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The local immune environment at the site of HIV exposure is an important determinant of whether exposure during sex will lead to productive infection, and the vaginal and penile immune milieus are each critically shaped by the local microbiome. However, there are key differences in the microbial drivers of inflammation and immune quiescence at these tissue sites. In both, a high abundance of anaerobic taxa (e.g., Prevotella) is associated with an increased local density of HIV target cells and an increased risk of acquiring HIV through sex. However, the taxa that have been associated to date with increased risk in the vagina and penis are not identical. Just as importantly, the microbiota associated with comparatively less inflammation and HIV risk\u2014i.e., the optimal microbiota\u2014are very different at the two sites. In the vagina, Lactobacillus spp. are immunoregulatory and may protect against HIV acquisition, whereas on the penis, \u201cskin type\u201d flora such as Corynebacterium are associated with reduced inflammation. Compared to its vaginal counterpart, much less is known about the dynamics of the penile microbiome, the ability of clinical interventions to alter the penile microbiome, or the impact of natural\/induced microbiome alterations on penile immunology and HIV risk.<\/jats:p>","DOI":"10.3390\/v14061164","type":"journal-article","created":{"date-parts":[[2022,5,31]],"date-time":"2022-05-31T05:25:42Z","timestamp":1653974742000},"page":"1164","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Penis, the Vagina and HIV Risk: Key Differences (Aside from the Obvious)"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1586-4093","authenticated-orcid":false,"given":"Rupert","family":"Kaul","sequence":"first","affiliation":[{"name":"Departments of Medicine and Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada"},{"name":"Department of Medicine, University Health Network, Toronto, ON M5S 1A8, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy M.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5139-5397","authenticated-orcid":false,"given":"Daniel E.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald M.","family":"Galiwango","sequence":"additional","affiliation":[{"name":"Rakai Health Sciences Program, Kalisizo P.O. 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Confronting Inequalities: Lessons for Pandemic Responses from 40 Years of AIDS. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2021-global-aids-update_en.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1097\/COH.0000000000000659","article-title":"The interplay between HIV and COVID-19: Summary of the data and responses to date","volume":"16","author":"Brown","year":"2021","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_3","unstructured":"UNAIDS (2021). UNAIDS Data 2021, Joint United Nations Programme on HIV\/AIDS."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1007\/s11904-015-0269-5","article-title":"Inflammation and HIV Transmission in Sub-Saharan Africa","volume":"12","author":"Kaul","year":"2015","journal-title":"Curr. HIV\/AIDS Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/j.1600-0897.2010.00962.x","article-title":"Biological factors that may contribute to regional and racial disparities in HIV prevalence","volume":"65","author":"Kaul","year":"2011","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1080\/21645515.2020.1765622","article-title":"The importance of semen leukocytes in HIV-1 transmission and the development of prevention strategies","volume":"16","author":"Cavarelli","year":"2020","journal-title":"Hum. Vaccin Immunother."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1001\/jama.2016.5148","article-title":"Sexual Activity Without Condoms and Risk of HIV Transmission in Serodifferent Couples When the HIV-Positive Partner Is Using Suppressive Antiretroviral Therapy","volume":"316","author":"Rodger","year":"2016","journal-title":"JAMA"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2428","DOI":"10.1016\/S0140-6736(19)30418-0","article-title":"Risk of HIV transmission through condomless sex in serodifferent gay couples with the HIV-positive partner taking suppressive antiretroviral therapy (PARTNER): Final results of a multicentre, prospective, observational study","volume":"393","author":"Rodger","year":"2019","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e438","DOI":"10.1016\/S2352-3018(18)30132-2","article-title":"Viral suppression and HIV transmission in serodiscordant male couples: An international, prospective, observational, cohort study","volume":"5","author":"Bavinton","year":"2018","journal-title":"Lancet HIV"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1097\/QAD.0000000000000298","article-title":"Estimating per-act HIV transmission risk: A systematic review","volume":"28","author":"Patel","year":"2014","journal-title":"AIDS"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2111","DOI":"10.1111\/jocn.15628","article-title":"Promoting safer sex in the context of heterosexual anal intercourse: A scoping review","volume":"30","author":"Stewart","year":"2021","journal-title":"J. Clin. Nurs."