Prevalence and factors associated with Trichomonas vaginalis infection in indigenous Brazilian women.

There is a scarcity of studies on the prevalence of Trichomonas vaginalis (TV) in indigenous populations of Brazil. We conducted a cross-sectional study between January and December 2018, on indigenous women living nearby an urban center of the Midwest region of Brazil and determined the prevalence of TV. Factors associated with TV infection and a comparison of molecular and direct microscopy diagnoses were determined. 241 indigenous women aged above 18 years participated in the study. Cervical and vaginal brush samples were collected to diagnose TV through polymerase chain reaction (PCR). Direct microscopy for detection of TV, and cellular changes was performed. A sociodemographic and behavioral questionnaire was applied at the beginning of the study. All the data were analyzed using Statistical Package for the Social Sciences. The result obtained showed that 27.8% [95% CI: 22.2-33.9] were positive for TV on PCR, while 7.41% [95% CI: 4.1-11] showed positive on direct microscopy. Direct microcopy also found 21 (8.71%) and 8 (3.31%) women infected with Gardnerella vaginalis and Candida albicans, respectively. In addition, 10 women presented atypical squamous cells of unknown significance and 14 lesions suggestive of HPV. Single women, under the age of 30 and who do not use condoms, were found to have a greater chance of getting TV infection. The high prevalence TV found in this population is comparable to highly vulnerable populations, as prisoners, sex workers and women in regions with low socioeconomic levels, moreover, seems to be an underdiagnosis of this infection. Therefore, a routine test program, as well as a review of the diagnostic method used, is encouraged for proper management.

Prevalence and risk factors for Trichomonas vaginalis infection among adults in the U.S., 2013-2014.

OBJECTIVE: Trichomonas vaginalis (TV) infection is common, curable, and associated with significant reproductive morbidity and risk for HIV infection. This analysis updates estimates of the prevalence of asymptomatic TV infection, and its associated risk factors, in the non-institutionalized U.S. population. METHODS: We analyzed data from 4057 individuals who participated in the National Health and Nutrition Examination Survey (NHANES) 2013-2014 data collection cycle. Participant interviews ascertained demographic characteristics, self-reported tobacco use, and sexual history. Self-collected urine specimens from participants aged 18 to 59 years were tested for TV infection using the Gen-Probe Aptima TV assay. Cotinine was assayed from serum to provide a biomarker of recent tobacco exposure. Weighted percentages are provided to account for unequal selection probabilities among participants and adjustments for non-response. RESULTS: Our sample included 1942 men (49.2%, 95% Confidence Interval [CI] 48.0-50.5) and 2115 women (50.8%, 95%CI 49.5-52.0). The infection prevalence among men was 0.5% (n = 16; 95%CI 0.2-1.0) and 1.8% (n = 55; 95%CI 1.1-3.1) in women. After controlling for participant characteristics associated with TV infection, females had a 5.2-fold increased odds of being infected compared to men (adjusted odds ratio (aOR) 5.2, 95% CI 2.4-11.4). Non-Hispanic blacks were more likely to be infected compared to non-Hispanic whites (aOR 11.2, 95% CI 4.6-27.2). Individuals below the federal poverty level were more likely to be infected compared to those earning >3 times the federal poverty level (aOR 6.7, 95% CI 1.7-26.6), and active smokers were more likely to be infected compared to participants with no nicotine exposure (aOR 8.7, 95% CI 4.1-18.2). CONCLUSION: Trichomonas vaginalis infection continues to be relatively common, especially in women, smokers, non-Hispanic blacks, and in groups of lower socioeconomic status. Identifying the demographic characteristics of populations in the United States disproportionately affected by TV could impact screening and treatment of this infection in clinical practice. Further research on whether screening and treating for asymptomatic TV infection in high-risk populations improves risk for reproductive morbidity and HIV infection is warranted.

