DMPA use and vaginal bacterial diversity among African women

Depot-medroxyprogesterone acetate (DMPA), a contraceptive, has been associated with increased female acquisition of HIV through unknown mechanisms. We will investigate vaginal microbial diversity and species-specific concentrations of vaginal anaerobes and Lactobacilli, using a tightly-controlled pre-post DMPA study design, to determination vaginal microbiota changes attributable to DMPA use and to correlated these changes with markers of vaginal inflammation. We will also correlate these changes with specific DMPA levels, hypothesizing that inflammatory changes may be linked to peak DMPA levels.