Figure 2.

Associations of Lactobacillus dominance with race, vaginal pH, HPV status, and socioeconomic and lifestyle factors. Stacked bar plots show the number of participants with Lactobacillus-dominant microbiota or dysbiotic Lactobacillus-depleted microbiota among the groups based on A, race, B, vaginal pH, C, HPV status, D, age, E, BMI, F, size of household, G, education level, H, number of pregnancies, and I, marital status. P values were calculated using Fisher’s exact test. Vaginal microbiota profiles were dominated by Lactobacillus species in 44% of Native American women, which was similar to levels observed in non-Native American participants (58%). Lactobacillus dominance was highly associated with low vaginal pH (≤4.5). HPV-positive women also tended to have lower Lactobacillus abundance compared with HPV-negative women. Vaginal microbiota profiles were also more frequently dominated by Lactobacillus species in participants with BMI < 25, living in smaller households (1–3 people), having a college (bachelor’s, master’s, and doctorate) or associate/technical degree, who were nulliparous, married or living with a partner. No difference was observed between the younger and older participants (dichotomized based on the median age).