Prevalence of Trichomonas vaginalis Among Civilian, Noninstitutionalized Male and Female Population Aged 14 to 59 Years: United States, 2013 to 2016.

Among the US civilian noninstitutionalized population aged 14 to 59 years in 2013 to 2016, prevalence of Trichomonas vaginalis infection in urine was 1.3% overall. Prevalence was 2.1% among females, 0.5% among males, and highest at 9.6% among non-Hispanic black females. Estimate instability limited analysis of factors beyond sex, age, and race/Hispanic ethnicity.

An evaluation study of the Becton-Dickinson ProbeTec Qx (BDQx) Trichomonas vaginalis trichomoniasis molecular diagnostic test in two large, urban STD services.

OBJECTIVES: The BASHH guidelines recommend molecular tests to aid diagnosis of Trichomonas vaginalis (TV) infection; however many clinics continue to use relatively insensitive techniques (pH, wet-prep microscopy (WPM) and culture). Our objectives were to establish a laboratory pathway for TV testing with the Becton-Dickinson Qx (BDQx) molecular assay, to determine TV prevalence and to identify variables associated with TV detection. METHODS: A prospective study of 901 women attending two urban sexual health services for STI testing was conducted. Women were offered TV BDQx testing in addition to standard of care. Data collected were demographics, symptoms, results of near-patient tests and BDQx results for TV, Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). Women with any positive TV result were treated and followed up for test of cure (TOC). RESULTS: 901 women had a TV BDQx test. 472 (53%) were white, 143 (16%) black and 499 (55%) were symptomatic. Infections detected by BDQx were: 11 TV (1.2%), three GC (0.3%) and 44 CT (4.9%). Of the 11 BDQx-detected TV infections, 8 (73%) were in patients of black ethnicity. Of these, four of seven cases (57%) were WPM-positive. All patients received treatment and nine of nine (100%) were BDQx-negative at TOC. In univariate analysis, only black ethnicity was associated with likelihood of a positive TV BDQx result (relative risk (RR) 10.2 (95% CI 2.15 to 48.4)). CONCLUSIONS: The use of the BDQ enhanced detection of TV in asymptomatic and symptomatic populations. Cost-effective implementation of the test will rely on further work to reliably detect demographic and clinical variables that predict positivity.

Demographic and behavioural risk factors associated with Trichomonas vaginalis among South African HIV-positive men with genital ulcer disease: a cross-sectional study.

OBJECTIVES: Demographic and risky sexual behaviours may increase the risk for Trichomonas vaginalis (TV) infection and, thus, enhance HIV transmission to uninfected partners. We assessed the demographic and behavioural risk factors associated with TV among South African HIV-positive men with genital ulcer disease. METHODS: We conducted a cross-sectional study with data from a randomised controlled trial conducted by the Centers for Disease Control and Prevention and the London School of Hygiene and Tropical Medicine. The data were obtained from three primary healthcare clinics in South Africa. At baseline (n=387), participants reported on demographics, sexual behaviour, history of sexually transmitted infections and clinical ulcers. The outcome TV was measured using real-time multiplex PCR assays and a Rotor-gene 3000 platform from the first and past urine samples of all participants. Logistic regression model estimated ORs and 95% CIs adjusted for demographics, sexual risk behaviours and ulcer conditions. RESULTS: An estimated 11.4% of TV was detected among the men. The odds of TV infection were significantly associated with high blister counts (OR 4.0, 95% CI 1.6 to 28, p=0.01), ulcer pain (OR 0.4, 95% CI 0.2 to 0.7, p=0.003), number of days with ulcers (OR 0.4, 95% CI 0.2 to 0.8, p=0.006), sought treatment before coming into clinics (OR 0.07, 95% CI 0.002 to 0.7, p=0.005) and being unqualified worker (OR 2.5, 95% CI 0.9 to 6.7 p=0.05). Multivariate analyses revealed that increased days with ulcers (OR 0.1, 95% CI 0.04 to 0.5, p=0.002) and ulcer pain intensity (OR 0.08, 95% CI 0.007 to 1.1, p=0.05) remained significantly associated with decreased odds of TV infection. Men from the Sotho ethnic group were eight times more likely to have TV infection (OR 8.6, 95% CI 1.3 to 55.7, p<0.02) than men from the other ethnic groups. CONCLUSION: HIV-positive men with severe ulceration should be screened and treated for TV to minimise HIV transmission to uninfected partners.