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/COH.0b013e3283504941","article-title":"Quality and quantity: Mucosal CD4+ T cells and HIV susceptibility","volume":"7","author":"McKinnon","year":"2012","journal-title":"Curr. Opin. HIV AIDS"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1097\/QAD.0000000000002037","article-title":"Age-disparate partnerships and incident HIV infection in adolescent girls and young women in rural South Africa","volume":"33","author":"Stoner","year":"2019","journal-title":"AIDS"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1111\/aji.12035","article-title":"Genital immunology and HIV susceptibility in young women","volume":"69","author":"Yi","year":"2013","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.1089\/aid.2012.0273","article-title":"Greentree Meeting on Sexual Violence and HIV (Kaul, Greentree white paper: Sexual violence, genitoanal injury, and HIV: Priorities for research, policy, and practice","volume":"28","author":"Klot","year":"2012","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S97","DOI":"10.1097\/00002030-200108004-00011","article-title":"The epidemiology of HSV-2 infection and its association with HIV infection in four urban African populations","volume":"15","author":"Weiss","year":"2001","journal-title":"Aids"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12981-017-0167-6","article-title":"The biology of how circumcision reduces HIV susceptibility: Broader implications for the prevention field","volume":"14","author":"Prodger","year":"2017","journal-title":"AIDS Res. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/S0140-6736(00)04331-2","article-title":"Probability of HIV-1 transmission per coital act in monogamous, heterosexual, HIV-1-discordant couples in Rakai, Uganda","volume":"357","author":"Gray","year":"2001","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1111\/j.1469-7580.2009.01066.x","article-title":"Structure and functions of keratin proteins in simple, stratified, keratinized and cornified epithelia","volume":"214","author":"Bragulla","year":"2009","journal-title":"J. Anat."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.ijpharm.2012.06.005","article-title":"The structure and function of the stratum corneum","volume":"435","author":"Menon","year":"2012","journal-title":"Int. J. Pharm."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1111\/aji.12230","article-title":"The structure of the human vaginal stratum corneum and its role in immune defense","volume":"71","author":"Anderson","year":"2014","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1159\/000114872","article-title":"Epidermal ceramidase activity regulates epidermal desquamation via stratum corneum acidification","volume":"21","author":"Houben","year":"2008","journal-title":"Skin Pharmacol. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s00253-005-0239-8","article-title":"Microbial keratinases and their prospective applications: An overview","volume":"70","author":"Gupta","year":"2006","journal-title":"Appl. Microbiol. Biotechnol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1038\/nrmicro2537","article-title":"The skin microbiome","volume":"9","author":"Grice","year":"2011","journal-title":"Nat. Rev. Microbiol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Dinh, M.H., Hirbod, T., Kigozi, G., Okocha, E.A., Cianci, G.C., Kong, X., Prodger, J.L., Broliden, K., Kaul, R., and Serwadda, D. (2012). No difference in keratin thickness between inner and outer foreskins from elective male circumcisions in Rakai, Uganda. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0041271"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4","DOI":"10.2174\/1573395514666180604084404","article-title":"Barriers of Mucosal Entry of HIV\/SIV","volume":"15","author":"Carias","year":"2019","journal-title":"Curr. Immunol. Rev."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1093\/cid\/civ298","article-title":"Genital inflammation and the risk of HIV acquisition in women","volume":"61","author":"Masson","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1038\/nm.4506","article-title":"Genital inflammation undermines the effectiveness of tenofovir gel in preventing HIV acquisition in women","volume":"24","author":"McKinnon","year":"2018","journal-title":"Nat. Med."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Prodger, J.L., Gray, R.H., Shannon, B., Shahabi, K., Kong, X., Grabowski, K., Kigozi, G., Nalugoda, F., Serwadda, D., and Wawer, M.J. (2016). Chemokine Levels in the Penile Coronal Sulcus Correlate with HIV-1 Acquisition and Are Reduced by Male Circumcision in Rakai, Uganda. PLoS Pathog., 12.","DOI":"10.1371\/journal.ppat.1006025"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1073\/pnas.1407466112","article-title":"Activated CD4+CCR5+ T cells in the rectum predict increased SIV acquisition in SIVGag\/Tat-vaccinated rhesus macaques","volume":"112","author":"Carnathan","year":"2015","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"5640","DOI":"10.1073\/pnas.0308425101","article-title":"Roles of substrate availability and infection of resting and activated CD4+ T cells in transmission and acute simian immunodeficiency virus infection","volume":"101","author":"Zhang","year":"2004","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1038\/mi.2010.2","article-title":"HIV-1 sexual transmission: Early events of HIV-1 infection of human cervico-vaginal tissue in an optimized ex vivo model","volume":"3","author":"Saba","year":"2010","journal-title":"Mucosal Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"10189","DOI":"10.1128\/JVI.02529-10","article-title":"HLA-DR+ CD38+ CD4+ T lymphocytes have elevated CCR5 expression and produce the majority of R5-tropic HIV-1 RNA in vivo","volume":"85","author":"Meditz","year":"2011","journal-title":"J. Virol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/mi.2015.28","article-title":"Identification of preferential CD4+ T-cell targets for HIV infection in the cervix","volume":"9","author":"Joag","year":"2016","journal-title":"Mucosal Immunol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e93230","DOI":"10.1172\/jci.insight.93230","article-title":"HIV-1 selectively targets gut-homing CCR6+CD4+ T cells via mTOR-dependent mechanisms","volume":"2","author":"Planas","year":"2017","journal-title":"JCI Insight"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Prodger, J.L., Ssemaganda, A., Ssetaala, A., Kitandwe, P.K., Muyanja, E., Mpendo, J., Nanvubya, A., Wambuzi, M., Nielsen, L., and Kiwanuka, N. (2015). Schistosoma mansoni Infection in Ugandan Men Is Associated with Increased Abundance and Function of HIV Target Cells in Blood, but Not the Foreskin: A Cross-sectional Study. