Figure 5.

The effect of the vaginal microbiome at baseline on the abundance of Th17-like cells in women randomized to the Cu-IUD (n = 17; red), DMPA-IM (n = 17; blue), or LNG implant (n = 13; green). (A) Relative abundance of the different vaginal bacterial species in each participant at baseline, where data were available (n = 47). The CSTs are shown above the panel. The color of the dots at the bottom of the panel indicates which contraceptive arm the participant was randomized to (red for CU-IUD, blue for DMPA-IM, and green for LNG implant). (B) Th17 cell frequency before and after initiation of contraception in women with a Lactobacillus-dominant (CSTs III-A or I-B; n = 15) or non–Lactobacillus-dominant microbiome (CSTs IV-A, IV-B, or IV-D; n = 32). Statistical comparisons were performed using the Wilcoxon matched-pairs tests. (C) The cross-sectional comparison of Th17 frequency post-contraceptive initiation across study arms in women with a Lactobacillus-dominant or non–Lactobacillus-dominant microbiome. Statistical comparisons were performed using Kruskal–Wallis with false discovery rate correction. (D) Linear associations between women with Lactobacillus-dominant microbiomes at baseline (pre) and at month 1 post–DMPA-IM (post) and Th17-like cell abundance post–DMPA-IM initiation. The associations are shown as a β-coefficient with error bars representing the 95% confidence interval. Abbreviations: CST, community state type; Cu-IUD, copper T intrauterine device; DMPA-IM, intramuscular depot medroxyprogesterone acetate; HIV, human immunodeficiency virus; LNG, 2-rod levonorgestrel; Th17, T-helper 17.