Vaginal Infections in Haitian Immigrant Women Living in Miami, Florida.

OBJECTIVE: To characterize vulvovaginal candidiasis (VC), trichomonas vaginalis (TV), and bacterial vaginosis (BV) among Haitian women living in Miami to identify contributing factors to cervical cancer disparity in this population. METHODS: Using a CBPR framework, 246 Haitian women (ages 21-65) were recruited. Self-collected cervical cytology specimens were analyzed for VC, TV, and BV. RESULTS: The proportion of participants with VC, TV, and BV, were 7.3%, 9.3%, and 19.9%, respectively. CONCLUSION: Haitian women may have a higher prevalence of TV than the general U.S. population, which may increase susceptibility to HPV, the primary cause of cervical cancer.

A prospective study of Trichomonas vaginalis and prostate cancer risk among African American men.

BACKGROUND: African Americans (AA) have a higher prevalence of Trichomonas vaginalis (Tv) infection and a higher prostate (PC) risk. Past studies suggest an association between Tv seropositivity and PC, and therefore we prospectively investigated this association among AA men. RESULTS: Incident PC cases were individually matched to controls in a nested case-control study within the Southern Community Cohort Study (SCCS). Primary analysis included 296 PC cases and 497 race-matched controls. Levels of Tv antibody response were measured by ELISA in serum collected at baseline. Tv antibody response did not significantly differ between cases and controls overall or within AA participants (253 AA cases). There were no significant associations or trends between levels of Tv response and PC risk or the diagnosis of aggressive PC. CONCLUSION: We found no evidence of a prospective association between baseline Tv infection and PC risk in AA men. Tv infection in men may have substantial health implications in HIV transmission and reproductive outcomes, but may not impact future PC risk in AA men at high-risk for PC. Further efforts need to define past vs. present Tv infection and to separate pathophysiology from PC detection.

Prevalence of chlamydia, gonorrhoea, syphilis and trichomonas in Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis.

Higher notification rates of sexually transmissible infections (STIs) are reported among Aboriginal and Torres Strait Islander (Aboriginal) compared with non-Aboriginal people in Australia. The aim of this study is to estimate the pooled prevalence of chlamydia, gonorrhoea, syphilis and trichomonas among Aboriginal people in Australia by sex, age-group, setting (clinic vs population/community-based) and population group [adults, pregnant females, young people (12-29 years) and prisoners]. The databases Medline, PubMed and Web of Science were searched in May 2015. A meta-analysis was conducted to estimate the pooled prevalence of the four STIs in Aboriginal people and if possible, by gender, age-group, setting and population group. A total of 46 studies were included. The pooled prevalence was 11.2% (95%CI: 9.4-13.0%) for chlamydia (36 studies), 12.5% (95%CI: 10.5-14.6%) for gonorrhoea (28 studies), 16.8% (95%CI: 11.0-22.6%) for syphilis (13 studies) and 22.6% (95%CI: 18.5-26.7%) for trichomonas (11 studies); however, there was significant heterogeneity between studies (I(2) <97.5%, P<0.01). In the subgroup analysis, a higher pooled prevalence occurred in females than males for chlamydia (12.7% vs 7.7%) and gonorrhoea (10.7% vs 8.1%). The prevalence of chlamydia was 12.4% in clinic-based compared with 4.3% in population-based studies. The highest pooled prevalence by population group was among pregnant females (16.8%) and young people (16.2%) for chlamydia, pregnant females (25.2%) for trichomonas; and young people for gonorrhoea (11.9%). This review highlights the need to decrease the prevalence of STIs among Aboriginal people through community-based programs that target asymptomatic young people.

