Correlates of trichomonas prevalence among street-recruited, drug-using women enrolled in a randomized trial.
OBJECTIVE
Substance-using women need prevention technologies and programs to reduce risk of HIV/sexually transmitted infection (STI). We examined STI prevalence and identified risk correlates for female drug users.


METHODS
We used interviewer-administered and computer-assisted surveys, and tested specimens for four, treatable STIs (trichomonas, early syphilis, gonorrhea, chlamydia) on 198 HIV-seronegative, street-recruited, substance-using women enrolled in a randomized trial to reduce HIV/STI risk.


RESULTS
Most women were crack users (88%), reported sex exchange (80%) and were not in drug user treatment (74%). Two-thirds were African-American and nearly all were unemployed. Protection during sex was infrequent. African-American women reported fewer unprotected sex acts and fewer sexual partners, but greater crack use and more sex-for exchange, than whites or Hispanics. Trichomonas prevalence (36.9%) exceeded that for chlamydia (3.5%), syphilis (1.5%), and gonorrhea (0%). In multivariate logistic regression, having a primary and casual partner more than doubled (AOR 2.86) the risk of having trichomonas and being African-American raised the risk by more than 8 times (AOR 8.45).


CONCLUSIONS
African-American, drug-using women, and women with multiple partner types, are in urgent need of effective STI/HIV prevention interventions.
Gollub
Erica L
EL
Robert Stempel School of Public Health, Florida International University, Miami, Florida 33199, USA. erica.gollub@fiu.edu
Armstrong
Kay
K
Boney
Tamara
T
Mercer
Delinda
D
Chhatre
Sumedha
S
Fiore
Danielle
D
Lavalanet
Antonella
A
Mackey
Katina
K
D000293:Adolescent; D000328:Adult; D016578:Crack Cocaine; D005260:Female; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D015999:Multivariate Analysis; D015143:Philadelphia / Q000453:epidemiology; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D019966:Substance-Related Disorders; D014244:Trichomonas / Q000302:isolation & purification*; D014245:Trichomonas Infections / Q000453:epidemiology*; D014584:User-Computer Interface; D055815:Young Adult
D016578:Crack Cocaine