Trichomoniasis and other sexually transmitted infections: results from the 2001-2004 National Health and Nutrition Examination Surveys.
BACKGROUND
To estimate the association between Trichomonas vaginalis infection (TV) and 6 sexually transmitted infections: chlamydia, gonorrhea, herpes simplex virus (Types 1 and 2), syphilis, and human immunodeficiency virus (HIV) in a nationally representative sample.


METHODS
We used data from the National Health and Nutrition Examination Survey combining the 2001-2002 and 2003-2004 waves to estimate the association between TV and sexually transmitted infections (STIs) among women in the civilian, noninstitutionalized US population. The final sample included data from 3648 women, which when weighted, represents the experience of 65,563,298 US women between the ages of 14 and 49. Crude and adjusted relative risks were estimated using logistic regression for rare STIs (<10%; chlamydia, syphilis, and HIV) and Poisson regression for common STIs (herpes simplex virus [HSV] Types 1 and 2). Statistical analyses were conducted using Stata (version 9.2).


RESULTS
The prevalence of trichomoniasis was 3.2% with over 80% of cases asymptomatic in the past month. All STIs examined (chlamydia, gonorrhea, HSV-1, HSV-2, syphilis, and HIV) were more common among women with a positive test for trichomoniasis. HSV-1 (RR = 1.20, 95% CI: 1.09, 1.34) and HSV-2 (RR = 1.51, 95% CI: 2.32, 3.23) were significantly associated with trichomoniasis after adjusting for race/ethnicity, age, and recent sexual partners. In crude analyses, a positive treponemal test was 6 times (95% CI: 2.07, 18.8) more common and HIV was 13 times (95% CI: 2.88, 59.1) more common among women with trichomoniasis, but these estimates were greatly attenuated after adjustment for potential confounders.


CONCLUSIONS
Trichomoniasis is significantly associated with concurrent STI.
Allsworth
Jenifer E
JE
Division of Clinical Research, Department of Obstetrics and Gynecology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA. allsworthj@wudosis.wustl.edu
Ratner
Jane Alyce
JA
Peipert
Jeffrey F
JF
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D015231:Sexually Transmitted Diseases, Bacterial / Q000150:complications / Q000453:epidemiology / Q000382:microbiology; D015229:Sexually Transmitted Diseases, Viral / Q000150:complications / Q000453:epidemiology / Q000821:virology; D014245:Trichomonas Infections / Q000150:complications / Q000453:epidemiology / Q000469:parasitology; D014246:Trichomonas vaginalis; D014481:United States / Q000453:epidemiology; D055815:Young Adult