The Female Reproductive Tract Microbiome in Healthy Women and Women Living with HIV

Greater than 90% of HIV transmission worldwide occurs following heterosexual intercourse, where women are twice as likely to contract HIV as men. The female reproductive tract (FRT) microbiota, including bacterial and viral components, plays a pivotal protective role in maintaining women’s health, and is pivotal in preventing pre-term birth, bacterial vaginosis (BV), yeast infections, and sexually transmitted diseases including HIV. Alterations in the FRT bacteriome are associated with increased inflammation and increased risk of acquisition and spread of sexually transmitted infections (STIs) including HIV. The vaginal bacteriome is highly dynamic, and bacterial populations rapidly change between healthy and disease states. While the underlying etiology for these fluctuations is unknown, one hypothesis is that bacteriophages may alter the abundance of bacterial taxa. Further, viral infections in the FRT have been associated with alterations in the FRT bacteriome.  In collaboration with Dr. David Adler and the Women’s Interagency HIV study, we are investigating how alterations in the FRT microbiome/virome in HIV positive and HIV negative women contribute to local and systemic inflammation and persistence of HPV strains. We will integrate these data to develop a model of host-microbe interactions in the FRT. Understanding of the basic composition of the FRT microbiome in relation to HIV infection may lead to the development of novel preventative strategies targeting the FRT mucosa.