Effects of three long-acting reversible contraceptive methods on HIV target cells in the human uterine cervix and peripheral blood

Liping Li*, Jie Zhou, Weijia Wang, Lina Huang, Jiaoqin Tu, Lyndsey Baiamonte, Moselle Stark, Mistie Mills, Thomas J. Hope, Erma Z. Drobnis, Alison J. Quayle, Danny J. Schust

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Background: Hormonal contraceptives, particularly depot medroxyprogesterone acetate (DMPA), have been reported to be associated with substantially enhanced HIV acquisition; however, the biological mechanisms of this risk remain poorly understood. We aimed to investigate the effects of different hormonal contraceptives on the expression of the HIV co-receptors, CXCR4 and CCR5, on female endocervical and peripheral blood T cells. Methods: A total of 59 HIV-negative women were enrolled, including 15 initiating DMPA, 28 initiating a levonorgestrel-releasing intrauterine device (LNG-IUD) and 16 initiating an etonogestrel (ETG)-delivering vaginal ring. Peripheral blood and endocervical cytobrush specimens were collected at enrollment and 3-4 weeks after contraception initiation to analyze the expression of CXCR4 and CCR5, on CD4 + and CD8 + T cells using flow cytometry. Results: Administration of DMPA increased the percentages of CD4 + and CD8 + T cells expressing CCR5 in the endocervix but not in the peripheral blood. Administration of the LNG-IUD or the ETG vaginal ring did not affect the percentages of T lymphocytes expressing CXCR4 or CCR5 in the female cervix or peripheral blood. Conclusions: Increase in the percentage of endocervical T cells expressing CCR5 upon DMPA exposure provides a plausible biological explanation for the association between DMPA use and an elevated risk of HIV infection.

Original languageEnglish (US)
Article number26
JournalReproductive Biology and Endocrinology
Issue number1
StatePublished - Feb 22 2019


  • CCR5
  • CXCR4
  • Depot medroxyprogesterone acetate (DMPA)
  • HIV
  • Hormonal contraception

ASJC Scopus subject areas

  • Endocrinology
  • Obstetrics and Gynecology
  • Reproductive Medicine
  • Developmental Biology


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