Hormonal Contraceptives Drive Genital Lipid Metabolism Reprogramming and Susceptibility to HIV Infection

The study examined how hormonal contraceptives affect lipid metabolism in the female genital tract and its relationship with HIV susceptibility. The research included a group of high-risk women from Kenya using injectable DMPA contraception, oral contraceptive pills, or no hormonal contraception. Using liquid chromatography and mass spectrometry, 1045 lipid species were identified. Injectable DMPA significantly reduced important membrane and signaling lipids, such as phospholipids, ceramides, and sphingomyelins, while increasing storage lipids and sterols. Oral contraceptive pills containing estrogen, conversely, lowered triglycerides in the genital area. The findings suggest that DMPA may increase HIV susceptibility by weakening the epithelial barrier and increasing chronic inflammation.