Sexually Transmitted Infections
The WHO estimated that 1 million new cases of STIs are acquired every day worldwide25. It is known that the vaginal microbiome is more diverse when certain STIs are present, such as chlamydia, HIV, and HPV26–29, a trend that is true across race and ethnicity. It appears that STIs correlate with metabolic differences in the vagina of healthy versus STI communities, namely decreases in lactate, which is produced byLactobacillus , in the STI communities29, though this isn’t always true for BV30. Recent studies exploring Lactobacillus dominance identified an association between STIs and lower abundance of Lactobacillus in people of color31. Historically higher rates of STIs have been reported among minority communities, though this is due to a multitude of structural and behavioral factors32. It should be noted that the healthy reference group in STI-vaginal microbiome studies is often majority white (or race unreported). This means the reference group is significantly more likely to have aLactobacillus dominated community instead of the diverse community. It is currently unexplored how the healthy, diverse microbiome differs from the diverse community when STIs are present, except for documenting the presence of pathogens.