Epidemiology of undiagnosed trichomoniasis in a probability sample of urban young adults.

T. vaginalis infection (trichomoniasis) is the most common curable sexually transmitted infection (STI) in the U.S. It is associated with increased HIV risk and adverse pregnancy outcomes. Trichomoniasis surveillance data do not exist for either national or local populations. The Monitoring STIs Survey Program (MSSP) collected survey data and specimens which were tested using nucleic acid amplification tests to monitor trichomoniasis and other STIs in 2006-09 among a probability sample of young adults (N = 2,936) in Baltimore, Maryland--an urban area with high rates of reported STIs. The estimated prevalence of trichomoniasis was 7.5% (95% CI 6.3, 9.1) in the overall population and 16.1% (95% CI 13.0, 19.8) among Black women. The overwhelming majority of infected men (98.5%) and women (73.3%) were asymptomatic. Infections were more common in both women (OR = 3.6, 95% CI 1.6, 8.2) and men (OR = 9.0, 95% CI 1.8, 44.3) with concurrent chlamydial infection. Trichomoniasis did not vary significantly by age for either men or women. Women with two or more partners in the past year and women with a history of personal or partner incarceration were more likely to have an infection. Overall, these results suggest that routine T vaginalis screening in populations at elevated risk of infection should be considered.

Socioeconomic disparities in sexually transmitted infections among young adults in the United States: examining the interaction between income and race/ethnicity.

BACKGROUND: There is considerable evidence of racial/ethnic patterning of sexually transmitted infection (STI) risk in the United States. There is also evidence that poorer persons are at increased STI risk. Evidence regarding the interaction of race/ethnicity and income is limited, particularly nationally at the individual level. METHODS: We examined the pattern of socioeconomic gradients in STI infection among young people in a nationwide US study and determined how these gradients varied by race/ethnicity. We estimated the cumulative diagnosis prevalence of chlamydia, gonorrhea, or trichomoniasis (via self-report or laboratory confirmation) for young adults (ages, 18-26 years old) Hispanics and non-Hispanic whites, blacks, and others across income quintiles in the Add Health data set. We ran regression models to evaluate these relationships adjusting for individual- and school-level covariates. RESULTS: Sexually transmitted infection diagnosis was independently associated with both racial/ethnic identity and with low income, although the racial/ethnic disparities were much larger than income-based ones. A negative gradient of STI risk with increasing income was present within all racial/ethnic categories, but was stronger for nonwhites. CONCLUSIONS: Both economic and racial/ethnic factors should be considered in deciding how to target STI prevention efforts in the United States. Particular focus may be warranted for poor, racial/ethnic minority women.

Gardnerella, Trichomonas and Candida in cervical smears of 58,904 immigrants participating in the Dutch national cervical screening program.

OBJECTIVE: To report the prevalence of Gardnerella, Trichomonas and Candida in the cervical smears of 9 immigrant groups participating in the Dutch national cervical screening program. STUDY DESIGN: Cervical smears were taken from 58,904 immigrant participants and 498,405 Dutch participants. As part of the routine screening process, all smears were screened for the overgrowth of Gardnerella (i.e. smears with an abundance of clue cells) and for the presence of Trichomonas and Candida. The smears were screened by 6 laboratories, all of which use the Dutch KOPAC coding system. The odds ratio and confidence interval were calculated for the 9 immigrant groups and compared to Dutch participants. RESULTS: Immigrants from Suriname, Turkey and the Dutch Antilles have a 2-5 times higher prevalence of Gardnerella and Trichomonas when compared to native Dutch women. Interestingly, the prevalence of Trichomonas in cervical smears of Moroccan immigrants is twice as high, yet the prevalence of Gardnerella is 3 times lower than in native Dutch women. CONCLUSIONS: Immigrants with a high prevalence of Gardnerella also have a high prevalence of Trichomonas. In the context of the increased risk of squamous abnormalities in smears with Gardnerella, such slides should be screened with extra care.