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0004067"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.chom.2016.03.005","article-title":"Th17 Cells Are Preferentially Infected Very Early after Vaginal Transmission of SIV in Macaques","volume":"19","author":"Stieh","year":"2016","journal-title":"Cell Host Microbe"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Ryan, E.S., Micci, L., Fromentin, R., Paganini, S., McGary, C.S., Easley, K., Chomont, N., and Paiardini, M. (2016). Loss of Function of Intestinal IL-17 and IL-22 Producing Cells Contributes to Inflammation and Viral Persistence in SIV-Infected Rhesus Macaques. PLoS Pathog., 12.","DOI":"10.1371\/journal.ppat.1005412"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1038\/mi.2012.72","article-title":"A role for mucosal IL-22 production and Th22 cells in HIV-associated mucosal immunopathogenesis","volume":"5","author":"Kim","year":"2012","journal-title":"Mucosal Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1038\/ni.1767","article-title":"Production of interleukin 22 but not interleukin 17 by a subset of human skin-homing memory T cells","volume":"10","author":"Duhen","year":"2009","journal-title":"Nat. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/QAI.0000000000000389","article-title":"Early HIV-1 infection is associated with reduced frequencies of cervical Th17 cells","volume":"68","author":"McKinnon","year":"2015","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/QAI.0b013e31829f6e1a","article-title":"The frequency of alpha(4)beta(7)(high) memory CD4(+) T cells correlates with susceptibility to rectal simian immunodeficiency virus infection","volume":"64","author":"Martinelli","year":"2013","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"eaam6354","DOI":"10.1126\/scitranslmed.aam6354","article-title":"Integrin alpha4beta7 expression on peripheral blood CD4+ T cells predicts HIV acquisition and disease progression outcomes","volume":"10","author":"Sivro","year":"2018","journal-title":"Sci. Transl. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"3440","DOI":"10.1172\/JCI34721","article-title":"TNF-alpha and TLR agonists increase susceptibility to HIV-1 transmission by human Langerhans cells ex vivo","volume":"118","author":"Oudhoff","year":"2008","journal-title":"J. Clin. Investig."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"6858","DOI":"10.1128\/JVI.02472-06","article-title":"Activated CD34-derived Langerhans cells mediate transinfection with human immunodeficiency virus","volume":"81","author":"Fahrbach","year":"2007","journal-title":"J. Virol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1366","DOI":"10.1093\/infdis\/jix088","article-title":"Distinct Effects of the Cervicovaginal Microbiota and Herpes Simplex Type 2 Infection on Female Genital Tract Immunology","volume":"215","author":"Shannon","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1038\/mi.2015.51","article-title":"Increased levels of inflammatory cytokines in the female reproductive tract are associated with altered expression of proteases, mucosal barrier proteins, and an influx of HIV-susceptible target cells","volume":"9","author":"Arnold","year":"2016","journal-title":"Mucosal Immunol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2049","DOI":"10.1097\/QAD.0b013e328311ac65","article-title":"Genital levels of soluble immune factors with anti-HIV activity may correlate with increased HIV susceptibility","volume":"22","author":"Kaul","year":"2008","journal-title":"Aids"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S0140-6736(07)60313-4","article-title":"Male circumcision for HIV prevention in men in Rakai, Uganda: A randomised trial","volume":"369","author":"Gray","year":"2007","journal-title":"Lancet"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1126\/science.1193748","article-title":"Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women","volume":"329","author":"Frohlich","year":"2010","journal-title":"Science"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000337927","article-title":"The emerging role of peptides and lipids as antimicrobial epidermal barriers and modulators of local inflammation","volume":"25","author":"Brogden","year":"2012","journal-title":"Skin Pharmacol. Physiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1129","DOI":"10.1097\/00002030-199308000-00019","article-title":"Defensins inhibit HIV replication in vitro","volume":"7","author":"Nakashima","year":"1993","journal-title":"Aids"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.febslet.2004.11.062","article-title":"Human neutrophil alpha-defensin 4 inhibits HIV-1 infection in vitro","volume":"579","author":"Wu","year":"2005","journal-title":"FEBS Lett."