Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.
Department of International Health, Georgetown University, Washington, DC, USA.
Am J Reprod Immunol. 2024 Sep;92(3):e13929. doi: 10.1111/aji.13929.
Female sex workers (FSW) experience a disproportionately high burden of HIV infection, yet characterization of the vaginal immune microenvironment that may impact biological risk is not well studied among FSW in the United States. Additionally, feasible methodology for collecting biological materials has not been evaluated in this population.
We enrolled 10 FSW (5 premenopausal, 5 postmenopausal) who participated in a survey and provided vaginal swabs. Biomarkers were assessed by ELISA, and included cytokines, chemokines, and antimicrobial/wound-healing mediators.
One hundred percent of FSW were African American, with a median age of 43.5. The median age when participants started sex work was 17.5, with 60% working 7 days per week and seeing up to 10 clients per night. Eighty percent reported recent unprotected sex and only 30% used some form of contraception. One self-reported sexually transmitted infection at the time of visit and two reported living with HIV. Vaginal secretions showed detectable levels of all biomarkers tested, except MIP3α and MIP1α, which were undetectable in all samples. When stratified by age/menopause status, no significant changes were observed except for Serpin A1 with higher median levels in premenopausal compared to postmenopausal FSW (median 5.79 vs. 5.205 log pg/mL, p = 0.016). Comparison with samples from an existing repository of non-FSW women showed significantly reduced chemokines IL8 (p = 0.045), MIP3α (p ≤ 0.001), and MIP1β (p = 0.015) in the FSW group.
We report characterization of the vaginal secretome in a cohort of FSW in the United States. Understanding of the genital immune microenvironment can inform future research in HIV prevention and therapeutic options in this population.
女性性工作者（FSW）感染艾滋病毒的负担不成比例地高，但在美国，FSW 的阴道免疫微环境特征（可能影响生物风险）尚未得到很好的研究。此外，在该人群中尚未评估收集生物材料的可行方法。
我们招募了 10 名 FSW（5 名绝经前，5 名绝经后），她们参加了一项调查并提供了阴道拭子。通过 ELISA 评估了生物标志物，包括细胞因子、趋化因子和抗菌/伤口愈合介质。
100%的 FSW 是非洲裔美国人，中位年龄为 43.5 岁。参与者开始从事性工作的中位年龄为 17.5 岁，其中 60%每周工作 7 天，每晚接待多达 10 名客户。80%报告最近有无保护性行为，只有 30%使用某种形式的避孕措施。有 1 人在就诊时报告了 1 次性传播感染，有 2 人报告了 HIV 感染。阴道分泌物显示出所有测试生物标志物的可检测水平，除了 MIP3α 和 MIP1α，它们在所有样本中均无法检测到。按年龄/绝经状态分层，除了绝经前 FSW 的 Serpin A1 中位数水平较高（中位数 5.79 vs. 5.205 log pg/mL，p = 0.016）外，未观察到显著变化。与非 FSW 女性现有储存库中的样本比较，FSW 组的趋化因子 IL8（p = 0.045）、MIP3α（p ≤ 0.001）和 MIP1β（p = 0.015）显著减少。
我们报告了美国 FSW 队列的阴道分泌物特征。了解生殖免疫微环境可以为该人群的 HIV 预防和治疗选择提供信息。
