Pilot Awards Recipient: Mimi Ghosh, PhD, MS

Cervical Immaturity and HIV Susceptibility Among Female Adolescents
January 01, 2014

HIV is the leading cause of death of women of reproductive age (UNAIDS factsheet 2012). Globally, young women aged 15-24, are most vulnerable to HIV with infection rates twice as high as in young men, and accounting for 22% of all new HIV infections (UN AIDS fact sheet 2012). Whereas issues of gender inequality and violence against women and girls are key drivers of the epidemic, critical yet ill- defined biological parameters play a major role in enhancing susceptibility in girls.

A major gap in our knowledge exists in understanding the immune alterations in the FRT in adolescents during puberty. What is known, however, is that the adolescent cervix is immature and typically characterized by ectopy, which can increase susceptibility to infections by HIV and other STI (Hwang 2011, Madan 2012). Several epidemiological studies have linked ectopy to increased risk of acquiring HIV in sexually active women (Moss 1991, Myer 2006, Tanton 2011). However, almost no information is available regarding the genital tract milieu in young girls, especially those who are sexually inactive.

Here we propose a pilot study to examine the feasibility of studying associations between cervical ectopy and immune biomarkers in the genital tract in both sexually active and sexually inactive adolescent girls from the Washington DC area. Our overall hypothesis is that during adolescence innate immune protection is compromised in a way that leads to increased risk of HIV acquisition. We also hypothesize that the immune microenvironment of the genital tract will be altered in sexually active girls compared to sexually inactive girls.

This proposal covers a priority area of emphasis for NIH for FY2013 and focuses on a research area that has been grossly under-studied. The outcomes can be significant as conclusions from this study can be used to develop prevention/ intervention strategies specifically designed for young women and girls.