# Mechanisms underlying recurrent bacterial vaginosis and HIV risk A Multidisciplinary approach

> **NIH NIH R01** · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · 2020 · $731,817

## Abstract

Abstract
Bacterial vaginosis (BV), the most common health condition affecting the female reproductive tract,
significantly increases the risk of HIV and STI acquisition in women. BV is characterized by changes in the
composition of the vaginal bacteria (microbiota), with a reduction in healthy vaginal Lactobacillus species and
an increase in gram negative anaerobic bacteria. Women with BV have impaired female reproductive tract
mucosal immune responses with increased HIV target cells, as well as decreased epithelial integrity; all which
lead to increased HIV risk. Furthermore, a recent study demonstrated that BV-associated bacteria can directly
hydrolyze drugs used for HIV prevention, setting up conditions that undermine treatment efficacy. Current
antibiotic-based treatments for BV result in failure of treatment or recurrence in the majority of women.
Behavioral (sexual behaviors and intravaginal hygiene practices such as intravaginal douching), bacterial
factors (microbiome and virome), and host biological factors (mucosal immune responses and inflammation),
all may underscore BV recurrence. In this study, we will assess the mechanisms underlying BV recurrence in a
unique cohort of reproductive age women (18-45 years) with BV. Reproductive age women with BV will be
provided BV treatment and followed longitudinally (one and six months post-BV treatment). Study aims are: 1)
To evaluate the role of intravaginal hygiene practices on BV recurrence; 2) To evaluate the role of the vaginal
microbiome and virome, and antibiotic metabolism by vaginal bacteria, on BV recurrence; and 3) To evaluate
the role of host biological factors on BV recurrence. To our knowledge, this is the first study to mechanistically
assess factors that underlie BV recurrence in vivo in a longitudinal study, and specifically, using a
comprehensive, multidisciplinary approach (behavioral, microbiological, and immunological). We will use
cutting edge technologies to measure these potential mechanisms relative to BV recurrence. Study results will
be critical to develop targeted intervention strategies to prevent BV recurrence and thus, better protect women
from HIV and STIs.

## Key facts

- **NIH application ID:** 9970187
- **Project number:** 5R01AI138718-03
- **Recipient organization:** UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
- **Principal Investigator:** MARIA LUISA ALCAIDE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $731,817
- **Award type:** 5
- **Project period:** 2018-08-20 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9970187

## Citation

> US National Institutes of Health, RePORTER application 9970187, Mechanisms underlying recurrent bacterial vaginosis and HIV risk A Multidisciplinary approach (5R01AI138718-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9970187. Licensed CC0.

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