HIV, Sexual Violence and Special Populations: Adolescence and Pregnancy

HIV, Sexual Violence and Special Populations: Adolescence and Pregnancy

Abortion — A medical procedure that ends a pregnancy. I had intercourse with my partner on the Thursday, was inseminated at my fertility clinic Saturday morning, started feeling symptoms of my first herpes (genital) outbreak by Sunday, had blisters by Wednesday. In this paper, we tested the hypothesis that adolescent pregnancy (aged 15 or younger) increases the risk of incident HIV infection in young South African women. STD seroprevalence was higher in those with more than one sexual partner, those sexually active by age 15 (very high in those sexually active by age 12), those involved in prostitution and those attending the family planning clinic. Our results show that of the 109 outpatients enrolled, 30% were HSV1 and/or HSV2 positive, of whom 30% were infected with both HSV1 and HSV2, 18% were infected with HSV1 alone and 52% with HSV2 alone. This computer-generated list may be inaccurate or incomplete. Because lack of education and economic dependence on men are believed to put women at increased risk for HIV infection, many countries have implemented cash transfer programs in an attempt to reduce poverty and promote education.

CONCLUSION Pregnant women’s sex partners reported lifetime sexual contact with core risk groups, had an elevated prevalence of HSV-2, and demonstrated the potential to spread HIV and other STIs to their partners. A recent study investigating the effects of pooled seminal fluid on immortalized and primary cervical cells found that TGF-β induced expression of GM-CSF and IL-6 from both human Ect1 cervical epithelial cells and primary cervical cells.20 Similar responses were not observed following stimulation of cells with a selection of other cytokines found in seminal plasma. Psychosocial effects of pregnancy on the mother, father, marriage and family. The survey was based on only 838 females who participatedin the nationally representative 2003-04 National Health and Nutrition Examination Survey. Semen also impacts genital tract immune cell populations. When they are formed, adhesions are easily treated by a health care professional. No significant differences in density of T lymphocyte activation markers were identified between the two groups.21 In a more recent cross-sectional study of HIV uninfected women in Australia, biopsies were taken from the ectocervix 12 hr after unprotected vaginal coitus, after vaginal coitus with use of a condom or in the absence of coitus.

Adolescents having unprotected heterosexual intercourse are at risk of HIV infection and unwanted pregnancy. Only 21% were attending a family planning clinic for annual check-ups; 14% of these females were using contraception. The prevalence of HSV1/2 varied in the presence of other vaginal microorganisms but a statistical significant association was not found. These findings suggest a state of genital mucosal immune activation in the adolescents sampled, which could also represent an influx of activated HIV target cells in the genital tract and thus a greater risk of HIV acquisition. Among participants who had been enrolled in school at baseline, the weighted HIV prevalence at the 18-month follow-up was 1.2% in the intervention group and 3.0% in the control group; in a regression analysis that adjusted for background characteristics, young women who had received cash transfers had reduced odds of being HIV-infected (odds ratio, 0.4). observed that the concentrations of pro-inflammatory cytokines, lysozyme, lactoferrin and HNP 1–3 correlated with the ability of CVL to inhibit HSV plaque formation ex vivo.42,43,45 Consistent with the observation that the adolescents had higher levels of these immune mediators, adolescents also had greater anti-HSV activity relative to adults.34 Whether this finding translates to protection against HSV or is simply a biomarker of inflammation will require further studies. The in vivo protective effects of pro-inflammatory antimicrobial peptides remain unclear.

F., Nash, E. These complex findings highlight the delicate balance of mucosal immunity (). While adolescents displayed increased levels of inflammatory mediators and anti-HSV activity relative to adults, they exhibited lower CVL levels of secretory leucocyte protease inhibitor (SLPI), IgG and IgA.34 Lower concentrations of vaginal SLPI have been associated with increased risk of HIV acquisition,48 and diminished cervicovaginal IgA could contribute to the high prevalence and recurrence rate of chlamydia observed in adolescents.49–53 Adolescent subjects were also noted to have a significantly higher average vaginal pH relative to reproductively mature women (mean ± SD 4.8 ± 0.08 versus 4.5 ± 0.07, P = 0.005). Also known as a barrier method, it is used with spermicide. This observed shift towards BV-associated microbiota could represent a significant risk factor for HIV acquisition,54 possibly by increasing concentrations of activated endocervical CD4+ T cells.55 Thus, a net increased inflammatory state in the genital tract of sexually active adolescents may synergize with behavioural factors to increase HIV acquisition risk. The 2003 Demographic Health Survey reported that 27.3% of women had a pregnancy while they were adolescents [8]. However, the available data suggest significant mucosal immune alterations in the setting of pregnancy relative to non-pregnant women, which may provide a rationale for the observed risk of HIV acquisition.

