Abstract Background: The cervicovaginal microbiota (CVM) is characterized by low microbial diversity and dominance of protective Lactobacillus species. Previous research indicates that contraceptive use may impact the CVM in both positive and negative ways. However, the effect of sterilization through bilateral partial salpingectomy—a method of contraception—on the CVM has not been directly investigated. This procedure may alter the CVM by disrupting the natural microbial continuum along the reproductive tract. Changes in the CVM can contribute to persistent Human Papillomavirus (HPV) infection, a key factor in the development of cervical lesions. This study evaluates how contraceptive use and sterilization influence the CVM among Hispanic women in Puerto Rico, considering their HPV status and varying levels of cervical disease. Methods: A cohort of 237 non-pregnant, non-menopausal women between the ages of 21 and 54 years was recruited. Questionnaire data provided information regarding contraceptive use and sterilization status. Cervicovaginal swab samples were collected for genomic DNA extraction, followed by 16S rRNA amplicon sequencing using Illumina MiSeq and HPV genotyping using SPF10-LiPA. Cervical phenotype was assessed through a clinical interpretation of cervical cytology and HPV typing. Microbial assessment was performed downstream using a Greengenes2 extended reference database through QIITA and QIIME2, while visualizations were performed with RStudio. Results: The cohort was divided into two groups based on contraceptive use: those who had never used contraceptives (n = 54) and those who had used any form of contraceptive (n = 181). A sub-cohort analysis focusing on sterilization status was also conducted (n = 75), classifying participants as either sterilized (n = 64) or non-sterilized (n = 11). Patients who had never used contraceptives had higher microbial richness (Chao1; Kruskal-Wallis p-value=0.016) and diversity (Shannon; Kruskal-Wallis p-value=0.015) when compared to patients who had used any type of contraceptives. Among women who had high-grade squamous intraepithelial lesions (n=42), those who had never used contraceptives had significantly higher levels of Chao and Shannon diversity when compared to women who had used any contraceptives. Significant differences in beta diversity were also observed between sterilized and non-sterilized women (p-value=0.001). Sterilized patients had higher levels of Lactobacillus iners and lower levels of Gardnerella vaginalis when compared to the non-sterilized group. Conclusion: Contraceptive use and sterilization status are associated with shifts in the cervicovaginal microbiota. Women who never used contraceptives showed greater microbial richness and diversity, particularly among those with high-grade cervical lesions. Sterilized women had distinct microbial profiles, including higher Lactobacillus iners and lower Gardnerella vaginalis. These findings suggest that reproductive interventions may influence HPV persistence and cervical disease risk through microbiome alterations. Citation Format: Jemilly Salas-Cruz, Natalie M. Meléndez-Vázquez, Saadia Jiménez-Ñeco, Desiré Vázquez-Ortíz, Josefina Romaguera, Filipa Godoy-Vitorino. Contraceptive use and sterilization via bilateral partial salpingectomy shift the cervicovaginal microbiota of women in Puerto Rico abstract. In: Proceedings of the 18th AACR Conference on the Science of Cancer Health Disparities; 2025 Sep 18-21; Baltimore, MD. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2025;34(9 Suppl):Abstract nr A138.
Salas-Cruz et al. (Thu,) studied this question.