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Background  Hormonal contraceptives, particularly depot medroxyprogesterone acetate (DMPA), have been reported to be associated with substantially enhanced HIV acquisition; however, the biological mechanisms of this risk remain poorly understood. We aimed to investigate the effects of different hormonal contraceptives on the expression of the HIV co-receptors, CXCR4 and CCR5, on female endocervical and peripheral blood T cells.    Methods  A total of 59 HIV-negative women were enrolled, including 15 initiating DMPA, 28 initiating a levonorgestrel-releasing intrauterine device (LNG-IUD) and 16 initiating an etonogestrel (ETG)-delivering vaginal ring. Peripheral blood and endocervical cytobrush specimens were collected at enrollment and 3–4 weeks after contraception initiation to analyze the expression of CXCR4 and CCR5, on CD4 +  and CD8 +  T cells using flow cytometry.    Results  Administration of DMPA increased the percentages of CD4 +  and CD8 +  T cells expressing CCR5 in the endocervix but not in the peripheral blood. Administration of the LNG-IUD or the ETG vaginal ring did not affect the percentages of T lymphocytes expressing CXCR4 or CCR5 in the female cervix or peripheral blood.    Conclusions  Increase in the percentage of endocervical T cells expressing CCR5 upon DMPA exposure provides a plausible biological explanation for the association between DMPA use and an elevated risk of HIV infection.    Electronic supplementary material  The online version of this article (10.1186/s12958-019-0469-8) contains supplementary material, which is available to authorized users.

Effects of three long-acting reversible contraceptive methods on HIV target cells in the human uterine cervix and peripheral blood