Patient-delivered partner treatment and Trichomonas vaginalis repeat infection among human immunodeficiency virus-infected women.
BACKGROUND
Repeat infections with Trichomonas vaginalis (TV) among human immunodeficiency virus (HIV)-infected women are common and may increase the risk of HIV transmission. Patient delivered partner treatment (PDPT) has been shown to reduce repeat infections of other sexually transmitted diseases. The purpose of this study was to evaluate adherence to PDPT and possible causes of repeat TV infection among HIV-infected women.


METHODS
A multicentered cohort study was conducted in 3 US cities. Women coinfected with HIV and TV were treated with metronidazole and given treatment to deliver to all reported sex partners. A test-of-cure visit was conducted 6 to 12 days post index treatment completion and behavioral data were collected.


RESULTS
Of 252 women (mean age = 40 years, s.d. 9.1) enrolled, 92.5% were black, 26.2% had CD4 cell counts <200/mm(3), 34.1% had plasma viral loads >10,000 copies, 58.3% were taking antiretrovial therapy, and 15.1% had multiple partners. Of the 183 women with partners at baseline, 75.4% provided PDPT to all partners and 61.7% reported they were sure all of their partners took the medication. Factors associated with not giving medications to all partner(s) were multiple sex partners, being single, and having at least one partner unaware of the index woman's HIV status. At test-of-cure, 10.3% were TV-positive and 16.7% reported having sex since baseline. Of the 24 repeat infections, 21 (87.5%) reported adherence to medication and no sexual exposure.


CONCLUSIONS
HIV-infected women with TV reported high adherence to PDPT, and treatment failure was the most common probable cause of repeat infection.
Gatski
Megan
M
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
Mena
Leandro
L
Levison
Judy
J
Clark
Rebecca A
RA
Henderson
Harold
H
Schmidt
Norine
N
Rosenthal
Susan L
SL
Martin
David H
DH
Kissinger
Patricia
P
D000328:Adult; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D015497:HIV-1; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D012725:Sexual Behavior; D012747:Sexual Partners; D016896:Treatment Outcome; D014247:Trichomonas Vaginitis / Q000150:complications / Q000188:drug therapy* / Q000469:parasitology / Q000517:prevention & control*; D014246:Trichomonas vaginalis / Q000187:drug effects
D000981:Antiprotozoal Agents; D008795:Metronidazole