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"F39","DOI":"10.1097\/00002030-200311070-00001","article-title":"Human epithelial beta-defensins 2 and 3 inhibit HIV-1 replication","volume":"17","author":"Lederman","year":"2003","journal-title":"Aids"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"14318","DOI":"10.1128\/JVI.79.22.14318-14329.2005","article-title":"Human beta-defensins suppress human immunodeficiency virus infection: Potential role in mucosal protection","volume":"79","author":"Sun","year":"2005","journal-title":"J. Virol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.virol.2010.10.004","article-title":"HIV is inactivated after transepithelial migration via adult oral epithelial cells but not fetal epithelial cells","volume":"409","author":"Tugizov","year":"2011","journal-title":"Virology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"410","DOI":"10.2174\/157016207781023947","article-title":"The antimicrobial peptide LL-37 inhibits HIV-1 replication","volume":"5","author":"Bergman","year":"2007","journal-title":"Curr. HIV Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1016\/j.peptides.2011.04.017","article-title":"Effects of cathelicidin and its fragments on three key enzymes of HIV-1","volume":"32","author":"Wong","year":"2011","journal-title":"Peptides"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/1742-4690-2-2","article-title":"Inhibition of early steps in the lentiviral replication cycle by cathelicidin host defense peptides","volume":"2","author":"Steinstraesser","year":"2005","journal-title":"Retrovirology"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"28821","DOI":"10.1074\/jbc.M112.375949","article-title":"Multifaceted mechanisms of HIV-1 entry inhibition by human alpha-defensin","volume":"287","author":"Demirkhanyan","year":"2012","journal-title":"J. Biol. Chem."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Levinson, P., Choi, R.Y., Cole, A.L., Hirbod, T., Rhedin, S., Payne, B., Guthrie, B.L., Bosire, R., Cole, A.M., and Farquhar, C. (2012). HIV-neutralizing activity of cationic polypeptides in cervicovaginal secretions of women in HIV-serodiscordant relationships. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0031996"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Ghosh, M., Fahey, J.V., Shen, Z., Lahey, T., Cu-Uvin, S., Wu, Z., Mayer, K., Wright, P.F., Kappes, J.C., and Ochsenbauer, C. (2010). Anti-HIV activity in cervical-vaginal secretions from HIV-positive and -negative women correlate with innate antimicrobial levels and IgG antibodies. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0011366"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"7560","DOI":"10.4049\/jimmunol.175.11.7560","article-title":"Cationic polypeptides are required for anti-HIV-1 activity of human vaginal fluid","volume":"175","author":"Venkataraman","year":"2005","journal-title":"J. Immunol."},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Drannik, A.G., Nag, K., Yao, X.D., Henrick, B.M., Ball, T.B., Plummer, F.A., Wachihi, C., Kimani, J., and Rosenthal, K.L. (2012). Anti-HIV-1 activity of elafin depends on its nuclear localization and altered innate immune activation in female genital epithelial cells. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0052738"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"4599","DOI":"10.1128\/JVI.06561-11","article-title":"Anti-HIV-1 activity of elafin is more potent than its precursor\u2019s, trappin-2, in genital epithelial cells","volume":"86","author":"Drannik","year":"2012","journal-title":"J. Virol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1365-2567.2009.03165.x","article-title":"Trappin-2\/Elafin: A novel innate anti-human immunodeficiency virus-1 molecule of the human female reproductive tract","volume":"129","author":"Ghosh","year":"2010","journal-title":"Immunology"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1172\/JCI118056","article-title":"Secretory leukocyte protease inhibitor: A human saliva protein exhibiting anti-human immunodeficiency virus 1 activity in vitro","volume":"96","author":"McNeely","year":"1995","journal-title":"J. Clin. Investig."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1182\/blood.V90.3.1141","article-title":"Inhibition of human immunodeficiency virus type 1 infectivity by secretory leukocyte protease inhibitor occurs prior to viral reverse transcription","volume":"90","author":"McNeely","year":"1997","journal-title":"Blood"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"S64","DOI":"10.1111\/j.1601-0825.1997.tb00377.x","article-title":"Secretory leukocyte protease inhibitor (SLPI) in mucosal fluids inhibits HIV-I","volume":"3","author":"Wahl","year":"1997","journal-title":"Oral Dis."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1097\/QAD.0b013e328321809c","article-title":"Levels of innate immune factors in genital fluids: Association of alpha defensins and LL-37 with genital infections and increased HIV acquisition","volume":"23","author":"Levinson","year":"2009","journal-title":"Aids"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Hirbod, T., Kong, X., Kigozi, G., Ndyanabo, A., Serwadda, D., Prodger, J.L., Tobian, A.A., Nalugoda, F., Wawer, M.J., and Shahabi, K. (2014). HIV acquisition is associated with increased antimicrobial peptides and reduced HIV neutralizing IgA in the foreskin prepuce of uncircumcised men. PLoS Pathog., 10.","DOI":"10.1371\/journal.ppat.1004416"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1042\/BST0391409","article-title":"WAP domain proteins as modulators of mucosal immunity","volume":"39","author":"Wilkinson","year":"2011","journal-title":"Biochem. Soc. Trans."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1038\/mi.2013.44","article-title":"Acting locally: Innate mucosal immunity in resistance to HIV-1 infection in Kenyan commercial sex workers","volume":"7","author":"Yao","year":"2013","journal-title":"Mucosal Immunol."},{"key":"ref_74","doi-asserted-by":"crossref","unstructured":"Chege, D., Chai, Y., Huibner, S., Kain, T., Wachihi, C., Kimani, M., Barasa, S., McKinnon, L.R., Muriuki, F.K., and Kariri, A. (2012). Blunted IL17\/IL22 and Pro-Inflammatory Cytokine Responses in the Genital Tract and Blood of HIV-Exposed, Seronegative Female Sex Workers in Kenya. