Department of Microbiology and Immunology, Montana State University, Bozeman, Montana, United States of America.
Department of Animal and Range Sciences, Montana State University, Bozeman, Montana, United States of America.
PLoS One. 2021 Dec 10;16(12):e0260813. doi: 10.1371/journal.pone.0260813. eCollection 2021.
Molecular-bacterial vaginosis (BV) is characterized by low levels of vaginal Lactobacillus species and is associated with higher risk of sexually transmitted infections (STI). Perceived psychosocial stress is associated with increased severity and persistence of infections, including STIs. American Indians have the highest rates of stress and high rates of STIs. The prevalence of molecular-BV among American Indian women is unknown. We sought to evaluate measures of psychosocial stress, such as historic loss (a multigenerational factor involving slavery, forced removal from one's land, legally ratified race-based segregation, and contemporary discrimination) and their association with the vaginal microbiota and specific metabolites associated with BV, in 70 Northwestern Plains American Indian women. Demographics, perceived psychosocial stressors, sexual practices, and known BV risk factors were assessed using a modified version of the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project survey. Self-collected mid-vaginal swabs were profiled for bacterial composition by 16S rRNA gene amplicon sequencing and metabolites quantified by targeted liquid-chromatography mass spectrometry. Sixty-six percent of the participants were classified as having molecular-BV, with the rest being either dominated by L. crispatus (10%) or L. iners (24%). High levels of lifetime trauma were associated with higher odds of having molecular-BV (adjusted Odds Ratio (aOR): 2.5, 95% Credible Interval (CrI): 1.1-5.3). Measures of psychosocial stress, including historic loss and historic loss associated symptoms, were significantly associated with lifestyle and behavioral practices. Higher scores of lifetime trauma were associated with increased concentrations of spermine (aFC: 3.3, 95% CrI: 1.2-9.2). Historic loss associated symptoms and biogenic amines were the major correlates of molecular-BV. Historical loss associated symptoms and lifetime trauma are potentially important underlying factors associated with BV.
分子细菌性阴道病（BV）的特征是阴道乳杆菌属水平较低，与性传播感染（STI）的风险增加有关。感知到的心理社会压力与感染（包括 STI）的严重程度和持续时间增加有关。美洲印第安人面临着最高的压力和高 STI 率。目前还不清楚美洲印第安妇女中分子细菌性阴道病的流行情况。我们试图评估心理社会压力的措施，如历史损失（涉及奴隶制、被迫离开自己的土地、合法批准的基于种族的隔离以及当代歧视的多代因素）及其与阴道微生物群和与 BV 相关的特定代谢物的关联，在 70 名西北平原美洲印第安妇女中进行了评估。使用美国印第安服务利用、精神流行病学、风险和保护因素项目调查的修改版评估人口统计学、感知心理社会压力源、性行为以及已知的 BV 危险因素。使用 16S rRNA 基因扩增子测序对自我收集的阴道中段拭子进行细菌组成分析，并通过靶向液相色谱-质谱法定量代谢物。66%的参与者被归类为患有分子细菌性阴道病，其余的要么由 L. crispatus（10%）要么由 L. iners（24%）主导。终生创伤水平较高与患有分子细菌性阴道病的几率较高相关（调整后的优势比（aOR）：2.5，95%可信区间（CrI）：1.1-5.3）。心理社会压力的测量，包括历史损失和与历史损失相关的症状，与生活方式和行为实践显著相关。终生创伤的分数越高，与 spermine 的浓度增加相关（aFC：3.3，95% CrI：1.2-9.2）。与历史损失相关的症状和生物胺是分子细菌性阴道病的主要相关因素。与历史损失相关的症状和终生创伤可能是与 BV 相关的重要潜在因素。
