HIV, sexual violence and special populations: adolescence and pregnancy.

The risk of male to female transmission of HIV is impacted by baseline inflammation in the female genital tract, semen viral load and seminal plasma's ability to induce specific patterns of cervical cytokine signalling and influx of immune cell populations. Disruption of the epithelial barrier during non-consensual intercourse may trigger further inflammation and initiation of cell-signalling pathways, thus facilitating transmission of HIV and expansion of local infection. Adolescent and pregnant women are at high risk for sexual violence and may exhibit alterations of genital mucosal immunity that promote immune activation, making them uniquely vulnerable to HIV acquisition.