Evaluation of Health Disparity in Bacterial Vaginosis and the Implications for <scp>HIV</scp>‐1 Acquisition in African American Women

Alcendor, Donald J.

doi:10.1111/aji.12497

Cited by 36 publications

(36 citation statements)

References 72 publications

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“…Self identified African American women were diagnosed with BV more frequently (Fisher’s exact test p=0.00112; odds ratio=3.48), consistent with previous literature [29] . African American women were also more likely to be HIV+ (Fisher’s exact test p=0.00014; odds ratio=3.77).…”

Section: Resultssupporting

confidence: 89%

“…BV has been associated with de novo HIV infection in previous work [29] —in contrast, most of the women studied here had been HIV positive for many years, but still a positive association between HIV and BV was detectable. Various models may explain this observation.…”

Section: Discussioncontrasting

confidence: 50%

“…When the test was conducted using only the first time point, so that each woman contributed only one measurement, results were still significant (Fisher’s exact test p=0.046). Following previous literature on BV and health disparities [29] , we investigated associations of HIV, BV and race. We found that when all data points were analyzed as a pool, HIV and BV were positively associated within both self-identified African Americans (Fisher’s exact test p=0.0087) and other racial groups (Fisher’s exact test p=0.009) independently.…”

Section: Resultsmentioning

confidence: 99%

“…Still another possibility is that high frequencies of BV are markers for socio-economic, genetic, or other factors that are positively associated with HIV infection as well without being directly causal. At present it seems simplest to invoke the first model, since inflammation associated with BV may result in recruitment of HIV infection target cells to the mucosa, and so provides a simple explanation for the data [29] . If correct, this emphasizes that interventions designed to reprogram the persistent frequent BV state may help prevent HIV transmission.…”

Section: Discussionmentioning

confidence: 99%

“…In a study of at-risk women in Kenya, BV and HSV2 infection were the two strongest risk factors measured for HIV acquisition over a 20-year period [28] . BV is known to be more common in African American women, motivating studies of associations with HIV infection [29] . In contrast, a study of the vaginal microbiome in 64 women in Chicago showed no differences associated with HIV infection [30] .…”

Section: Introductionmentioning

confidence: 99%

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Associations of the vaginal microbiota with HIV infection, bacterial vaginosis, and demographic factors

Chehoud

Stieh

Bailey

et al. 2017

Aids

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Objective We sought to investigate the effects of HIV infection on the vaginal microbiota, and associations with treatment and demographic factors. We thus compared vaginal microbiome samples from HIV+ and HIV− women collected at two Chicago area hospitals. Design We studied vaginal microbiome samples from 178 women analyzed longitudinally (n=324 samples), and collected extensive data on clinical status and demographic factors. Methods We used 16S rRNA gene sequencing to characterize the bacterial lineages present, then UniFrac, Shannon Diversity and other measures to compare community structure to sample metadata. Results Differences in microbiota measures were modest in the comparison of HIV+ and HIV− samples, in contrast to several previous studies, consistent with effective antiretroviral therapy. Proportions of healthy Lactobacillus species were not higher in HIV-negative subjects overall, but were significantly higher when analyzed within each hospital in isolation. Rates of bacterial vaginosis (BV) were higher among African American women and HIV+ women. BV was associated with higher frequency of HIV+. Unexpectedly, African-American women were more likely to switch BV status between sampling times; switching was not associated with HIV+ status. Conclusions The influence of HIV infection on the vaginal microbiome was modest for this cohort of well-suppressed urban American women, consistent with effective anti-retroviral therapy. HIV+ was found to be associated with BV. Although BV has previously been associated with HIV transmission, most of the women studied here became HIV+ many years before our test for BV, thus implicating additional mechanisms linking HIV infection and BV.

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Section: Resultssupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 50%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Associations of the vaginal microbiota with HIV infection, bacterial vaginosis, and demographic factors

Chehoud

Stieh

Bailey

et al. 2017

Aids

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The vaginal microbiome in women of reproductive age with healthy weight versus overweight/obesity

Allen

Edupuganti

Edwards

et al. 2021

Obesity

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Objective The aim of this study was to evaluate the differences between the vaginal microbiome of reproductive‐aged women with overweight and obesity (Ow/Ob) compared with healthy weight (HW). Methods In this case‐control study, a cohort of 367 nonpregnant women (18 to 40 years) with Ow/Ob (BMI ≥25 kg/m2) was case‐matched with 367 women with HW (BMI 18.0 to 24.9 kg/m2). The study was a secondary analysis of 16S rRNA vaginal microbiome surveys through the Vaginal Human Microbiome Study (VaHMP). Groups were matched on age, race/ethnicity, income, and nulliparity status. Results Mean age and BMI of Ow/Ob and HW groups were 26.8 versus 26.7 years and 37.0 versus 22.1 kg/m2, respectively. The overall vaginal microbiome composition differed between groups (PERMANOVA, p = 0.035). Women with Ow/Ob had higher alpha diversity compared with women with HW (Wilcoxon test, Shannon index p = 0.025; inverse Simpson index p = 0.026). Lactobacillus dominance (≥30% proportional abundance) was observed in a greater proportion of women with HW (48.7%) compared with Ow/Ob (40.1%; p = 0.026). Conclusions The vaginal microbiome differs in reproductive‐aged women with Ow/Ob compared with women with HW, with increased alpha diversity and decreased predominance of Lactobacillus. Observed differences in the vaginal microbiome may partially explain differences in preterm birth and bacterial vaginosis risk between these populations.

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Women of Color and HIV

Flash

Johnson

Stone

2020

HIV in US Communities of Color

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Evaluation of Health Disparity in Bacterial Vaginosis and the Implications for HIV‐1 Acquisition in African American Women

Cited by 36 publications

References 72 publications

Associations of the vaginal microbiota with HIV infection, bacterial vaginosis, and demographic factors

Associations of the vaginal microbiota with HIV infection, bacterial vaginosis, and demographic factors

The vaginal microbiome in women of reproductive age with healthy weight versus overweight/obesity

Women of Color and HIV

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