Impact of menopause and sexual trauma on HIV acquisition in women

项目摘要/摘要： 异性传播现在是新的艾滋病毒感染的主要来源和感染人数 在女性中的比例正在上升。对绝经后妇女的危险因素缺乏了解可能会增加 她们对艾滋病毒的易感性正成为一个主要问题，因为许多女性在 更年期。 虽然众所周知，衰老会导致性激素的丧失和某些免疫功能的降低， 在我们对女性先天免疫功能丧失的理解上仍有很大差距。 绝经后的生殖道，特别是在艾滋病毒感染和传播的背景下。 另一个可能加剧老年妇女艾滋病毒易感性的关键辅助因素是性创伤，这 被严重低估了。绝经后妇女更容易发生阴道损伤和感染 由于阴道粘膜变薄和干燥以及伤口愈合过程较慢而导致的性暴力。 我们在这项提议中的目标是检验这样一种假设，即更年期性激素的损失，妥协 女性生殖道的免疫保护。我们将在以下背景下评估免疫保护的丧失 病原体的识别和反应、性激素的调节以及粘膜损伤的影响 是性暴力造成的。我们假设，所有这些参数都将影响艾滋病毒在老龄化中的易感性。 女人。 这项研究将为我们提供绝经后女性对性的易感性的独特观点 传播艾滋病毒，并检查性暴力引起的粘膜损伤后的免疫变化。 这是有意义的，因为我们的发现可以用来促进预防/干预的发展 专门为提高老年妇女生殖道免疫力而设计的战略。

Project Summary/Abstract: Heterosexual transmission is now the predominant source of new HIV infections and the number of infections in women is on the rise. Lack of knowledge about risk factors in postmenopausal women that can increase their susceptibility to HIV is becoming a major issue as many women continue to be sexually active beyond menopause. Although it is known that aging results in loss of sex hormones and reduction of certain immune functions, there remains a major gap in our understanding regarding the loss of innate immune functions in the female reproductive tract following menopause, particularly in the context of HIV acquisition and transmission. An additional critical co-factor that might exacerbate HIV susceptibility in older women is sexual trauma, which is severely under-reported. Postmenopausal women are more prone to vaginal injury and infections following sexual violence due to the thinning and dryness of vaginal mucosa and slower wound healing processes. Our goal in this proposal is to test the hypothesis that the loss of sex hormones at menopause, compromise immune protection in the female reproductive tract. We will evaluate loss of immune protection in the context of pathogen recognition and response, regulation by sex hormones, as well as the influence of mucosal injury resulting from sexual violence. We hypothesize that all these parameters will impact HIV susceptibility in aging women. This study will provide us with a unique outlook on susceptibility of postmenopausal women to sexually transmitted HIV and examine immune alterations following mucosal injuries resulting from sexual violence. This is significant because our findings can be used to promote the development of prevention/intervention strategies specifically designed to boost genital tract immunity in older women.