title: The influence of sexual activity on the vaginal microbiota and Gardnerella vaginalis clade diversity in young women.
abstract: OBJECTIVE
  To examine the influence of sexual activity on the composition and consistency of the vaginal microbiota over time, and distribution of Gardnerella vaginalis clades in young women.
  
  
  METHODS
  Fifty-two participants from a university cohort were selected. Vaginal swabs were self-collected every 3-months for up to 12 months with 184 specimens analysed. The vaginal microbiota was characterised using Roche 454 V3/4 region 16S rRNA sequencing, and G.vaginalis clade typing by qPCR.
  
  
  RESULTS
  A Lactobacillus crispatus dominated vaginal microbiota was associated with Caucasian ethnicity (adjusted relative risk ratio[ARRR] = 7.28, 95%CI:1.37,38.57,p = 0.020). An L.iners (ARRR = 17.51, 95%CI:2.18,140.33,p = 0.007) or G.vaginalis (ARRR = 14.03, 95%CI:1.22,160.69, p = 0.034) dominated microbiota was associated with engaging in penile-vaginal sex. Microbiota dominated by L.crispatus, L.iners or other lactobacilli exhibited greater longitudinal consistency of the bacterial communities present compared to ones dominated by heterogeneous non-lactobacilli (p<0.030); sexual activity did not influence consistency. Women who developed BV were more likely to have clade GV4 compared to those reporting no sex/practiced non-coital activities (OR = 11.82, 95%CI:1.87,74.82,p = 0.009). Specimens were more likely to contain multiple G.vaginalis clades rather than a single clade if women engaged in penile-vaginal sex (RRR = 9.55, 95%CI:1.33,68.38,p = 0.025) or were diagnosed with BV (RRR = 31.5, 95%CI:1.69,586.87,p = 0.021).
  
  
  CONCLUSIONS
  Sexual activity and ethnicity influenced the composition of the vaginal microbiota of these young, relatively sexually inexperienced women. Women had consistent vaginal microbiota over time if lactobacilli were the dominant spp. present. Penile-vaginal sex did not alter the consistency of microbial communities but increased G.vaginalis clade diversity in young women with and without BV, suggesting sexual transmission of commensal and potentially pathogenic clades.
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Carlton, Melbourne, Australia.|Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.|Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria.|Department of Molecular Microbiology, Murdoch Children's Research Institute, Melbourne, Australia.
authors.forename: Lenka A
authors.identifier: http://orcid.org/0000-0003-3679-9195
authors.initials: LA
authors.lastname: Vodstrcil
authors.affiliation: Department of Molecular Microbiology, Murdoch Children's Research Institute, Melbourne, Australia.|Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Melbourne, Australia.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Twin
authors.affiliation: Department of Molecular Microbiology, Murdoch Children's Research Institute, Melbourne, Australia.|Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Melbourne, Australia.|Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Garland
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Carlton, Melbourne, Australia.|Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Fairley
authors.affiliation: Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Hocking
authors.affiliation: The Kirby Institute, University of New South Wales, Darlinghurst, Australia.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Law
authors.affiliation: Department of Molecular Microbiology, Murdoch Children's Research Institute, Melbourne, Australia.|Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Melbourne, Australia.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Plummer
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Carlton, Melbourne, Australia.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Fethers
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Carlton, Melbourne, Australia.|Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
authors.forename: Eric P F
authors.initials: EP
authors.lastname: Chow
authors.affiliation: Department of Molecular Microbiology, Murdoch Children's Research Institute, Melbourne, Australia.|Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Melbourne, Australia.|Department of Microbiology, The Royal Children's Hospital, Melbourne, Australia.
authors.forename: Sepehr N
authors.initials: SN
authors.lastname: Tabrizi
authors.affiliation: Melbourne Sexual Health Centre, Alfred Health, Carlton, Melbourne, Australia.|Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.|Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria.
authors.forename: Catriona S
authors.initials: CS
authors.lastname: Bradshaw
mesh_terms: D000293:Adolescent; D044466:Asian People; D001315:Australia; D044822:Biodiversity; D003075:Coitus / Q000502:physiology; D005260:Female; D006194:Gardnerella vaginalis / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007778:Lactobacillus / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D008137:Longitudinal Studies; D008297:Male; D064307:Microbiota / Q000235:genetics*; D010802:Phylogeny; D012336:RNA, Ribosomal, 16S / Q000235:genetics*; D014621:Vagina / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000208:ethnology / Q000382:microbiology; D044465:White People; D055815:Young Adult
chemical_list: D012336:RNA, Ribosomal, 16S