Magee-Womens Research Institute & Foundation

Research in Brief

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 address 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.