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Background: Antenatal education is part of antenatal care in many countries. Physical and mental preparation for childbirth and information on pain management are considered key elements of antenatal education classes. Evidence suggests that women who participate in antenatal education classes appear to benefit in terms of self-efficacy and childbirth experience. In particular, women with increased fear of childbirth benefit from trained breathing and relaxation techniques in antenatal education. However, little is known about the effect of breathing and relaxation techniques on the outcomes of healthy pregnant women without fear of childbirth or who do not have medical or obstetric risks, or on neonatal outcomes. Objective: The aim of this study is to test whether including a breathing and relaxation technique in an antenatal education class will improve self-efficacy towards birth compared to a standard antenatal education class. Methods: The study will be a two-armed randomised controlled trial (RCT). Healthy pregnant women between the 12th and 30th week of gestation with singleton low-risk pregnancies and who are receiving routine antenatal care will be recruited in a hospital in Switzerland. All women included will attend an 8-hour antenatal education class. The intervention group will additionally practise a breathing and relaxation technique, receive a handbook to guide their exercise practice at home, and be provided with access to an online brochure with video and audio recordings for guidance. Data on maternal and neonatal outcomes will be collected after recruitment, in the 37th week of pregnancy, and two to four weeks postpartum. Discussion: The effectiveness of including a breathing and relaxation technique in antenatal education classes on women's self-efficacy is discussed as a means to improving women's pregnancy and childbirth outcomes. Trial registration number: NCT06003946, SNCTP000005672. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to assess prevalence and age at menopause, identify factors associated with early menopause and explore the provision and utilization of healthcare in women living with HIV in Switzerland. Methods: This was a retrospective Swiss HIV Cohort Study analysis from January 2010 to December 2018. Descriptive statistics to characterise the population and menopause onset. Logistic regression analysis to identify risk factors for early menopause. Results: Of all women in the SHCS, the proportion of postmenopausal women tripled from 11.5% (n = 274) in 2010 to 36.1% (n = 961) in 2018. The median age at menopause was 50 years. Early menopause (< 45 years) occurred in 115 (10.2%) women and premature ovarian insufficiency (POI) (< 40 years) in 23 (2%) women. Early menopause was associated with black ethnicity (52.2% vs. 21.6%, p < 0.001), but not with HIV acquisition mode, CDC stage, viral suppression, CD4 cell count, hepatitis C, smoking or active drug use. While 92% of the postmenopausal women underwent a gynaecological examination during the 36 months before menopause documentation, only 27% received a bone mineral density measurement within 36 months after the last bleed and 11% were on hormone replacement therapy at the time of menopause documentation. Conclusions: The median age of women living with HIV at menopause is around 2 years lower than that reported for HIV‐negative women in Switzerland. HIV care providers need to adapt their services to the requirements of the increasing number of women living with HIV transitioning through menopause. They should be able to recognize menopause‐associated symptoms and improve access to bone mineral density measurement as well as hormone replacement therapy. [ABSTRACT FROM AUTHOR]

Background: Increasing numbers of women living with HIV transition through menopause. It is unclear whether this transition has an impact on treatment adherence, viral suppression, psychiatric comorbidities, or drug use. We aimed at examining adherence and viral suppression during the perimenopausal period and explored the influence of psychiatric comorbidities and active injection drug use (IDU)., Setting: Retrospective Swiss HIV Cohort Study analysis from January 2010 to December 2018., Methods: We explored perimenopausal and postmenopausal trends of viral blips, low-level viremia, viral failure, adherence, psychiatric comorbidities, and IDU using interrupted time series models., Results: Rates of depression and psychiatric care increased during perimenopause before decreasing afterward. Negative treatment outcomes such as viral blips, low-level viremia, viral failure, and low adherence steadily declined while transitioning through menopause-this was also true for subgroups of women with depression, psychiatric treatment, and active IDU., Conclusions: Increased rates of depression and psychiatric care while transitioning through menopause do not result in lower rates of adherence or viral suppression in women living with HIV in Switzerland., Competing Interests: None of the authors has declared a possible conflict of interest related to this study. A.H.'s institution has received travel grants, congress and advisory fees from MSD, ViiV, and Gilead, unrelated to this work. B.B. Flury has undertaken Advisory Boards or ad hoc consultancy for Merck/MSD, Melinta/Menarini, Shionogi, and Pfizer, and has received research grants from Melinta/Menarini unrelated to this work. K.E.A.D.'s institution has received research funding unrelated to this publication from Gilead and offered expert testimony for MSD. P.T.'s institution has received grants, advisory fees, and educational grants from Gilead, MSD, and ViiV outside the submitted work. K.A.-P.’s institution has received travel grants and advisory fees from MSD, Gilead, and ViiV healthcare unrelated to this work. I.A.A. is supported by the ProMedica Foundation., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.)