{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T01:12:07Z","timestamp":1790471527926,"version":"4.1.0"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T00:00:00Z","timestamp":1597104000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","award":["682810"],"award-info":[{"award-number":["682810"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["86721"],"award-info":[{"award-number":["86721"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["201605762"],"award-info":[{"award-number":["201605762"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The hormonal contraceptive depot medroxyprogesterone acetate (DMPA) may be associated with an increased risk of acquiring human immunodeficiency virus (HIV). We hypothesize that DMPA use influences the ectocervical tissue architecture and HIV target cell localization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Quantitative image analysis workflows were developed to assess ectocervical tissue samples collected from DMPA users and control subjects not using hormonal contraception.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared to controls, the DMPA group exhibited a significantly thinner apical ectocervical epithelial layer and a higher proportion of CD4+CCR5+ cells with a more superficial location. This localization corresponded to an area with a nonintact E-cadherin net structure. CD4+Langerin+ cells were also more superficially located in the DMPA group, although fewer in number compared to the controls. Natural plasma progesterone levels did not correlate with any of these parameters, whereas estradiol levels were positively correlated with E-cadherin expression and a more basal location for HIV target cells of the control group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>DMPA users have a less robust epithelial layer and a more apical distribution of HIV target cells in the human ectocervix, which could confer a higher risk of HIV infection. Our results highlight the importance of assessing intact genital tissue samples to gain insights into HIV susceptibility factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaa514","type":"journal-article","created":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T11:13:44Z","timestamp":1596885224000},"page":"1151-1161","source":"Crossref","is-referenced-by-count":27,"title":["Regular Use of Depot Medroxyprogesterone Acetate Causes Thinning of the Superficial Lining and Apical Distribution of Human Immunodeficiency Virus Target Cells in the Human Ectocervix"],"prefix":"10.1093","volume":"225","author":[{"given":"Gabriella","family":"Edfeldt","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Lajoie","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada"},{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"R\u00f6hl","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Oyugi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada"},{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"\u00c5hlberg","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Behnaz","family":"Khalilzadeh-Binicy","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frideborg","family":"Bradley","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Center for Molecular Medicine, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Mack","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\u2013Nephrology, University Hospital Regensburg, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Kimani","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada"},{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya"},{"name":"Partners for Health and Development in Africa, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Omollo","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"W\u00e4hlby","sequence":"additional","affiliation":[{"name":"Department of Information Technology, Uppsala University, Uppsala, Sweden"},{"name":"SciLifeLab BioImage Informatics Facility, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith R","family":"Fowke","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada"},{"name":"Department of Medical Microbiology, University of Nairobi, Nairobi, Kenya"},{"name":"Partners for Health and Development in Africa, Nairobi, Kenya"},{"name":"Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Broliden","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Solna, 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