# Hormones, Immunity and HIV Risk

> **NIH NIH R01** · MAGEE-WOMEN'S RES INST AND FOUNDATION · 2020 · $434,251

## Abstract

ABSTRACT
Our over arching goal of this application is to determine if exogenous progestins used in long acting reversible
contraceptives (LARCs) will enhance adolescent risk for mucosal HIV acquisition. In the U.S., persons aged
13-24 years accounted for 26% of all new HIV infections. The HIV epidemic in adolescent girls reflects the
strong combined impact of gender and income inequality, early sexual debut, age disparate sexual
relationships, psychosexual maturation, sociocultural context, and heightened biological vulnerability.
Exogenous progestins, expecially medroxyprogesterone acetate (MPA), have been epidemiologically linked to
greater HIV acquisition. Gaps remain in our understanding of biological factors that might be associated with
increased risk of HIV acqusition in adolescent girls and how exogenous progestins will influence this risk.
LARCs use is encouraged for all women desiring to not become pregnant as they release progestins over 3 to
5 years. Typical LARCs include etonogestrel implants (ENG-I) or levonorgestrel-intrauterine system (LNG-
IUS). Our preliminary data shows cervical tissue collected from women using MPA and LNG-IUS for
contraception replicates HIV 2- to 3.5-fold higher than cervical tissue from non-contracepting women.
Therefore, our aims center on potential genital tract differences non-contracepting and contracepting (ENG-I
and LNG-IUS) 120 adolescents (18 to 19 years old) and correlate our findings to non-contracepting and
contracepting 90 adult women (≥25 years old). First, differences in the capcity of cerivcal tissue to replicate
HIV will be assess between the groups and associated with resident cell populations. Secondly, the vaginal
fluid and epithelium, which provide the first line of defense against pathogens, including HIV, will be
systematically studied. Vaginal fluid will be characterized for the microflora and the soluble mucosal proteins
using an unbiased proteomic approach. These results will be correlated to functional activity of the luminal fluid
as measured by in vitro anti-HIV activity. Our premise is that non-contracepting adolescent women will
demonstrate higher levels of mediators and activated immune cells that are associated with increased HIV
infection compared to more mature women. However, contracepting adolescent and adult women will have
comparable levels of the mediators, activated immune cells, and capacity of tissue to replicate HIV. A key
challenge will be the recruitment of adolescent girls. Our advantage is that adolescents frequent the outpatient
clinic at Magee Womens Hospital and our clinical team has worked with adolescents in other studies, which
overcomes many of the recruitment challenges. We have close working relationships among the groups
represented in this application and have optimized specimen handling/processing/testing which is key for
reproducibility in our work. This application will uniquely associate quantified analyses with functional outcomes
and begin to a...

## Key facts

- **NIH application ID:** 9859224
- **Project number:** 5R01HD092016-04
- **Recipient organization:** MAGEE-WOMEN'S RES INST AND FOUNDATION
- **Principal Investigator:** KATHERINE E BUNGE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $434,251
- **Award type:** 5
- **Project period:** 2017-05-01 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9859224

## Citation

> US National Institutes of Health, RePORTER application 9859224, Hormones, Immunity and HIV Risk (5R01HD092016-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9859224. Licensed CC0.

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