HIV and mucosal barrier interactions: consequences for transmission and pathogenesis

•Mucosal barrier dysfunction is a key component of HIV transmission and pathogenesis.•Inflammation results in mucosal damage, target cell accumulation, and altered immunity, driving increased HIV susceptibility and pathogenesis.•Altered microbiome in the reproductive tract is associated with increased HIV susceptibility.•Altered microbiome in gastrointestinal tract of HIV-infected individuals is associated with increased inflammation and HIV pathogenesis.