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0043670"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"598307","DOI":"10.3389\/fimmu.2020.598307","article-title":"Differential Elevation of Inflammation and CD4(+) T Cell Activation in Kenyan Female Sex Workers and Non-Sex Workers Using Depot-Medroxyprogesterone Acetate","volume":"11","author":"Omollo","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1038\/mi.2013.83","article-title":"Immune correlates of HIV exposure without infection in foreskins of men from Rakai, Uganda","volume":"7","author":"Prodger","year":"2014","journal-title":"Mucosal Immunol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1086\/513820","article-title":"Increase in endocervical CD4 lymphocytes among women with nonulcerative sexually transmitted diseases","volume":"177","author":"Levine","year":"1998","journal-title":"J. Infect. Dis."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1111\/imm.12527","article-title":"Relationship between female genital tract infections, mucosal interleukin-17 production and local T helper type 17 cells","volume":"146","author":"Masson","year":"2015","journal-title":"Immunology"},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Dabee, S., Barnabas, S.L., Lennard, K.S., Jaumdally, S.Z., Gamieldien, H., Balle, C., Happel, A.U., Murugan, B.D., Williamson, A.L., and Mkhize, N. (2019). Defining characteristics of genital health in South African adolescent girls and young women at high risk for HIV infection. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0213975"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1038\/nm.2006","article-title":"Persistence of HIV-1 receptor-positive cells after HSV-2 reactivation is a potential mechanism for increased HIV-1 acquisition","volume":"15","author":"Zhu","year":"2009","journal-title":"Nat. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"5074","DOI":"10.4049\/jimmunol.1302916","article-title":"Impact of asymptomatic herpes simplex virus type 2 infection on mucosal homing and immune cell subsets in the blood and female genital tract","volume":"192","author":"Shannon","year":"2014","journal-title":"J. Immunol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1038\/mi.2016.118","article-title":"Enrichment of herpes simplex virus type 2 (HSV-2) reactive mucosal T cells in the human female genital tract","volume":"10","author":"Posavad","year":"2017","journal-title":"Mucosal Immunol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"e25355","DOI":"10.1002\/jia2.25355","article-title":"Sexually transmitted infections and HIV in the era of antiretroviral treatment and prevention: The biologic basis for epidemiologic synergy","volume":"22","author":"Cohen","year":"2019","journal-title":"J. Int. AIDS Soc."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1093\/infdis\/jix188","article-title":"Cytomegalovirus Kinetics Following Primary Infection in Healthy Women","volume":"215","author":"Forman","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1111\/cei.13558","article-title":"Cervical cytomegalovirus reactivation, cytokines and spontaneous preterm birth in Kenyan women","volume":"203","author":"Begnel","year":"2021","journal-title":"Clin. Exp. Immunol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1038\/mi.2016.129","article-title":"Association of HPV infection and clearance with cervicovaginal immunology and the vaginal microbiota","volume":"10","author":"Shannon","year":"2017","journal-title":"Mucosal Immunol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"5227","DOI":"10.1038\/s41467-019-13089-2","article-title":"HPV infection and the genital cytokine milieu in women at high risk of HIV acquisition","volume":"10","author":"Liebenberg","year":"2019","journal-title":"Nat. Commun."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1097\/QAI.0b013e3181743936","article-title":"Bacterial vaginosis and vaginal yeast, but not vaginal cleansing, increase HIV-1 acquisition in African women","volume":"48","author":"Morrison","year":"2008","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1089\/154099903766651612","article-title":"Candida infection as a risk factor for HIV transmission","volume":"12","author":"Hester","year":"2003","journal-title":"J. Womens Health"},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Perez-Soto, E., Fernandez-Martinez, E., Oros-Pantoja, R., Medel-Flores, O., Miranda-Covarrubias, J.C., and Sanchez-Monroy, V. (2021). Proinflammatory and Oxidative Stress States Induced by Human Papillomavirus and Chlamydia trachomatis Coinfection Affect Sperm Quality in Asymptomatic Infertile Men. Medicina, 57.","DOI":"10.3390\/medicina57090862"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1038\/s41385-019-0209-6","article-title":"Impact of chemokine C-C ligand 27, foreskin anatomy and sexually transmitted infections on HIV-1 target cell availability in adolescent South African males","volume":"13","author":"Gray","year":"2020","journal-title":"Mucosal Immunol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1128\/JVI.06077-11","article-title":"Associations between virologic and immunologic dynamics in blood and in the male genital tract","volume":"86","author":"Gianella","year":"2012","journal-title":"J. Virol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1038\/mi.2012.1","article-title":"Mucosal correlates of isolated HIV semen shedding during effective antiretroviral therapy","volume":"5","author":"Sheth","year":"2012","journal-title":"Mucosal Immunol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1093\/infdis\/jiq091","article-title":"Effects of HIV-1 and herpes simplex virus type 2 infection on lymphocyte and dendritic cell density in adult foreskins from Rakai, Uganda","volume":"203","author":"Johnson","year":"2011","journal-title":"J. Infect. Dis."