Female Genital Tract Secretions and Semen Impact the Development of Microbicides for the Prevention of HIV and Other Sexually Transmitted Infections

Betsy C. Herold, Pedro M. Mesquita, Rebecca P. Madan, Marla J. Keller

Research output: Contribution to journalReview articlepeer-review

36 Scopus citations

Abstract

Citation Herold BC, Mesquita PM, Madan RP, Keller MJ. Female genital tract secretions and semen impact the development of microbicides for the prevention of human immunodeficiency virus (HIV) and other sexually transmitted infections. Am J Reprod Immunol 2011; 65: 325-333 Pharmacologic strategies for the prevention of HIV include vaccines, post-exposure prophylaxis with antiretroviral therapy, and topical microbicides. Vaginal microbicides have the potential to augment innate defenses in the genital tract but may also disrupt endogenous protection and increase HIV acquisition risk, as observed in clinical trials of nonoxynol-9. The initially disappointing results of microbicide clinical trials stimulated the development of more sensitive and comprehensive pre-clinical safety studies, which include dual-chamber culture systems to model the epithelial barrier and post-coital studies to evaluate the effects of semen and sexual intercourse on microbicide efficacy. This review discusses the key factors that contribute to a healthy female genital tract environment, the impact of semen on mucosal defense, and how our understanding of these mediators informs the development of effective vaginal microbicides.

Original languageEnglish (US)
Pages (from-to)325-333
Number of pages9
JournalAmerican Journal of Reproductive Immunology
Volume65
Issue number3
DOIs
StatePublished - Mar 2011

Keywords

  • Defensins
  • HIV
  • Microbicides
  • Mucosal immunity
  • SLPI
  • Semen

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Reproductive Medicine
  • Obstetrics and Gynecology

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