{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T02:51:49Z","timestamp":1790304709102,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,8,3]],"date-time":"2018-08-03T00:00:00Z","timestamp":1533254400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Problem<\/jats:title><jats:p>In women, the use of progestin\u2010based contraception may increase the risk of vaginal <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> acquisition. We previously showed in macaques that there is a significantly higher simian\u2010human immunodeficiency virus (<jats:styled-content style=\"fixed-case\">SHIV<\/jats:styled-content>) acquisition rate in the luteal phase of the menstrual cycle, which presents a naturally high\u2010progesterone state, and this may be attributable to altered expression of innate immune factors. We hypothesized that progestin\u2010based contraception, especially depot medroxyprogesterone acetate (<jats:styled-content style=\"fixed-case\">DMPA<\/jats:styled-content>), would, in a similar way, affect mucosal immune factors that influence <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> acquisition risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method of study<\/jats:title><jats:p>We used a pig\u2010tailed macaque model to evaluate the effects of two progestin\u2010based contraceptives, <jats:styled-content style=\"fixed-case\">DMPA<\/jats:styled-content>, and levonorgestrel (<jats:styled-content style=\"fixed-case\">LNG<\/jats:styled-content>)\/ethinyl estradiol (<jats:styled-content style=\"fixed-case\">EE<\/jats:styled-content>)\u2010based combined oral contraceptives (<jats:styled-content style=\"fixed-case\">COC<\/jats:styled-content>s), on innate mucosal factors. We compared the vaginal epithelial thickness data from previous studies and used cytokine profiling and microarray analysis to evaluate contraception\u2010induced molecular changes in the vagina.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The administration of <jats:styled-content style=\"fixed-case\">DMPA<\/jats:styled-content> caused a reduction in the thickness of the vaginal epithelium relative to that of the follicular or luteal phase. <jats:styled-content style=\"fixed-case\">DMPA<\/jats:styled-content> also induced a significant increase in vaginal levels of the anti\u2010inflammatory cytokine <jats:styled-content style=\"fixed-case\">IL<\/jats:styled-content>\u201010. Both <jats:styled-content style=\"fixed-case\">DMPA<\/jats:styled-content>\u2010 and <jats:styled-content style=\"fixed-case\">LNG<\/jats:styled-content>\u2010based contraception induced a signature of gene expression similar to that of the luteal phase, only more exacerbated, including widespread downregulation of antiviral genes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The use of progestin\u2010based contraception might engender a milieu that poses an increased risk of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> acquisition as compared to both the luteal and follicular phases of the menstrual cycle.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.13029","type":"journal-article","created":{"date-parts":[[2018,8,7]],"date-time":"2018-08-07T06:24:52Z","timestamp":1533623092000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Progestin\u2010based contraception regimens modulate expression of putative <scp>HIV<\/scp> risk factors in the vaginal epithelium of pig\u2010tailed Macaques"],"prefix":"10.1111","volume":"80","author":[{"given":"Steven E.","family":"Bosinger","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Emory University  Atlanta Georgia"},{"name":"Division of Microbiology and Immunology Yerkes National Primate Research Center Emory University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory K.","family":"Tharp","sequence":"additional","affiliation":[{"name":"Division of Microbiology and Immunology Yerkes National Primate Research Center Emory University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirav B.","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Microbiology and Immunology Yerkes National Primate Research Center Emory University  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxia","family":"Zhao","sequence":"additional","affiliation":[{"name":"Libra Management Group  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamika L.","family":"Payne","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS Prevention CDC  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Dietz Ostergaard","sequence":"additional","affiliation":[{"name":"Division of Scientific Resources CDC  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Butler","sequence":"additional","affiliation":[{"name":"Office of the Associate Director for Laboratory Science and Safety CDC  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanon","family":"Ellis","sequence":"additional","affiliation":[{"name":"Libra Management Group  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan L.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS Prevention CDC  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen N.","family":"Kersh","sequence":"additional","affiliation":[{"name":"Division of Sexually Transmitted Disease Prevention CDC  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet M.","family":"McNicholl","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS Prevention CDC  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9157-4709","authenticated-orcid":false,"given":"Sundaram A.","family":"Vishwanathan","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS Prevention CDC  Atlanta Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1086\/651483"},{"key":"e_1_2_8_3_1","unstructured":"United Nations Department of Economic and Social Affairs Population Division World Contraceptive Use. 2017.2017. 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