Comparing the Vaginal Bacteria of Sex Workers with NonSex Workers in - PowerPoint PPT Presentation

Comparing the Vaginal Bacteria of Sex Workers with Non‐Sex Workers in Nairobi, Kenya Jocelyn M. Wessels 1 , Julie Lajoie 2 , Ken Omollo 3 , Keith R. Fowke 2,3 , Joshua Kimani 2,3,4 , Julius Oyugi 3 , Juliana Cheruiyot 4 , Mike G. Surette 1 , and Charu Kaushic 1 1 McMaster University, Hamilton, Ontario, Canada; 2 University of Manitoba, Winnipeg, Manitoba, Canada; 3 University of Nairobi, Nairobi, Kenya; 4 Kenyan AIDS Control Program, Nairobi, Kenya OHTN, Toronto Ontario Monday 24 th October, 2016

Presenter Disclosure • Presenter: Jocelyn Wessels • Relationships with commercial interests: • No Conflicts of Interest to Declare

The Vaginal Microbiome  Vaginal cells lined with bacteria  “Healthy” vaginal microbiome thought to be dominated by Lactobacillus species and low pH (~4.0)  “Unhealthy” vaginal microbiome has a greater diversity of bacteria  Bacterial Vaginosis linked to adverse reproductive outcomes, and Sexually Transmitted Infections Modified from: Burgener et al., 2015

The Vaginal Microbiome  A greater variety of bacterial species in the Vaginal Microbiome is associated with negative reproductive outcomes (HIV, STIs, PID, preterm birth) % of Women in Cluster Species Diversity Modified from: Borgdorff et al., 2014

The Vaginal Microbiome African American Women Women of European Ancestry Modified from: Fettweis et al., 2014

The “Health” of the Vaginal Microbiome May Depend on Ethnicity From: Ravel et al., 2011 polymicrobial

The Vaginal Microbiome From: Burgener et al., 2015

Research Questions  Does sex work change the vaginal bacteria? Aim  Profile (species abundance and identity) the vaginal microbiome of Sex Workers and Non‐Sex Workers from the same community Hypothesis  The vaginal microbiome of Sex Workers will have a greater variety of bacteria than Non‐Sex Workers fredhutch.org

Study Framework and Design  Retrospective Clinical Study  In Collaboration with Universities of Manitoba and Nairobi  Nairobi, Kenya (Pumwani Clinics)  Sex Worker Cohort  Non‐Sex Workers  Banked Cervico‐vaginal Lavage  Sex Workers N=62  New Sex Workers N=48  HESN N=10  HIV+ N=4  Non‐Sex Workers N= 15

New Sex Workers less likely to have Lactobacillus as the most abundant genus in the vaginal microbiome

Sex Workers have greater bacterial diversity in the vagina compared with Non‐Sex Workers from the same Community 400 * * * * * 300 * 200 100 0 Sex Workers Non-Sex Workers  New Sex Workers (<3 years) account for the majority of the diversity in the vaginal microbiome

The vaginal microbiomes cluster based on the dominance of Lactobacillus in the vaginal microbiome  Community State Type (CST) II ( L. gasseri ) and V ( L. jensenii ) were not observed in this cohort

Conclusions  Bacterial diversity is greatest in the vaginal microbiome of New Sex Workers  Sex Workers are less likely to have Lactobacillus as the most abundant genus as compared to women from the same community who are not engaged in sex work  Sex work is associated with alterations in the Vaginal Microbiome Significance ↑ Inflammation ↑ Susceptibility ↑ Species ↑ Dysbiosis & Barrier to HIV Diversity Breakdown

Acknowledgements U. of Manitoba/ U. of Nairobi Keith Fowke Julie Lajoie Joshua Kimani Julius Oyugi Ken Omollo Genevieve Boily-Larouche Kenyan AIDS Control Project Juliana Cheruiyot Makubu Kimani Clinic Staff (Pumwani Clinics) Lab Staff Study Participants!!! McMaster University Kaushic Lab Charu Kaushic Mike Surette Jen Stearns Ontario Women’s Laura Rossi Health Scholars Michelle Shah McMaster Immunology Research Centre (MIRC)

Thank You! The Human Microbiome Project says the Human Body has 100 Trillion Microscopic Life Forms Living in it. You call this Living? Modified from: Medicine.emory.edu