Prevalence and Correlates of HIV Type 1 Shedding in the Female Genital Tract

Heterosexual transmission is the predominant mode of transmission of HIV-1 in most of the world. Factors correlated with viral shedding from the female reproductive tract (and thus infectivity of women) are discussed in this review. Hormonal contraceptive use, cervical ectopy, pregnancy, abnormal cervical and vaginal discharge, and CD4 lymphocyte depletion have been associated with increased HIV-1 shedding in women; however, findings vary between studies. Prevalence and correlates of cervicovaginal HIV-1 shedding in larger published studies are discussed and potential mechanisms for observed associations are reviewed.