Fighting HIV, a virus responsible for 35 million deaths globally to this day, is a major medical challenge. With sexual transmission accounting for 80% of infections, researchers are investigating how the virus is taken up in our most intimate tissues. In women, evidence suggests that levels of hormones such as progesterone, varying naturally throughout the menstrual cycle or manipulated by contraceptives, affect the likelihood of infection with HIV-1. Why this happens is still unclear, though testing the effects of contraceptives on other primates has recently revealed tantalising clues. Increased hormone levels lead to reduced barriers of mucus and epithelial cells inside the reproductive tracts of female macaques, allowing virus particles to move more freely; they also cause an increase in target cells available for the virus, such as CD4+ T cells, shown in pink. Similar mechanisms could be at work in women, hinting at new targets for therapies limiting HIV infection.
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