[In Depth] Vaginal microbiome affects HIV risk

South African teen girls and young women have astonishingly high rates of HIV infection, and researchers for years have suspected that there might be biological factors making them unusually susceptible to infection. New studies presented at the International AIDS Conference being held in Durban, South Africa—located in KwaZulu-Natal province, the hardest hit region in the country—suggest a possible culprit, Prevotella bivia, a bacterium found in the vagina that causes inflammation. The close examination of the vaginal microbiome found a second bacterium, Gardnerella, may help explain why a microbicide gel that contained the anti-HIV drug tenofovir failed to protect many uninfected women who used it in a clinical trial. In test tube experiments, Garnderella "gobbled up" tenofovir, rapidly reducing levels of the drug. Author: Jon Cohen

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