Changes in key vaginal bacteria among postpartum African women initiating intramuscular depot-medroxyprogesterone acetate.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
21
08
2019
accepted:
11
02
2020
entrez:
6
3
2020
pubmed:
7
3
2020
medline:
17
6
2020
Statut:
epublish
Résumé
The ECHO trial has relieved apprehension about intramuscular depot medroxyprogesterone acetate (DMPA-IM), however it is still important to understand how DMPA-IM affects the vaginal environment. We sought to describe how DMPA-IM initiation influences vaginal bacteria associated with HIV acquisition in postpartum women. Vaginal swabs were collected for Nugent score determination and taxon-specific quantitative PCR of eight bacteria. Enrollment occurred at contraceptive initiation (DMPA-IM or non-hormonal contraception (non-HC)) and repeat vaginal swabs were collected after three months. Generalized estimating equations were used to estimate changes in Nugent score, total bacterial load, and taxa concentrations among contraceptive groups. Women who chose DMPA-IM (n = 33) were more likely to be married (97%vs.67%) and have resumed intercourse since delivery (52%vs.29%) compared to women who chose non-HC (n = 21). After three months, significant decreases in the concentrations of Sneathia species, Mycoplasma hominis, and Parvimonas species Type 1 were seen among non-HC users, however concentrations remained stable among DMPA-IM users; contraceptive method was associated with significantly different changes in M. hominis concentration between groups (p = 0.010). Our findings suggest that postpartum use of DMPA-IM and non-HC may have differential impacts on the vaginal concentrations of some bacteria that have previously been associated with HIV acquisition.
Sections du résumé
BACKGROUND
The ECHO trial has relieved apprehension about intramuscular depot medroxyprogesterone acetate (DMPA-IM), however it is still important to understand how DMPA-IM affects the vaginal environment. We sought to describe how DMPA-IM initiation influences vaginal bacteria associated with HIV acquisition in postpartum women.
METHODS
Vaginal swabs were collected for Nugent score determination and taxon-specific quantitative PCR of eight bacteria. Enrollment occurred at contraceptive initiation (DMPA-IM or non-hormonal contraception (non-HC)) and repeat vaginal swabs were collected after three months. Generalized estimating equations were used to estimate changes in Nugent score, total bacterial load, and taxa concentrations among contraceptive groups.
RESULTS
Women who chose DMPA-IM (n = 33) were more likely to be married (97%vs.67%) and have resumed intercourse since delivery (52%vs.29%) compared to women who chose non-HC (n = 21). After three months, significant decreases in the concentrations of Sneathia species, Mycoplasma hominis, and Parvimonas species Type 1 were seen among non-HC users, however concentrations remained stable among DMPA-IM users; contraceptive method was associated with significantly different changes in M. hominis concentration between groups (p = 0.010).
CONCLUSIONS
Our findings suggest that postpartum use of DMPA-IM and non-HC may have differential impacts on the vaginal concentrations of some bacteria that have previously been associated with HIV acquisition.
Identifiants
pubmed: 32134931
doi: 10.1371/journal.pone.0229586
pii: PONE-D-19-23637
pmc: PMC7058341
doi:
Substances chimiques
Contraceptive Agents, Female
0
Medroxyprogesterone Acetate
C2QI4IOI2G
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0229586Subventions
Organisme : NIAID NIH HHS
ID : P30 AI027757
Pays : United States
Organisme : NICHD NIH HHS
ID : K23 HD071788
Pays : United States
Organisme : NCATS NIH HHS
ID : TL1 TR002318
Pays : United States
Organisme : NIAID NIH HHS
ID : R21 AI129712
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI007140
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002319
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2 TR002317
Pays : United States
Déclaration de conflit d'intérêts
I have read the journal's policy and the authors of this manuscript have the following competing interests: David N. Fredricks has a financial relationship with BD for licensure of molecular diagnosis of BV. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
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