Incidence of sexually transmitted infections among hazardously drinking women after incarceration.

INTRODUCTION AND BACKGROUND: At the time of incarceration, women have a high prevalence of sexually transmitted infections (STI). In the months after community release, women remain at high risk for new infections. This study assessed the rates and predictors of incident chlamydia, gonorrhea, and trichomoniasis in a sample of hazardously drinking women after incarceration. METHODS: Self-reported behavioral data were collected from 245 incarcerated women. Vaginal swabs were collected at baseline, and 3- and 6-month time points and tested for chlamydia, gonorrhea, and trichomoniasis. Treatment was provided for all positive tests. RESULTS: Participants' mean age was 34.1 years of age; 175 (71.4%) were Caucasian, 47 (19.2%) were African American, 17 (6.9%) were Hispanic, and 6 (2.4%) were of other ethnic origins. The STI incidence rate was estimated to be 30.5 (95% confidence interval, 21.3-43.5) new infections per 100 person-years. Number of male sex partners reported during follow-up was a significant (z = 2.16; p = .03) predictor of STI; each additional male sex partner increased the estimated hazard of STI by 1.26. CONCLUSION: Incarcerated women who are hazardous drinkers are at high risk for STI in the months after their return to the community. In addition to testing and treatment during incarceration, post-release rescreening, education, partner treatment, and follow-up are recommended.

Neighborhood social disorganization and the acquisition of trichomoniasis among young adults in the United States.

OBJECTIVES: We examined relationships between neighborhood social disorganization and trichomoniasis among young US adults. METHODS: We employed multilevel logistic regression modeling with secondary data from wave III of the National Longitudinal Study of Adolescent Health (2001-2002). The dependent variable-trichomoniasis-was measured via urine testing. The measures for neighborhood social disorganization were derived from the 2000 US Census-racial and ethnic composition, concentrated poverty, and residential instability. The sample comprised 11 370 individuals across 4912 neighborhoods. RESULTS: Trichomoniasis was more likely in neighborhoods with higher concentrations of Black residents (adjusted odds ratio [AOR] = 1.16; 95% confidence interval [CI] = 1.03, 1.30). However, this association was mediated by neighborhood concentrated poverty. Furthermore, young adults who lived in neighborhoods with higher concentrations of poverty were significantly more likely to have trichomoniasis (AOR = 1.25; 95% CI = 1.07, 1.46). Neither immigrant concentration nor residential instability was significantly associated with trichomoniasis. CONCLUSIONS: These findings strengthen the evidence that neighborhood structural conditions are associated with individual sexually transmitted infection (STI) acquisition. Research is needed to explore the mechanisms through which these conditions influence STI. In addition, STI-prevention programs that include structural interventions targeting neighborhood disadvantage are needed.

Does education matter? Examining racial differences in the association between education and STI diagnosis among black and white young adult females in the U.S.

OBJECTIVES: Education has long been considered a protective factor against sexual risk behaviors and sexually transmitted infections (STIs) among adolescents; however, few have explored this association and determined differences across racial/ethnic groups of young adult females on a national scale. The purpose of this study was to (1) describe the association between education and STI diagnosis among a national sample of black and white young adult females and (2) examine racial differences in this association. METHODS: We used data from the National Longitudinal Study of Adolescent Health (Add Health) to assess the association between education and chlamydia, gonorrhea, and/or trichomoniasis (self-reported and assay-diagnosed) in 2001-2002 using logistic regression analysis. RESULTS: After adjustment for risk behaviors, education was inversely associated with any assay-diagnosed STI, but this association was nonsignificant among black women for self-reported STI. Additionally, black females enrolled in, or who graduated from, college had significantly higher predicted probabilities of having an STI (12.4% self-reported; 13.4% assay-diagnosed) compared with white females who had less than a high school diploma (6.4% self-reported; 2.3% assay-diagnosed). CONCLUSIONS: Educational status was not uniformly protective against STIs for black and white females in this sample. Particularly for young black women, other factors may play a more prominent role in determining STI risk. Social determinants, such as education, should be viewed as important factors associated with STI prevalence, but their differential impact on various racial/ethnic groups should also be considered when addressing the disproportionate rates of STIs in the U.S.

