{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:03:58Z","timestamp":1790960638656,"version":"4.1.0"},"reference-count":73,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2019,8,30]],"date-time":"2019-08-30T00:00:00Z","timestamp":1567123200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Research and Human Retroviruses"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>\n                    Reproductive age women may choose to concurrently use topical antiretrovirals and hormonal contraceptives (HCs) to simultaneously prevent HIV-1 infection and unintended\/mistimed pregnancy. There are conflicting data on the effect of HCs on mucosal susceptibility to HIV-1. The objective of this study was to evaluate cervicovaginal (CV) mucosal data from healthy women before and after initiation of either oral contraceptive pills (OCPs) or depot medroxyprogesterone acetate (DMPA) injection. CONRAD A10-114 was a prospective, open-label, parallel cohort study. We enrolled 74 women and 62 completed the visits (32 and 30 who selected OCPs and DMPA, respectively). Participants provided CV lavage, vaginal biopsies, and CV swabs at baseline in the luteal phase and then \u223c6 weeks after initiating HCs. After contraceptive initiation, there were significant increases in vaginal immune cell density among both DMPA and OCP users. Changes for OCP users were concentrated in the subepithelial lamina propria, whereas for DMPA users, they were distributed throughout the vaginal tissue, including the epithelium (CD45\n                    <jats:sup>+<\/jats:sup>\n                    , CD3\n                    <jats:sup>+<\/jats:sup>\n                    , CD4\n                    <jats:sup>+<\/jats:sup>\n                    , and CD1a\n                    <jats:sup>+<\/jats:sup>\n                    ). Contraceptive use altered concentrations of soluble CV inflammatory and immune mediators, with significant reductions in some proinflammatory cytokines and secretory leukoprotease inhibitor. Compared with baseline, p24 antigen production after\n                    <jats:italic toggle=\"yes\">ex vivo<\/jats:italic>\n                    HIV-1 infection of vaginal biopsies doubled after DMPA use, but all\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    -values were &gt;.05. HIV-1 replication was significantly higher in DMPA-exposed tissues compared with those from the OCP group at the end of the tissue culture (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u2009.01). Although not statistically significant, median\n                    <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                    inhibition of HIV-1 by CV fluid (innate antiviral activity), was reduced by \u223c50% with HCs (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&gt;\u2009.21). Exposure to exogenous contraceptive hormones significantly increased vaginal immune cells and reduced CV proinflammatory cytokines and antimicrobial peptides. DMPA users showed higher susceptibility to HIV-1\n                    <jats:italic toggle=\"yes\">ex vivo<\/jats:italic>\n                    infection.\n                  <\/jats:p>","DOI":"10.1089\/aid.2018.0298","type":"journal-article","created":{"date-parts":[[2019,4,18]],"date-time":"2019-04-18T06:30:19Z","timestamp":1555569019000},"page":"853-864","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["The Effect of Hormonal Contraception on Cervicovaginal Mucosal End Points Associated with HIV Acquisition"],"prefix":"10.1177","volume":"35","author":[{"given":"Andrea","family":"Thurman","sequence":"first","affiliation":[{"name":"Eastern Virginia Medical School, CONRAD, Norfolk, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelima","family":"Chandra","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School, CONRAD, Norfolk, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill L.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School, CONRAD, Norfolk, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Brache","sequence":"additional","affiliation":[{"name":"Profamilia, Santo Domingo, Dominican Republic."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice A.","family":"Chen","sequence":"additional","affiliation":[{"name":"Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Asin","sequence":"additional","affiliation":[{"name":"V.A. Medical Center, White River Junction, VT and Geisel School of Medicine, Dartmouth, New Hampshire."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Rollenhagen","sequence":"additional","affiliation":[{"name":"V.A. Medical Center, White River Junction, VT and Geisel School of Medicine, Dartmouth, New Hampshire."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betsy C.","family":"Herold","sequence":"additional","affiliation":[{"name":"Department of Pediatric Infectious Diseases, Albert Einstein College of Medicine, Bronx, New York."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raina N.","family":"Fichorova","sequence":"additional","affiliation":[{"name":"Laboratory of Genital Tract Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon L.","family":"Hillier","sequence":"additional","affiliation":[{"name":"Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra H.","family":"Weiner","sequence":"additional","affiliation":[{"name":"FHI 360, Durham, North Carolina."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Mauck","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School, CONRAD, Norfolk, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo F.","family":"Doncel","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School, CONRAD, Norfolk, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,8,30]]},"reference":[{"issue":"1","key":"e_1_3_4_2_2","first-page":"46","article-title":"Rates of unintended pregnancy remain high in developing regions","volume":"37","author":"Kott A","year":"2011","unstructured":"Kott A: Rates of unintended pregnancy remain high in developing regions. 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