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. Wessels1, Julie Lajoie2, Ken Omollo3, Keith R. Fowke2,3, Joshua Kimani2,3,4, Julius Oyugi3, Juliana Cheruiyot4, Mike G. Surette1, and Charu Kaushic1

1McMaster University, Hamilton, Ontario, Canada; 2University of Manitoba, Winnipeg,

Manitoba, Canada; 3University of Nairobi, Nairobi, Kenya; 4Kenyan AIDS Control Program, Nairobi, Kenya

OHTN, Toronto Ontario Monday 24th 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

Modified from: Borgdorff et al., 2014

% of Women in Cluster

Species Diversity

The Vaginal Microbiome

 A greater variety of bacterial species in the Vaginal Microbiome is

associated with negative reproductive outcomes (HIV, STIs, PID, preterm birth)

The Vaginal Microbiome

Modified from: Fettweis et al., 2014

African American Women Women of European Ancestry

The “Health” of the Vaginal Microbiome May Depend on Ethnicity

From: Ravel et al., 2011

polymicrobial

The Vaginal Microbiome

From: Burgener et al., 2015

 The vaginal microbiome of Sex Workers

will have a greater variety of bacteria than Non‐Sex Workers

fredhutch.org

Hypothesis 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

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 Non-Sex Workers 100 200 300 400

*

Sex Workers have greater bacterial diversity in the vagina compared with Non‐Sex Workers from the same Community

 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

 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

↑ Species Diversity ↑ Dysbiosis ↑ Inflammation & Barrier Breakdown ↑ Susceptibility to HIV

Conclusions Significance

• 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 Laura Rossi Michelle Shah McMaster Immunology Research Centre (MIRC)

Acknowledgements

Ontario Women’s Health Scholars

Modified from: Medicine.emory.edu

Thank You!

The Human Microbiome Project says the Human Body has 100 Trillion Microscopic Life Forms Living in it.

You call this Living?