Modulation of Mucosal and Systemic Immunity by Hormonal Contraceptives

Feminization of the HIV pandemic is impetus for better understanding of the risk factors
promoting male to female sexual transmission. One putative risk factor is hormonal
contraceptive use. Our laboratory recently reported that dendritic cell activation,
virus-specific T cell expansion, and memory T cell development were impaired among female
mice administered depot-medroxyprogesterone acetate (DMPA) prior to viral infection of
mucosal tissue, and we now are enrolling women into a clinical investigation exploring the
immunomodulatory effects of several common hormonal contraceptive forms. Completion of this
research will provide important comparative evaluation of the capacity of these drugs to
modulate host defenses combating genital tract infection, eventually supplying healthcare
providers more informed recommendations regarding appropriate hormonal contraceptive choices
among women at risk for acquisition of HIV.

Inclusion Criteria:

- not pregnant

- regular menstrual cycle

Exclusion Criteria:

- use of oral contraceptive or Mirena in 3 months prior to enrollment

- use of depot-medroxyprogesterone acetate in 6 months prior to enrollment

- diagnosis of sexually transmitted infection in 30 days prior to enrollment

- history of cervical malignancy