# Sexual trauma and HIV susceptibility among women: the role of stress and genital immunity

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN DIEGO · 2020 · $494,694

## Abstract

Project Summary
Extensive epidemiological data has documented an association between sexual violence and HIV acquisition
through direct and indirect pathways. However, the underlying biological mechanism to explain this association
is less understood. Sexual violence may contribute to HIV acquisition by disrupting the cervicovaginal
epithelium and magnifying local inflammation and immune activation. Sexual violence may also alter the
hypothalamic-pituitary-adrenal (HPA) axis resulting in changes to the innate and adaptive immune system in
the female genital tract (FGT) and alterations to cervicovaginal epithelial health. When compared to adult
women, adolescent girls may be at heightened biological risk due to differences in the genital mucosa such as
cervical ectopy and high baseline inflammation rendering girls more vulnerable to adverse effects of stress.
Our preliminary data indicate both recent and chronic cases of sexual violence cause dysregulation of critical
FGT immune mediators that have the potential to affect HIV susceptibility. Establishing a better understanding
of the correlation between immunity in the FGT and the dysregulated HPA axis, as well as the differences
between adolescent girls and adult women is critical for the development of strategies to counter the adverse
effects of sexual trauma resulting from mucosal injury in efforts to reduce the risk of HIV acquisition. To that
end, we will: 1) assess the impact of sexual trauma on FGT immunity; 2) assess the impact of sexual trauma
on the central and peripheral HPA axis; 3) determine the extent to which the dysregulated HPA axis affects
FGT immunity following sexual trauma; and 4) examine whether risk factors linked to sexual violence (i.e.,
sexual risk behaviors, substance use, mental health) are associated with HPA axis dysregulation and FGT
immunity in adolescent girls and adult women post-sexual trauma. We will further determine how these
associations change over time following the traumatic event. Our multi-disciplinary team will conduct a case-
control study with follow-up among adolescent girls aged 14-19 n=30; 15 cases and 15 controls) and adult
women aged 20 and older (n=30; 15 cases and 15 controls). All participants will complete a quantitative survey
and clinical assessment at baseline, 1- and 3-month follow-up visits. The proposed research will advance the
FY2016 Trans-NIH Plan for HIV-related Research by “examining the relationship of the female genital tract
immune function, including genital injury due to sexual violence, to HIV risk” and is highly responsive to RFA-
AI-15-058 by “conducting research that addresses the gaps in our understanding of how reproductive
maturation impacts HIV susceptibility.” Findings from this research will facilitate future hypothesis-driven
longitudinal research and development of safe and efficacious biomedical prevention strategies.

## Key facts

- **NIH application ID:** 9933798
- **Project number:** 5R01AI128803-04
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN DIEGO
- **Principal Investigator:** Mimi Ghosh
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $494,694
- **Award type:** 5
- **Project period:** 2017-06-20 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9933798

## Citation

> US National Institutes of Health, RePORTER application 9933798, Sexual trauma and HIV susceptibility among women: the role of stress and genital immunity (5R01AI128803-04). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/9933798. Licensed CC0.

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