV
AU - Emily M. Cherenack
AU - Suresh Pallikkuth
AU - Patricia Racchamarich
AU - Nicholas F. Nogueira
AU - Daniel Westreich
AU - Elizabeth F. Topper
AU - Deborah Konkle-Parker
AU - Aadia I. Rana
AU - Seble G. Kassaye
AU - Anandi N. Sheth
AU - Deborah L. Jones
AU - Maria L. Alcaide
PY - 2026
DA - 2026/07/01
JO - BMC Infectious Diseases
DO - 10.1186/s12879-026-14029-4
UR - https://doi.org/10.1186/s12879-026-14029-4
AB - 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.
SN - 1471-2334
ER -