Evidence map›Paper›PMID 42448874›Full record

ArticleCommunications medicine2026

Biosocial influences of gender identity and geography on mucosal microbial phenotypes.

Vanessa E Van Doren, S Abigail Smith, Cassie Grimsley Ackerley, Jadah Keith, Robert A Arthur, Henry Claussen, Phillip Murray, Vin Tangpricha, Yi-Juan Hu, Chang Su and 2 more

Abstract read
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Article in Communications medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Vanessa E Van DorenThe Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Decatur, GA, USA. vvandoren@brownhealth.org.ORCID http://orcid.org/0000-0003-4165-6025
S Abigail SmithThe Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Decatur, GA, USA.
Cassie Grimsley AckerleyThe Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Decatur, GA, USA.
Jadah KeithEmory University School of Medicine, Atlanta, GA, USA.
Robert A ArthurEmory Integrated Computational Core, Emory University, Woodruff Memorial Research Building, Atlanta, GA, USA.ORCID http://orcid.org/0000-0003-4824-4971
Henry ClaussenEmory Integrated Computational Core, Emory University, Woodruff Memorial Research Building, Atlanta, GA, USA.
Phillip MurrayThe Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Decatur, GA, USA.
Vin TangprichaDivision of Endocrinology, Metabolism, and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Yi-Juan HuDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Chang SuDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.ORCID http://orcid.org/0000-0002-8704-1512
Mengyu HeDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Colleen F KelleyThe Hope Clinic of the Emory Vaccine Center, Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Decatur, GA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransgender women (TGW) experience unique hormonal contexts and high HIV incidence, yet the mucosal microbiome among TGW remains understudied. Sex hormones and geography may shape microbial composition, but the relative contributions of gender identity, feminizing hormone therapy (FHT), and location are unclear.

methodsWe conducted a multi-site study of TGW using FHT and cisgender men who have sex with men (MSM), all without HIV, in Atlanta, USA (n = 58; 25 TGW, 33 MSM) and Bangkok, Thailand (n = 147; 97 TGW, 50 MSM)(n = 205). We also conducted longitudinal sampling in 21 TGW pre/post FHT initiation. Rectal swabs were collected from all participants, with optional neovaginal sampling in TGW. Microbiota composition was analyzed using 16S rRNA sequencing, and associations with gender category, geography, and hormone concentrations were assessed using linear decomposition modeling (LDM) and BOUTH analysis.

resultsHere we show that the rectal microbiota differ significantly by both gender category and geography. TGW exhibit enrichment of estrogen-metabolizing taxa across sites, while MSM show Prevotellaceae enrichment in Atlanta only. Alpha diversity varies by location but not gender category. Neovaginal microbiota differ markedly from rectal composition, showing enrichment of skin- and gut-associated taxa and anaerobic taxa associated with HIV seroconversion. No significant rectal microbiota shifts are observed after short-term FHT initiation, possibly reflecting subtherapeutic hormone exposure.

conclusionsThese findings underscore the need to consider gender identity as a complex biosocial phenotype in HIV prevention and highlight the potential role of mucosal microbiota in shaping HIV vulnerability in TGW.

Identifiers

PMID42448874

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.