Long-term effect of depot medroxyprogesterone acetate on vaginal microbiota, epithelial thickness and HIV target cells.

Publication Type:

Journal Article


The Journal of infectious diseases (2014)


2014, April 2014, Center-Authored Paper, Experimental Histopathology Core Facility, Scientific Imaging Core Facility, Vaccine and Infectious Disease Division


Background. Depot medroxyprogesterone acetate (DMPA) has been linked to HIV-1 acquisition.Methods. Vaginal microbiota of women using DMPA for up to two years were cultured; mucosal immune cell populations measured by immunohistological staining.Results. Over 12 months, the proportion with H2O2-positive lactobacilli decreased (n=32; 53 vs. 27%; p=0.03). Median vaginal CD3(+) cells also decreased (n=15; 355 vs. 237cells/mm(2); p=0.03), as did CD3(+)CCR5(+)(195 vs. 128cells/mm(2); p=0.04), HLA-DR(+) (130 vs. 96cells/mm(2); p=0.27), and HLA-DR(+)CCR5(+) cells (18 vs. 10cells/mm(2); p=0.33).Conclusion. DMPA contraception does not increase vaginal mucosal CCR5(+) HIV-1 target cells, but does decrease CD3(+) T lymphocytes and vaginal H2O2-producing lactobacilli.