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1097\/QAD.0b013e328354675c","article-title":"Impact of asymptomatic Herpes simplex virus-2 infection on T cell phenotype and function in the foreskin","volume":"26","author":"Prodger","year":"2012","journal-title":"AIDS"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1713","DOI":"10.1093\/infdis\/jit035","article-title":"Human Papillomavirus Clearance Among Males Is Associated With HIV Acquisition and Increased Dendritic Cell Density in the Foreskin","volume":"207","author":"Tobian","year":"2013","journal-title":"J. Infect. Dis."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Low, N., Chersich, M.F., Schmidlin, K., Egger, M., Francis, S.C., van de Wijgert, J.H., Hayes, R.J., Baeten, J.M., Brown, J., and Delany-Moretlwe, S. (2011). Intravaginal practices, bacterial vaginosis, and HIV infection in women: Individual participant data meta-analysis. PLoS Med., 8.","DOI":"10.1371\/journal.pmed.1000416"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1097\/QAD.0000000000001097","article-title":"Postcoital penile washing and the risk of HIV acquisition in uncircumcised men","volume":"30","author":"Makumbi","year":"2016","journal-title":"AIDS"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/S0140-6736(02)11079-8","article-title":"Effectiveness of COL-1492, a nonoxynol-9 vaginal gel, on HIV-1 transmission in female sex workers: A randomised controlled trial","volume":"360","author":"Ramjee","year":"2002","journal-title":"Lancet"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1095\/biolreprod.104.029603","article-title":"Interleukin (IL)-1, IL-6, and IL-8 predict mucosal toxicity of vaginal microbicidal contraceptives","volume":"71","author":"Fichorova","year":"2004","journal-title":"Biol. Reprod."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1086\/322047","article-title":"The molecular basis of nonoxynol-9-induced vaginal inflammation and its possible relevance to human immunodeficiency virus type 1 transmission","volume":"184","author":"Fichorova","year":"2001","journal-title":"J. Infect. Dis."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1097\/OLQ.0b013e3181644669","article-title":"Mucosal irritation potential of personal lubricants relates to product osmolality as detected by the slug mucosal irritation assay","volume":"35","author":"Adriaens","year":"2008","journal-title":"Sex. Transm. Dis."},{"key":"ref_103","doi-asserted-by":"crossref","unstructured":"Dezzutti, C.S., Brown, E.R., Moncla, B., Russo, J., Cost, M., Wang, L., Uranker, K., Kunjara Na Ayudhya, R.P., Pryke, K., and Pickett, J. (2012). Is wetter better? An evaluation of over-the-counter personal lubricants for safety and anti-HIV-1 activity. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0048328"},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Sharma, P., Shahabi, K., Spitzer, R., Farrugia, M., Kaul, R., and Yudin, M. (2018). Cervico-vaginal inflammatory cytokine alterations after intrauterine contraceptive device insertion: A pilot study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0207266"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"e13287","DOI":"10.1111\/aji.13287","article-title":"Zim CHIC: A cohort study of immune changes in the female genital tract associated with initiation and use of contraceptives","volume":"84","author":"Achilles","year":"2020","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1016\/j.contraception.2007.01.020","article-title":"Copper-T intrauterine device and levonorgestrel intrauterine system: Biological bases of their mechanism of action","volume":"75","author":"Ortiz","year":"2007","journal-title":"Contraception"},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"622.e1","DOI":"10.1016\/j.ajog.2018.02.017","article-title":"Impact of contraceptive initiation on vaginal microbiota","volume":"218","author":"Achilles","year":"2018","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1136\/bmjsrh-2019-200509","article-title":"Hormonal contraception and HIV acquisition among women: An updated systematic review","volume":"46","author":"Curtis","year":"2020","journal-title":"BMJ Sex. Reprod. Health"},{"key":"ref_109","doi-asserted-by":"crossref","unstructured":"Morrison, C.S., Chen, P.L., Kwok, C., Baeten, J.M., Brown, J., Crook, A.M., Van Damme, L., Delany-Moretlwe, S., Francis, S.C., and Friedland, B.A. (2015). Hormonal contraception and the risk of HIV acquisition: An individual participant data meta-analysis. PLoS Med., 12.","DOI":"10.1371\/journal.pmed.1001778"},{"key":"ref_110","unstructured":"Evidence for Contraceptive Options, and HIV Outcomes (ECHO) Trial Consortium (2019). HIV incidence among women using intramuscular depot medroxyprogesterone acetate, a copper intrauterine device, or a levonorgestrel implant for contraception: A randomised, multicentre, open-label trial. Lancet, 394, 303\u2013313."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/S1473-3099(15)00429-6","article-title":"Association between injectable progestin-only contraceptives and HIV acquisition and HIV target cell frequency in the female genital tract in South African women: A prospective cohort study","volume":"16","author":"Byrne","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1298","DOI":"10.1056\/NEJMoa0802556","article-title":"Male circumcision for the prevention of HSV-2 and HPV infections and syphilis","volume":"360","author":"Tobian","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1001\/jama.2011.1431","article-title":"The medical benefits of male circumcision","volume":"306","author":"Tobian","year":"2011","journal-title":"JAMA"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/S0140-6736(10)61967-8","article-title":"Effect of circumcision of HIV-negative men on transmission of human papillomavirus to HIV-negative women: A randomised trial in Rakai, Uganda","volume":"377","author":"Wawer","year":"2011","journal-title":"Lancet"},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.1086\/652184","article-title":"Male circumcision decreases acquisition and increases clearance of high-risk human papillomavirus in HIV-negative men: A randomized trial in Rakai, Uganda","volume":"201","author":"Gray","year":"2010","journal-title":"J. Infect. Dis."