Factors associated with subsequent Trichomonas vaginalis positivity among HIV-infected women
Description
Trichomonas vaginalis infection is the most common non-viral sexually transmitted disease (STD) and is capable of harming the reproductive system and amplifying the transmission of human immunodeficiency virus (HIV). T. vaginalis infection among HIV-infected women has public health as well as clinical implications; it has been associated with HIV transmission, diverse symptoms, and adverse outcomes of pregnancy. The purpose of this study was to characterize demographic, clinical, and behavioral factors associated with T. vaginalis positivity The study was conducted in three parts: two non-concurrent cohort studies using the Adult Spectrum of Disease database and medical records, and a cross-sectional survey of women. Longitudinal analytic methods including Generalized Estimating Equations were used The majority (67.6%) of subjects were 35 years of age or under, African-American (83.2%), had stable immune status (CD4 ≥ 200 cells/mul) (57.8%), and were identified as being infected via heterosexual exposure or unidentified risk (72.2%). Of 1578 women, 30.2% had T. vaginalis at least once; over a third (36.9%) of those women had at least one subsequent infection. Out of 786 infections, 61.7% were among women with one or more previous positive. The incidence of initial T. vaginalis infection was 8.9 per 100 person-years and that of subsequent positivity 16.4 per 100 person-years. After adjusting for confounders, age less than 22, African-American race, substance abuse, and other STDs were associated wish incident T. vaginalis , and age 22 years or older and increased follow-up time were predictors of and pregnancy was protective of subsequent T. vaginalis positivity The survey suggests that sexual behavior plays a role in subsequent T. vaginalis positivity: 27.3% of women reported never using condoms with specific partners and 44.4% reported no condom use at last sexual encounter. Only half of the women reported informing their partners about the need for treatment and 20.8% reported non-adherence with T. vaginalis treatment The results of this study further our understanding of the epidemiology T. vaginalis, and suggest that improved screening and re-screening of high-risk populations is necessary to reduce the burden of T. vaginalis . These findings will be useful in innovating public health interventions to reduce this common STD