Immune activation during pregnancy and contraception in HIV-infected Kenyan women

HIV-1 infected pregnant women and contraception users may have increased HIV-1 genital shedding and disease progression, but the mechanism behind these changes is poorly understood. Systemic T-cell immune activation has been linked to shedding and progression. We propose to measure systemic and local immune activation among pregnant women and contraceptive users, with a goal of understanding immunologic function in pregnancy and the postpartum period among HIV-1-infected women in Africa, to clarify mechanisms by which pregnancy and hormonal contraception may impact genital and breast milk HIV-1 shedding and disease progression, and to optimize recommendations for promoting appropriate family planning among these women.