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s40168-021-01185-9","article-title":"Immune milieu and microbiome of the distal urethra in Ugandan men: Impact of penile circumcision and implications for HIV susceptibility","volume":"10","author":"Galiwango","year":"2022","journal-title":"Microbiome"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/S1473-3099(18)30058-6","article-title":"Evaluation of the association between the concentrations of key vaginal bacteria and the increased risk of HIV acquisition in African women from five cohorts: A nested case-control study","volume":"18","author":"McClelland","year":"2018","journal-title":"Lancet Infect. Dis."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.immuni.2016.12.013","article-title":"Lactobacillus-Deficient Cervicovaginal Bacterial Communities Are Associated with Increased HIV Acquisition in Young South African Women","volume":"46","author":"Gosmann","year":"2017","journal-title":"Immunity"},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"e147363","DOI":"10.1172\/jci.insight.147363","article-title":"Penile bacteria associated with HIV seroconversion, inflammation, and immune cells","volume":"6","author":"Prodger","year":"2021","journal-title":"JCI Insight"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"e00996-17","DOI":"10.1128\/mBio.00996-17","article-title":"Penile Anaerobic Dysbiosis as a Risk Factor for HIV Infection","volume":"8","author":"Liu","year":"2017","journal-title":"MBio"},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1067\/mob.2002.125280","article-title":"Antimicrobial components of vaginal fluid","volume":"187","author":"Valore","year":"2002","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_122","doi-asserted-by":"crossref","unstructured":"Mirmonsef, P., Hotton, A.L., Gilbert, D., Gioia, C.J., Maric, D., Hope, T.J., Landay, A.L., and Spear, G.T. (2016). Glycogen Levels in Undiluted Genital Fluid and Their Relationship to Vaginal pH, Estrogen, and Progesterone. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0153553"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1111\/aji.12232","article-title":"The barrier to HIV transmission provided by genital tract Lactobacillus colonization","volume":"71","author":"Mirmonsef","year":"2014","journal-title":"Am. J. Reprod. Immunol."},{"key":"ref_124","doi-asserted-by":"crossref","unstructured":"O\u2019Hanlon, D.E., Moench, T.R., and Cone, R.A. (2011). In vaginal fluid, bacteria associated with bacterial vaginosis can be suppressed with lactic acid but not hydrogen peroxide. BMC Infect. Dis., 11.","DOI":"10.1186\/1471-2334-11-200"},{"key":"ref_125","doi-asserted-by":"crossref","unstructured":"O\u2019Hanlon, D.E., Moench, T.R., and Cone, R.A. (2013). Vaginal pH and microbicidal lactic acid when lactobacilli dominate the microbiota. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0080074"},{"key":"ref_126","doi-asserted-by":"crossref","unstructured":"Gong, Z., Luna, Y., Yu, P., and Fan, H. (2014). Lactobacilli inactivate Chlamydia trachomatis through lactic acid but not H2O2. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0107758"},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"29024","DOI":"10.1038\/srep29024","article-title":"Lactobacillus crispatus inhibits the infectivity of Chlamydia trachomatis elementary bodies, in vitro study","volume":"6","author":"Nardini","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1476-0711-10-8","article-title":"The role of acidification in the inhibition of Neisseria gonorrhoeae by vaginal lactobacilli during anaerobic growth","volume":"10","author":"Graver","year":"2011","journal-title":"Ann. Clin. Microbiol. Antimicrob."},{"key":"ref_129","doi-asserted-by":"crossref","unstructured":"Breshears, L.M., Edwards, V.L., Ravel, J., and Peterson, M.L. (2015). Lactobacillus crispatus inhibits growth of Gardnerella vaginalis and Neisseria gonorrhoeae on a porcine vaginal mucosa model. BMC Microbiol., 15.","DOI":"10.1186\/s12866-015-0608-0"},{"key":"ref_130","doi-asserted-by":"crossref","first-page":"e01548-19","DOI":"10.1128\/mBio.01548-19","article-title":"The Cervicovaginal Microbiota-Host Interaction Modulates Chlamydia trachomatis Infection","volume":"10","author":"Edwards","year":"2019","journal-title":"mBio"},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1089\/aid.2018.0304","article-title":"The Evolving Facets of Bacterial Vaginosis: Implications for HIV Transmission","volume":"35","author":"McKinnon","year":"2019","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"2374","DOI":"10.1093\/aje\/kwab147","article-title":"Perceived Stress and Molecular-BV in the NIH Longitudinal Study of Vaginal Flora","volume":"190","author":"Turpin","year":"2021","journal-title":"Am. J. Epidemiol."},{"key":"ref_133","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1186\/s40168-020-00934-6","article-title":"VALENCIA: A nearest centroid classification method for vaginal microbial communities based on composition","volume":"8","author":"France","year":"2020","journal-title":"Microbiome"},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"e00234-20","DOI":"10.1128\/MRA.00234-20","article-title":"Complete Genome Sequences of Six Lactobacillus iners Strains Isolated from the Human Vagina","volume":"9","author":"France","year":"2020","journal-title":"Microbiol. Resour. Announc."