Abstract
Young South African women, from resource-poor communities, face several sexual and reproductive health challenges. Here we describe the vaginal microbiota and sexually transmitted infection (STI) prevalence of 102; 16–22-year-old, HIV-negative South African women from a low-income, high-population-density community in Cape Town (CPT). Vaginal microbiota were profiled using 16S rRNA amplicon sequencing; bacterial vaginosis (BV) status was established using Nugent scoring and STIs were determined by multiplex polymerase chain reaction. STIs were common, with 55% of women having at least one STI; 41% were infected with high-risk human papilloma virus (HPV) and a further 28% with low-risk HPV; 44% were infected with Chlamydia, 16% of whom had at least one additional STI. Similarly, BV rates were very high, with 55% of women classified as BV-positive (Nugent score ≥7), 7% as BV-intermediate (Nugent score 3–6) and 38% as BV-negative (Nugent 0–2). Group B Streptococcus (Streptococcus agalactiae), the leading cause of neonatal sepsis, was present in 25% of BV-positive women and 28% of BV-negative women, and was significantly more abundant among BV-negative women. Both Chlamydia infection and BV may adversely affect reproductive health and place these women at additional risk for HIV acquisition. The high abundance of Prevotella amnii, in particular, may increase HIV risk, given its inflammatory capacity. Laboratory-based testing for STIs (Chlamydia and Gonorrhoeae in particular) appear to be warranted in this community, together with further monitoring or treatment of BV.Research correlation: This article is the original version, of which an Afrikaans translation was made available to provide access to a larger readership, available here: https://doi.org/10.4102/satnt.v36i1.1495
Highlights
Young South African women from resource-poor communities face several sexual and reproductive health challenges
A total of 149 HIV-negative 16–22-year-old women were recruited from a low-income, high-population-density community in Cape Town (CPT)
A staggering 44% of women were infected with Chlamydia, 16% of whom had at least one additional sexually transmitted infections (STIs)
Summary
Young South African women from resource-poor communities face several sexual and reproductive health challenges. Several factors have been proposed to cause genital inflammation, including bacterial vaginosis (BV) (characterised by increased vaginal microbial diversity and a decrease in the proportion of Lactobacilli) and sexually transmitted infections (STIs). These factors appear to be interdependent, as BV is associated with increased risk of STIs (Balkus et al 2014; Gallo et al 2012; Wiesenfeld et al 2003), including HIV (Atashili et al 2008; Myer et al 2005; Taha et al 1998), and vice versa (Gallo et al 2012). BV is more prevalent in women of African descent, compared to European women (Buvé et al 2014; Ravel et al 2010; Srinivasan et al 2012), with extremely high rates in South Africa (34% – 58%), relative to other countries (Kenyon, Colebunders & Crucitti 2013)
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