The Impact of Sexual Violence on the Systemic and Female Genital Tract

Mimi Ghosh, PhD, MS

September 19, 2013

The epidemics of violence and HIV overlap intricately. Sexual violence (SV) or the fear of violence may interfere with a woman's ability to negotiate safer sex or refuse unwanted sex. There is an increased risk of HIV infection associated with SV, possibly due to abrasions and lacerations that occur during coercive sex. However, the relationship between SV and immune response has not been well characterized. A deeper understanding of these relationships may help inform development of interventions to reduce HIV transmisison.

A major gap in our knowledge exists in understanding the immunological alterations following SV. We hypothesize that women who experience SV will develop a localized and systemic pro-inflammatory immune response characterized by changes in cellular and soluble biomarkers in blood and genital tract secretions. These changes in host immunity can result in increased risk of HIV acquisition.

The proposed pilot study will compare HIV-negative women who have experienced SV in the past 4 weeks to age matched control women without SV history, all from the Washington DC area where prevalence of both HIV and SV are elevated. Specifically, blood and genital tract secretions from both groups will be examined for selected pro-inflammatory and anti-inflammatory soluble markers in addition to cellular markers of activation. The impact of these changes in genital tract secretions will be further examined through in-vitro assays of HIV-infection on cells obtained from a community based sample of women without SV infection.

This proposal addresses a priority area of emphasis for NIH and focuses on a research area that is critical yet grossly understudied. Outcomes from this study may be important for developing specific prevention intervention strategies for this vulnerable group.