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/2049-2618-1-29","article-title":"Daily temporal dynamics of vaginal microbiota before, during and after episodes of bacterial vaginosis","volume":"1","author":"Ravel","year":"2013","journal-title":"Microbiome"},{"key":"ref_136","doi-asserted-by":"crossref","first-page":"106","DOI":"10.3389\/fcimb.2020.00106","article-title":"Asymptomatic Bacterial Vaginosis Is Associated With Depletion of Mature Superficial Cells Shed From the Vaginal Epithelium","volume":"10","author":"Gajer","year":"2020","journal-title":"Front. Cell Infect. Microbiol."},{"key":"ref_137","doi-asserted-by":"crossref","unstructured":"Zevin, A.S., Xie, I.Y., Birse, K., Arnold, K., Romas, L., Westmacott, G., Novak, R.M., McCorrister, S., McKinnon, L.R., and Cohen, C.R. (2016). Microbiome Composition and Function Drives Wound-Healing Impairment in the Female Genital Tract. PLoS Pathog., 12.","DOI":"10.1371\/journal.ppat.1005889"},{"key":"ref_138","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.cmi.2018.04.019","article-title":"The vaginal microbiota and its association with human papillomavirus, Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium infections: A systematic review and meta-analysis","volume":"25","author":"Tamarelle","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_139","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1093\/cid\/ciy762","article-title":"Impact of Standard Bacterial Vaginosis Treatment on the Genital Microbiota, Immune Milieu, and Ex Vivo Human Immunodeficiency Virus Susceptibility","volume":"68","author":"Joag","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_140","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1086\/367658","article-title":"Bacterial vaginosis is a strong predictor of Neisseria gonorrhoeae and Chlamydia trachomatis infection","volume":"36","author":"Wiesenfeld","year":"2003","journal-title":"Clin. Infect. Dis."},{"key":"ref_141","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1086\/657320","article-title":"Bacterial vaginosis assessed by gram stain and diminished colonization resistance to incident gonococcal, chlamydial, and trichomonal genital infection","volume":"202","author":"Brotman","year":"2010","journal-title":"J. Infect. Dis."},{"key":"ref_142","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1067\/mob.2003.339","article-title":"Bacterial vaginosis as a risk factor for preterm delivery: A meta-analysis","volume":"189","author":"Leitich","year":"2003","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_143","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/0002-9378(88)90078-6","article-title":"Diagnosis and clinical manifestations of bacterial vaginosis","volume":"158","author":"Eschenbach","year":"1988","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_144","doi-asserted-by":"crossref","first-page":"354","DOI":"10.3389\/fcimb.2020.00354","article-title":"Bacterial Vaginosis: Current Diagnostic Avenues and Future Opportunities","volume":"10","author":"Redelinghuys","year":"2020","journal-title":"Front. Cell Infect. Microbiol."},{"key":"ref_145","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/0029-7844(96)00233-5","article-title":"Validity of the vaginal gram stain for the diagnosis of bacterial vaginosis","volume":"88","author":"Schwebke","year":"1996","journal-title":"Obstet. Gynecol."},{"key":"ref_146","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1016\/j.immuni.2015.04.019","article-title":"Cervicovaginal bacteria are a major modulator of host inflammatory responses in the female genital tract","volume":"42","author":"Anahtar","year":"2015","journal-title":"Immunity"},{"key":"ref_147","doi-asserted-by":"crossref","first-page":"e00589","DOI":"10.1128\/mBio.00589-15","article-title":"Penile Microbiota and Female Partner Bacterial Vaginosis in Rakai, Uganda","volume":"6","author":"Liu","year":"2015","journal-title":"MBio"},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"e00076","DOI":"10.1128\/mBio.00076-13","article-title":"Male circumcision significantly reduces prevalence and load of genital anaerobic bacteria","volume":"4","author":"Liu","year":"2013","journal-title":"MBio"},{"key":"ref_149","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/S0140-6736(07)60312-2","article-title":"Male circumcision for HIV prevention in young men in Kisumu, Kenya: A randomised controlled trial","volume":"369","author":"Bailey","year":"2007","journal-title":"Lancet"},{"key":"ref_150","doi-asserted-by":"crossref","unstructured":"Auvert, B., Taljaard, D., Lagarde, E., Sobngwi-Tambekou, J., Sitta, R., and Puren, A. (2005). Randomized, controlled intervention trial of male circumcision for reduction of HIV infection risk: The ANRS 1265 Trial. PLoS Med., 2.","DOI":"10.1371\/journal.pmed.0020298"},{"key":"ref_151","doi-asserted-by":"crossref","unstructured":"Armstrong, E., Hemmerling, A., Miller, S., Burke, K.E., Newmann, S.J., Morris, S.R., Reno, H., Huibner, S., Kulikova, M., and Liu, R. (2022). Metronidazole treatment rapidly reduces genital inflammation through effects on bacterial vaginosis-associated bacteria rather than lactobacilli. J. Clin. Investig., 132.","DOI":"10.1172\/JCI152930"}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/6\/1164\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:19:53Z","timestamp":1760138393000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/14\/6\/1164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,27]]},"references-count":151,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["v14061164"],"URL":"https:\/\/doi.org\/10.3390\/v14061164","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,27]]}}}