ArticleBMC infectious diseases2026
Abnormal uterine bleeding during the COVID-19 pandemic among reproductive-age women with and without HIV.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWomen 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.
methodsFrom 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.
resultsAmong 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.
conclusionsIn 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.
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