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The Penis, the Vagina and HIV Risk: Key Differences (Aside from the Obvious).

Authors:
Rupert Kaul Cindy M Liu Daniel E Park Ronald M Galiwango Aaron A R Tobian Jessica L Prodger

Viruses 2022 05 27;14(6). Epub 2022 May 27.

Department of Microbiology and Immunology, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada.

Globally, most Human Immunodeficiency Virus type 1 (HIV) transmission occurs through vaginal-penile sex (heterosexual transmission). 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., ) 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-i.e., the optimal microbiota-are very different at the two sites. In the vagina, spp. are immunoregulatory and may protect against HIV acquisition, whereas on the penis, "skin type" flora such as 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.

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http://dx.doi.org/10.3390/v14061164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227947PMC
May 2022

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