Screening for Trichomonas vaginalis in high-risk adolescent females with a new transcription-mediated nucleic acid amplification test (NAAT): associations with ethnicity, symptoms, and prior and current STIs.

PURPOSE: The importance of diagnosing trichomoniasis is highlighted by its strong association with HIV acquisition and viral shedding. The low sensitivity of wet preparation and often asymptomatic nature of trichomoniasis results in failure to recognize and treat this sexually transmitted infection. The purpose of this study was to evaluate the feasibility of screening high-risk adolescent females using a new highly sensitive and specific NAAT assay. METHODS: We enrolled a consecutive, clinical sample of 144 sexually active females, aged 13 through 21. Subjects completed a questionnaire on sexual history and current vaginal symptoms, and provided two self- or physician-collected vaginal swabs and urine. A wet preparation test was performed with one swab and the APTIMA Trichomonas vaginalis (ATV) assay (Gen-Probe, Inc.) was performed with the other and with urine. RESULTS: Mean age was 18 +/- 1.6 years; 55% Hispanic and 35% black. A three-fold higher prevalence of trichomoniasis (6.3%) was detected by ATV than by wet preparation (2.1%) with 100% concordance between vaginal swab and urine. Prevalence of chlamydia by APTIMA was 11%; no gonorrhea was detected. Subjects with trichomoniasis were more likely than those without to be black (P < 0.01), and to report past gonorrhea (P < 0.01) and past PID (P < 0.001). No vaginal symptom distinguished those with trichomoniasis. CONCLUSION: Three times as many cases of trichomoniasis were identified with ATV compared to wet preparation and identical results were obtained with vaginal swabs and urine. No symptoms were associated with trichomoniasis. These findings highlight the imperative and feasibility of screening and treating at-risk populations.

Trichomoniasis in cosmopolitan Malaysia: is it under control or is it under diagnosed?

In a prospective, observational study, 380 women attending a family planning (LPPKN) clinic and Sexually Transmitted Diseases (STD) clinic in Kuala Lumpur between January 2008 and November 2008 were enrolled. Patient information was obtained from the medical records and patients voluntarily completed questionnaires. Three vaginal swabs from the posterior fornix were taken from each patient examined. Different staining methods and cultivation in Diamonds medium were performed on the collected samples. Study subjects recruited in this survey were mostly young, with a geometric mean ages of 37.31 years (LPPKN clinic) and 32.06 years (STD clinic). Malay, Chinese, Indians and others ethnic groups accounted for 91, 4, 2 and 3%, respectively, at the LPPKN clinic. At the STD clinic, almost all subjects were Chinese. The prevalence rate of trichomoniasis was 0.36% at the LPPKN clinic and 0.0% at the STD clinic. Our findings suggested no association between contraceptive methods used and trichomoniasis infection at the LPPKN clinic. At the STD clinic, it was found a high risk for STD acquisition was not associated with trichomoniasis positivity. The data demonstrated the prevalence of trichomoniasis was very low at LPPKN clinic and absent at STD clinic. The high prevalence rates of other STD among sex workers found in this survey suggest the need for more active interventions focused on this group.

Sexually transmitted infection is associated with increased risk of preterm birth in South Carolina women insured by Medicaid.

