Characteristics associated with Lactobacillus-depleted vaginal microbiota in women with different sexual behavior.

The aim of this study was to compare the vaginal microbiome of women with different sexual behaviors and to examine characteristics associated with Lactobacillus-deprived community state type IV. In this prospective study performed in a community-based population in a city of approximately 150,000 inhabitants in Southeast region of Brazil, vaginal swabs were obtained of 109 participants, including women who only had sex with women (n = 54) and women who only had sex with man (n = 55). Sociodemographic data, sexual and intimated hygiene practices of the participants were also assessed. Vaginal microbiota was assessed by sequencing the hypervariable regions V3 and V4 of 16 S ribosomal nucleic acid gene (Illumina 250 PE). Alpha diversity (Shannon index) was compared between the two groups by the Mann-Whitney test. Logistic regression analyses were performed to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between covariates with the Lactobacillus-deprived community state type IV. Results showed that overall distribution of vaginal CSTs did not differ between the two study groups (P = 0.19). However, alpha diversity was increased in women that only have sex with women (P = 0.0018). Lactobacillus-deprived community state type IV was associated with lower income (OR: 4.15, 95% CI: 1.04–16.46) and use of sex toys (OR: 3.97, 95% CI: 1.09–14.45). In conclusion, nearly one-third of women that only have sex with women had a sub-optimal vaginal microbiome and show evidence of sex transmissibility of CST-IV associated organisms.