Factors associated with the prevalence and incidence of Trichomonas vaginalis infection among African American women in New York city who use drugs.
BACKGROUND
Trichomoniasis vaginalis, the most prevalent nonviral sexually transmitted infection, is associated with negative reproductive outcomes and increased HIV transmission and may be overrepresented among African Americans.


METHODS
A total of 135 African American women who used drugs were screened for Trichomonas vaginalis on > or =2 occasions between March 2003 and August 2005. Women were administered a structured questionnaire in a community-based research center, underwent serological testing for human immunodeficiency virus and herpes simplex virus type 2, and were screened for Neisseria gonorrhoeae and Chlamydia trachomatis.


RESULTS
Fifty-one women (38%) screened positive for T. vaginalis at baseline. Twenty-nine (31%) of 95 women with negative results of baseline tests became infected, for an incidence of 35.1 cases per 100 person-years at risk (95% confidence interval [CI], 23.5-49.0). Prevalent infection was associated with drug use in the past 30 days, and incident infection was associated with sexual behavior in the past 30 days, namely having >1 male sex partner. Women who reported having >1 partner were 4 times as likely as women with fewer partners to acquire T. vaginalis (hazard ratio, 4.3; 95% CI, 2.0-9.4).


CONCLUSIONS
T. vaginalis may be endemic in this community of African American women. A control strategy that includes T. vaginalis screening in nonclinical settings and rapid point-of-care testing could contribute to the disruption of transmission of this pathogen.
Miller
Maureen
M
Department of Epidemiology and Biostatistics, School of Public Health, New York Medical College, Valhalla, New York 10595, USA. maureen.miller@nymc.edu
Liao
Yuyan
Y
Gomez
Anu Manchikanti
AM
Gaydos
Charlotte A
CA
D'Mellow
Delysha
D
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000818:Animals; D002690:Chlamydia Infections / Q000453:epidemiology / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology / Q000208:ethnology; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D006679:HIV Seropositivity / Q000469:parasitology; D015497:HIV-1 / Q000472:pathogenicity*; D006558:Herpes Genitalis / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009519:New York City / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012725:Sexual Behavior; D019966:Substance-Related Disorders / Q000150:complications / Q000208:ethnology; D014247:Trichomonas Vaginitis / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology; D014246:Trichomonas vaginalis / Q000472:pathogenicity*