Studies employing 16S rRNA sequencing to evaluate the cervicovaginal microbiota suggest that high-intensity urinary S. haematobium infection, in the absence of investigation for genital involvement, may alter cervicovaginal microbiota diversity. In addition, studies reporting qPCR-defined FGS have either not investigated or reported STI prevalence or STI prevalence has been correlated with visual FGS findings. In this cross-sectional study we utilized qPCR to detect Schistosoma DNA in the female genital tract and evaluated the association of PCR-defined FGS with the concentration and presence of key markers of the cervicovaginal microbiota, including STI.

The cross-sectional bilharzia and HIV (BILHIV) study was nested in HPTN 071 (PopART), a cluster randomized trial to measure the impact of an HIV-1 combination prevention package. In HPTN 071 (PopART), HIV-1 incidence was measured in a Population Cohort at baseline, 12, 24, and 36 months. Between January and August 2018, after the 36-month HPTN 071 (PopART) visit, community workers made home visits to women expressing interest in the BILHIV study. Eligible women were 18-31 years, not pregnant, sexually active, and resident in one of two urban communities that participated in HPTN 071 (PopART) in Livingstone, Zambia.