About this Research Topic
Young women are disproportionally affected by HIV. In sub-Saharan Africa, adolescent girls and young women accounted for 25% of all new HIV infections in 2019. Several behavioral and biological characteristics are known to impact a young woman’s vulnerability for acquiring HIV. One key, but lesser understood, biological factor impacting vulnerability is the composition of the vaginal microbiome. Although the composition of each woman’s vaginal microbiome is unique, a microbiome dominated by one or two species of Lactobacillus is generally associated with vaginal health. Disturbances in the vaginal microbiota, characterized by a shift from a low-diversity, Lactobacillus-dominant state to a high-diversity non- Lactobacillus-dominant state, have been shown to be associated with a range of adverse reproductive health outcomes, including increasing the risk of genital inflammation and HIV acquisition.
In addition to the impact on HIV risk, the composition of the vaginal microbiome affects the efficacy of some antiretroviral drugs that are used as pre-exposure prophylaxis (PrEP) for HIV prevention. PrEP for HIV prevention is being rapidly scaled up throughout Africa as one of the prevention options for women. However, there is paucity of data on the effects of PrEP on the vaginal microbiome. A better understanding of how PrEP and other antiretrovirals impact or alter the vaginal microbiota of women may help us to better understand the association between the vaginal microbiota and bacterial vaginosis as well as HIV acquisition, prevention, and treatment.
This Research Topic will welcome Original Research, Reviews, and Opinion pieces that highlight experiences from research and programs that have evaluated the vaginal microbiome of women using antiretrovirals as PrEP or as treatment. Areas of interest include women using antiretroviral therapy (ART) or PrEP during pregnancy, HIV-infected women taking antiretrovirals with good control of viral load versus those not on ART, and examining the effects between oral and vaginal PrEP.
The aim of this Topic is to advance our understanding of the impact of antiretrovirals on the vaginal microbiome in women, and to better characterize the vaginal microbiome of HIV-infected and HIV-uninfected women on antiretrovirals.
Keywords: HIV, PrEP, Vaginal microbiome, dysbiosis, bacterial vaginosis
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