HIV, Sexual Violence and Special Populations: Adolescence and Pregnancy
Vaginal swabs collected at a single time point from 70 pregnant women in the United States at 35–37 weeks gestation had significantly higher concentrations of IL-1α, IL-1β, IL-1 receptor antagonist (ra), IL-8 and RANTES45 relative to non-pregnant women. These higher chemokine and cytokine concentrations may reflect a heightened state of immune activation to prevent ascending infection to the foetus but may also promote an influx of activated HIV target cells. 30%). Of note, in this study, the in vitro ability of CVL to prevent HIV infection of TZM-bl cells was similar between pregnant and non-pregnant women, although it remains unclear if this activity translates to in vivo protection against HIV acquisition. However, as with the anti-HSV activity of genital tract secretions, the host and/or bacterial factors that contribute to E. (eds.),Current Practice in Obstetric and Gyneocologic Nursing C. The increased activity observed in pregnant women could reflect an increased net state of immune activation and thus, paradoxically, a greater risk of HIV acquisition.

Two studies conducted with samples from African women suggest that increased E. Condom — Typically refers to the latex or polyurethane sheath rolled over a male’s penis to prevent including semen and pre-cum from entering another’s body. In a small sub-study that took advantage of vaginal swabs collected during the HIV Prevention Trials Network 035 study, women who acquired HIV during the trial had significantly increased bactericidal E. Women clustered in the intervention condition were randomized to receive a 17-session (50-hour) group intervention over a period of 3–12 weeks. coli activity were observed in South African women who acquired HIV during the CAPRISA 002 Acute Infection Study (R. P. Madan, J.

Tugetman, L. Roberts, L. Werner, A. (1971). S. Abdool Karim, J. It’s illegal to give these drugs to someone.

Passmore, B. The Determine (Abbott Diagnostics, Johannesburg, South Africa) test was used for screening, and samples with positive results were retested with Uni-Gold (Trinity Biotech, Dublin, Ireland). Herold, manuscript in progress). The high prevalence of BV in these cohorts suggests that mediators other than those produced by lactobacilli contributed to this activity. Thus, whether this activity serves as a biomarker of vaginal health and intact host defence or as a biomarker of inflammation and increased HIV risk (reflecting recruitment and/or activation of immune target cells) may depend on the population being studied. Larger, prospective studies are needed in diverse populations, including victims of sexual violence, to define the host and bacterial mediators of bactericidal E. coli activity in genital tract secretions and to elucidate the association between this activity, vaginal health and HIV acquisition risk.

The risk of HIV acquisition depends upon multiple, dynamic viral and host variables, which may be adversely impacted by sexual violence. Larger prospective studies that focus on the epithelial barrier, immune cell populations, concentrations of inflammatory and protective immune mediators, genital tract microbiota and the antimicrobial activity of genital tract secretions should promote the identification of factors that facilitate or prevent HIV infection. These studies are critical to informing the development of safe and effective oral and vaginal forms of HIV pre-exposure prophylaxis (PrEP) for adolescent and pregnant women, who are typically excluded from PrEP clinical trials. Defining the biological mechanisms that place specific populations at increased risk of HIV acquisition, including those that are more likely to be victims of sexual violence, such as adolescent and pregnant women, will accelerate the identification of novel prevention strategies. To find a clinic to get a prescription near you, click here or call the Emergency Contraception Hotline at 1-888-NOT-2-LATE (668-2528). Lingappa JT, Hughes K, Baeten J, Fife K, De Bruyn G, Farquhar C, Kapiga S, Makhema J, Celum C. Three categories were created: early adolescent pregnancy, which included young women who experienced a first pregnancy at age 15 years or younger; later adolescent pregnancy, which included those who experienced their first pregnancy at age 16 to 19 years; and the referent group consisted of women who did not report an adolescent pregnancy.

18th Conference on Retroviruses and Opportunistic Infections; Boston, MA, USA. 2011.

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