Project Leader:  Dr. Carl Yeoman | Montana State University

Abstract

American Indian populations have some of the poorest sexual and reproductive health outcomes in the United States. One critical factor underlying urogenital health and of potential importance to AI reproductive and gynecologic complications is the state of the vaginal microbial community. Typically Lactobacillus spp. dominate the vaginal microbiota of reproductive age women and by fermenting derivatives of vaginal glycogen produce large quantities of lactic acid that maintain an acidic (pH ~3.5 – 4.5) environment. The bacteriocidal effects of the lactic acid and low pH limits the colonizing potential and outgrowth of potential pathogens and is considered one of the primary barriers for the maintenance of reproductive and gynecological health.

Reductions in vaginal lactobacilli (vaginal dysbiosis) is associated with increased risks of urogenital infection and reproductive complications. The urogenital microbiota of AI women remains to be determined and therefore its role in predisposing these individuals to the reproductive and gynecological morbidities that are exacerbated in this population is unclear.

Herein, we propose a single project that will for the first time provide insight into the distributions of vaginal microbiota among AI women and explore a contemporary biochemical-based mechanistic hypothesis that links dysbiosis of the vaginal microbiota, to psychosocial, environmental, and behavioral factors, and risk of urogenital infection. This project represents the culmination of substantial effort over the past year to engage AI communities and build the underlying foundation to ensure this project will succeed. To achieve this we have assembled expertise in both basic and social science disciplines, a community advisory board, and FPCC faculty. The project will be embedded within a community-based participatory research framework and will additionally provide a model for working with indigenous populations on a culturallysensitive topic.