Sharon L. Achilles, MD, PhD

Assistant Professor, Department of Obstetrics, Gynecology & Reproductive Sciences Director, University of Pittsburgh Center for Family Planning Research

Research

Description

Use of hormonal contraception is common among sexually active women, including those at the highest risk of sexual acquisition of HIV. Use of certain types of hormonal contraceptives, particularly depot medroxyprogesterone acetate (DMPA) has been associated with an increased risk of HIV acquisition in several observational studies. Our research primarily focuses on understanding the biological and immunological changes that occur in the reproductive tract of women when various forms of contraception are initiated. Characterizing changes in microflora and HIV target lymphocytes within the female genital tract is critical to our understanding of HIV acquisition risk and will inform the design of future clinical trials assessing HIV and contraceptive use risk. Optimally, HIV prevention strategies should be linked to contraception for maximal public health benefit. Understanding the impact of contraceptives and microbicides (current and future) on genital tract lymphocytes is fundamental to the goal of developing safe and effective methods to prevent HIV and unwanted pregnancy. There are limited data exploring how hormonal contraceptive methods impact the distribution and numbers of HIV-susceptible immune cells in the upper and lower genital tract. Our ongoing research studies are aimed to addresses this significant knowledge gap that lies at the intersection between HIV prevention and family planning.

Dr Achilles has longstanding research and clinical interests in contraception, microbicides and prevention of reproductive infectious disease. Her work will fill identified gaps in understanding hormonal concentrations in the genital tract with typical use of FDA-approved highly effective contraceptives. These gaps have been evident in discussions surrounding local dose goals for the eventual development of multipurpose prevention technologies that can prevent both HIV and unplanned pregnancy.

 

Research Support

Project Title: Quantification of Immune Cells in Women Using Contraception

Funding: NIH/NIAID (R01 AI102835)

 

Project Title: HIV-Target Cell Response in Women Initiating Contraception in High HIV-Incidence Areas

Funding: Bill & Melinda Gates Foundation

Clinical Protocol

 

Project Title: IFN-epsilon and hormonal contraceptive modulation of the risk of HIV acquisition

Funding: Bill & Melinda Gates Foundation

 

Project Title: Phase 1 Assessment of TMC-278 LA

Funding: Bill & Melinda Gates Foundation (Co-Investigator)

 

Selected Publications

  • Achilles, Sharon L, Hillier, Sharon L. The Complexity of Contraceptives: Understanding their Impact on Genital Immune Cells and Vaginal Microbiota. AIDS Volume 27, Supplement 1, October 2013: S5-S15. doi: 10.1097/QAD.0000000000000058. PMID: 24088684. PMCID: PMC4012023.
  • Achilles SL, Creinin MD, Stoner KA, Chen BA, Meyn L, Hillier SL. Changes in genital tract immune cell populations after initiation of intrauterine contraception. Am J Obstet Gynecol (2014) 211(5):489-491. 2014 May 13. Epub ahead of print. doi: 10.1016/j.ajog.2014.05.016. PMID: 24834865. PMCID: PMC4231025.
  • Achilles Sharon L., Chen Beatrice A., Lee Jessica K., GariepyAileen M., Creinin Mitchell D. Acceptability of randomization to levonorgestrel versus copper intrauterine device among women requesting IUD insertion for contraception. Contraception (2015) Dec;92(6):572-4. doi: 10.1016/j.contraception.2015.08.009. (Epub 2015 Aug 18). PMID: 26297203. PMCID: PMC4654647.
  • Tarleton J, Haddad L, Achilles SL. Hormonal contraceptive effects on the vaginal milieu: microbiota and immunity. Curr Obstet Gynecol Rep (2015) doi: 10.1007/s13669-016-0142-6. In Press.

For additional publications, see link to Pubmed: http://www.ncbi.nlm.nih.gov/pubmed/?term=Achilles+SL

 

Clinical trials

NCT01873170 (open to enrollment): Quantification of Immune Cells in Women Using Contraception (CHIC II)

LINKNCT02416154 (open to enrollment): Expression of IFN-epsilon in the Female Reproductive Tract

LINKNCT02038335 (enrollment completed, study in follow-up only phase): HIV-Target Cell Response in Women Initiating Various Contraceptive Methods in High HIV-Incidence Areas: Zim CHIC

LINKNCT01240811 (completed): Study of Immune Cell Changes in the Genital Tract 2 Months After Initiation of an IUD for Contraception

For further information about our ongoing studies, please contact the Center for Family Planning Research at 412-641-5496.