Blood and Cervical Immune Biomarkers Associated With HIV Susceptibility Are Compromised Rapidly After Sexual Trauma.

PROBLEM: Sexual violence compromises women's health and increases susceptibility to pathogens. Yet immunobiological consequences of acute sexual trauma remain incompletely understood.

METHODS

We conducted a cross-sectional study among women without HIV, comparing women exposed to forced vaginal penetration in the past 4 days (Acute Cases, n = 10), within the past 12 weeks (Cases, n = 10) and never exposed (Controls, n = 12). Sixteen immune biomarkers were measured by ELISA in plasma and cervical swabs. Blood CD4 and CD8 T cells were quantified by flow cytometry. Group differences were analyzed using Kruskal-Wallis tests followed by Dunn's test and Bonferroni correction for continuous variables and Fisher's exact test followed by pairwise Fisher's tests with Bonferroni correction for categorical variables.

RESULTS

Participants were predominantly Black (66%), publicly insured (59%) and less than 30 years of age (29%). Black women were more likely to be Acute Cases and Cases (p = 0.02). Cervical fluid from Acute Cases showed significantly elevated inflammatory cytokines, TNF-α (p = 0.02), IL-1α (p < 0.001) and IL-6 (p = 0.001); chemokines, IL-8 (p < 0.05) and MIP-3α (p < 0.001); and antimicrobials, serpinA1 (p < 0.001), SLPI (p = 0.035) and elafin (p = 0.001). Plasma biomarkers differed significantly for inflammatory cytokine IL-1α (p = 0.001), acute phase protein CRP (p = 0.03), chemokine MCP-1 (p = 0.043), antimicrobials SLPI (p = 0.001) and HBD-2 (p = 0.03) as well as MMP-1 (p = 0.004) and 9 (p = 0.006). CD4 and CD8 T cell proportions in blood were not significantly different between groups.

CONCLUSIONS

Sexual violence exposure is associated with rapid systemic and mucosal immune dysregulation that may increase susceptibility to HIV and other sexually transmitted infections.