{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:04:28Z","timestamp":1790960668962,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,6,25]],"date-time":"2020-06-25T00:00:00Z","timestamp":1593043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1055833"],"award-info":[{"award-number":["OPP1055833"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Rep Immunol"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Problem<\/jats:title><jats:p>Contraceptive hormones are systemically active, potent, and likely to invoke biological responses other than known fertility regulation impacts. We hypothesized that initiation of depot medroxyprogesterone acetate (DMPA) would increase genital HIV\u2010target\u2010cells and soluble immune mediators compared with baseline and initiation of other contraceptive methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method of Study<\/jats:title><jats:p>We collected cervical cytobrushes and cervicovaginal fluid from healthy Zimbabwean women aged 18\u201034 to assess immune cell populations, cytokines, and innate anti\u2010HIV activity at baseline and after 30, 90, and 180\u00a0days use of DMPA (n\u00a0=\u00a038), norethisterone enanthate (n\u00a0=\u00a041), medroxyprogesterone acetate\/estradiol cypionate (n\u00a0=\u00a036), levonorgestrel implant (n\u00a0=\u00a043), etonogestrel implant (n\u00a0=\u00a047), or copper intrauterine device (Cu\u2010IUD) (n\u00a0=\u00a045). Cells were quantified by flow cytometry, cytokines were detected by multiplex assays, and innate anti\u2010HIV activity was assessed by in vitro HIV challenge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to baseline, the number of cervical HIV target cells (#CD4 cells <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.04 and #CD11c cells <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.04), the concentration of the inflammatory cytokine IL\u20101\u03b2 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01), and the innate in vitro anti\u2010HIV activity (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) significantly decreased following DMPA initiation. In Cu\u2010IUD users, genital HIV target cells increased (#CD4 cells <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001, #CD4CCR5 cells <jats:italic>P<\/jats:italic>\u00a0=\u00a0.02, #CD4CD69 cells <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001, #CD8CD69 <jats:italic>P<\/jats:italic>\u00a0=\u00a0.01, and #CD11c cells <jats:italic>P<\/jats:italic>\u00a0=\u00a0.003) at day 30 and resolved by day 180. IFN\u2010\u03b3 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), IL\u20101\u03b2 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), IL\u20106 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), IL\u20108 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), IL\u201010 (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01), and RANTES (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) were also significantly increased at day 30. Minimal alterations were observed following initiation of subdermal implantable contraceptives.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This head\u2010to\u2010head study compared six contraceptives and found increased HIV target cells and cervical inflammation temporally associated with Cu\u2010IUD initiation. Use of hormonal contraception, including DMPA, did not increase cervical HIV target cells or inflammation.<\/jats:p><jats:p>Clinical Trial Number: NCT02038335<\/jats:p><\/jats:sec>","DOI":"10.1111\/aji.13287","type":"journal-article","created":{"date-parts":[[2020,6,13]],"date-time":"2020-06-13T19:15:21Z","timestamp":1592075721000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Zim CHIC: A cohort study of immune changes in the female genital tract associated with initiation and use of contraceptives"],"prefix":"10.1111","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7478-8262","authenticated-orcid":false,"given":"Sharon L.","family":"Achilles","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences and Center for Family Planning Research University of Pittsburgh School of Medicine Pittsburgh PA USA"},{"name":"Magee\u2010Womens Research Institute Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie A.","family":"Meyn","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences and Center for Family Planning Research University of Pittsburgh School of Medicine Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix G.","family":"Mhlanga","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Zimbabwe College of Health Science Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5361-7686","authenticated-orcid":false,"given":"Allen T.","family":"Matubu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Zimbabwe College of Health Science Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin A.","family":"Stoner","sequence":"additional","affiliation":[{"name":"Magee\u2010Womens Research Institute Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May A.","family":"Beamer","sequence":"additional","affiliation":[{"name":"Magee\u2010Womens Research Institute Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zvavahera M.","family":"Chirenje","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology University of Zimbabwe College of Health Science Harare Zimbabwe"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon L.","family":"Hillier","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Sciences and Center for Family Planning Research University of Pittsburgh School of Medicine Pittsburgh PA USA"},{"name":"Magee\u2010Womens Research Institute Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,6,25]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"United Nations. 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