The epidemiology of sexually transmitted infections (STI) is constantly evolving, and the mechanisms of infection risk in the oral cavity (OC) are poorly characterized. Evidence indicates that microbial community (microbiota) compositions vary widely between the OC, genitalia and the intestinal and rectal mucosa, and microbiome-associated STI susceptibility may also similarly vary. The opioid misuse epidemic is at an epidemic scale, with >11 million US residents misusing in the past 30 days. Opioids can substantially influence HIV progression, microbiota composition and immune function, and these three factors are all mutually influential via direct and indirect pathways. While many of these pathways have been explored independently, the supporting data are mostly derived from studies of gut and vaginal microbiotas and non-STI infectious agents. Our purpose is to describe what is known about the combination of these pathways, how they may influence microbiome composition, and how resultant oral STI susceptibility may change. A better understanding of how opioid misuse influences oral microbiomes and STI risk may inform better mechanisms for oral STI screening and intervention. Further, the principles of interaction described may well be applied to other aspects of disease risk of other health conditions which may be impacted by the opioid epidemic.

中文翻译：

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不断变化的阿片类药物滥用和HIV感染的流行病如何通过微生物组调节改变口服性传播感染的风险。

性传播感染（STI）的流行病学在不断发展，口腔（OC）感染风险的机制尚不明确。有证据表明，OC，生殖器以及肠粘膜和直肠粘膜之间的微生物群落（微生物群）组成差异很大，与微生物组相关的STI敏感性也可能相似地变化。阿片类药物滥用流行是一种流行病，过去30天内有超过1100万美国居民滥用。阿片类药物可以极大地影响HIV的进程，微生物群的组成和免疫功能，这三个因素都通过直接和间接途径相互影响。尽管已经独立探索了许多这些途径，但支持数据主要来自肠道和阴道微生物群以及非STI感染因子的研究。我们的目的是描述有关这些途径的组合的已知信息，它们如何影响微生物组组成，以及口腔STI易感性如何变化。更好地了解阿片类药物滥用如何影响口腔微生物群和性传播感染风险，可能会为口腔性传播感染筛查和干预提供更好的机制。此外，所描述的相互作用原理可以很好地应用于可能受到阿片类药物流行影响的其他健康状况的疾病风险的其他方面。