OBJECTIVE: We investigated the association between diagnosed maternal sexually transmitted infections (STIs) and very preterm or late preterm birth in 108,346 South Carolina women receiving medical care purchased by Medicaid from 1996 through 2002, and delivering singleton infants. METHODS: ICD9 codes in South Carolina Medicaid data were used to identify maternal infections. Gestational age was obtained from birth certificates. RESULTS: Trichomoniasis, gonorrhea, and/or Chlamydia/non-gonococcal urethritis (NGU) were diagnosed in 4,208 women. Preterm birth occurred in just over 9% of pregnancies. Women diagnosed with one of the infections in the first 7 months of pregnancy were significantly more likely to deliver very preterm infants (adjusted HR = 1.73, p < 0.0001). Women with infection in the first 8 months were significantly more likely to deliver between 33 and 36 weeks (adjusted HR = 1.39, p < 0.0001). Of the three infections, Chlamydia/NGU was most strongly associated with preterm birth and infections occurring later in pregnancy (months 6, 7, and 8). CONCLUSION: STIs appear to be preventable risk factors for very and late preterm birth.

Ethnic patterns of cytologic abnormalities in cervical smears in suriname, a high-risk area for cervical cancer.

OBJECTIVE: To determine the prevalence of cytologic abnormalities in cervical smears from women attending the first organized screening program in Suriname and to compare the prevalences in 4 Surinamese ethnicities with different cervical carcinoma incidences. STUDY DESIGN: Cervical scrapes were taken from women with 4 different ethnicities: Maroons, Amerindians, Javanese and Hindustani. Papanicolaou staining and cytologic screening were performed on 807 cervical smears. RESULTS Cervical cytologic abnormalities were seen in 13.4%, of which 8.1% (62 of 764) had atypical changes, 2.6% (20 of 764) had mild and 2.6% (20 of 764) had moderate and severe dysplasia/carcinoma in situ (CIS). The cytologic abnormalities varied between the ethnicities: 42.1% (83 of 197) in the Maroons and 2.3% (4 of 176), 5.0% (9 of 183) and 3.0% (6 of 208) in the Javanese, Amerindians, and Hindustani, respectively. CONCLUSION: The high prevalence of moderate and severe dysplasia/CIS in all ethnicities correlates with the high cervical carcinoma incidence in Suriname. A significantly higher prevalence of mild abnormalities in the Maroons was observed; it did not reflect the relatively low cervical cancer incidence in this ethnicity. However, this can be explained by the possibility that these women have a different sexual lifestyle, leading to a higher prevalence of

The prevalence of trichomoniasis in young adults in the United States.

BACKGROUND AND OBJECTIVES: The prevalence of trichomoniasis in the general population of the United States is unknown. This study provides the first population-based prevalence estimates of trichomoniasis among young adults in the United States. METHODS: The National Longitudinal Study of Adolescent Health (Add Health) is an ongoing prospective cohort study. In a cross-sectional analysis of Wave III of Add Health (N = 12,449), we determined the prevalence of trichomoniasis using a polymerase chain reaction assay. RESULTS: The estimated overall prevalence of trichomoniasis in U.S. young adults was 2.3% (95% confidence interval [CI], 1.8-2.7%). The prevalence was slightly higher among women (2.8%; 95% CI, 2.2-3.6%) than men (1.7%; 95% CI, 1.3-2.2%). The prevalence increased with age and varied by region, with the south having the highest prevalence (2.8%; 95% CI, 2.2-3.5%). The prevalence was highest among black women (10.5%; 95% CI, 8.3-13.3%) and lowest among white women (1.1%; 95% CI, 0.8-1.6%). Among men, the prevalence was highest among Native Americans (4.1%; 95% CI, 0.4-29.3%) and blacks (3.3%; 95% CI, 2.2-4.9%), and lowest among white men (1.3%; 95% CI, 0.9-1.8%). CONCLUSIONS: Trichomoniasis is moderately prevalent among the general U.S. population of young adults and disturbingly high among certain racial/ethnic groups.