Trichomonas vaginalis infection in male sexual partners: implications for diagnosis, treatment, and prevention.
BACKGROUND
Trichomonas vaginalis causes a common sexually transmitted infection (STI) in women, yet trichomoniasis in male sexual partners is not well recognized. Nucleic acid amplification tests can increase detection of T. vaginalis in men compared with culture.


METHODS
We conducted a prospective, multicenter study to evaluate T. vaginalis infection among male partners of women with trichomoniasis and factors associated with infection by recruiting patients from 3 public clinics in the United States. Male partners were tested for concordant T. vaginalis infection, defined as a positive urethral culture, urine culture, or urine polymerase chain reaction (PCR) result. A subset of men also provided a semen sample for T. vaginalis culture and PCR. Factors associated with concordant infection were determined from bivariable and multivariable analyses.


RESULTS
We enrolled 540 women with trichomoniasis (diagnosed using wet mount microscopy and/or culture) and 261 (48.4%) of their male partners. T. vaginalis infection was detected in 177 (71.7%) of 256 male partners (95% confidence interval [CI], 66.0%-77.3%), of whom 136 (77.3%) were asymptomatic. A vaginal pH of >4.5 in a woman was independently associated with infection in the male partner (adjusted odds ratio, 2.5; 95% CI, 1.0-6.3). Younger male age (20-29 and 30-39 years) was also found to be an independent risk factor for concordant trichomoniasis.


CONCLUSIONS
The majority of male partners of women with trichomoniasis were infected; however, few factors predicted infection. T. vaginalis causes a highly prevalent STI, necessitating vastly improved partner management, application of sensitive nucleic-acid based testing, and better clinical recognition.
Seña
Arlene C
AC
Division of Infectious Diseases, Department of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA. idrod@med.unc.edu
Miller
William C
WC
Hobbs
Marcia M
MM
Schwebke
Jane R
JR
Leone
Peter A
PA
Swygard
Heidi
H
Atashili
Julius
J
Cohen
Myron S
MS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D003470:Culture Media; D016054:DNA, Protozoan / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012661:Semen / Q000469:parasitology; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control; D014245:Trichomonas Infections / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control; D014247:Trichomonas Vaginitis / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control; D014246:Trichomonas vaginalis / Q000235:genetics / Q000302:isolation & purification*; D014521:Urethra / Q000469:parasitology; D014556:Urine / Q000469:parasitology; D014626:Vaginal Smears
D003470:Culture Media; D016054:DNA, Protozoan