Grant: Project Grant

To prevent the risk of pregnancy, many women opt for a form of hormonal contraceptives (HC). However, little is known about how using HC impacts the immune response. Depot medroxyprogesterone acetate (DMPA) is an injectable contraception provided every three months. It is used by over 55 million females worldwide. In Sub-Saharan Africa, 38% of all females using hormonal contraception use this form of birth control. However, its use has been associated with a potential increased risk for HIV infection. Female sex workers are at higher risk of HIV infection and also more likely to use birth control. It is, therefore, essential to understand the mechanisms by which this increased risk may happen to empower women in their choices and provide education about risk. In this study, we will follow female sex workers (FSWs) from Nairobi, Kenya, using DMPA for six months (two injection cycles) and determine the immune activation and inflammatory profile in the blood and at the female genital tract. We will also look at whether the use of DMPA impacts the capacity to respond to previously exposed viruses and affects the cells' capacity to respond to the stress hormone cortisol. Understanding the relationship between hormonal contraception and the immune response is essential to providing young women and FSWs with the best reproductive health care.