title: The association between Trichomonas infection and incarceration in HIV-seropositive and at-risk HIV-seronegative women.
abstract: BACKGROUND
  The prevalence of Trichomonas vaginalis is higher among incarcerated women than in the general community. We sought to determine whether a history of incarceration itself was independently associated with trichomoniasis.
  
  
  METHODS
  The HIV Epidemiology Research Study is a prospective cohort study of 871 HIV-seropositive and 439 high-risk seronegative women in 4 urban centers (Bronx, NY; Detroit, MI; Providence, RI; Baltimore, MD). All participants enrolled between April 1993 and January 1995, with interviews and physical examinations conducted at baseline and at follow-up visits every 6 months up to 7 years.
  
  
  RESULTS
  Of 1310 subjects, 427 (33%) reported being incarcerated on at least one occasion. In addition, 724 (55%) were found to have a sexually transmitted infection on at least one occasion during the study; baseline rates were 21% for T. vaginalis, 4.3% for Chlamydia trachomatis, 0.6% for N. gonorrhea, and 8% for syphilis. Incarceration was associated with the detection of trichomonas infection (between-subject, odds ratio, 2.4; 95% confidence interval: 1.85-3.14; P < 0.01 and within-subject, odds ratio, 1.56; 95% confidence interval: 1.26-1.92; P < 0.01). The association with incarceration remained significant after adjusting for age, race, HIV status, enrollment risk group, number of sexual partners, marital status, education, bacterial vaginosis, vaginal candidiasis, drug use (crack, cocaine, heroin), alcohol use, health insurance, receipt of public assistance, employment status, visit number, and study site.
  
  
  CONCLUSIONS
  A history of incarceration was independently associated with the detection of trichomonas infection in a cohort of high-risk women. These data have implications for increased sexually transmitted infection prevention, screening, and treatment upon entry to jail as well as in the communities most affected by incarceration.
authors.affiliation: Division of General Internal Medicine and Primary Care, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA. anijhawa@bidmc.harvard.edu
authors.forename: Ank E
authors.initials: AE
authors.lastname: Nijhawan
authors.forename: Alison K
authors.initials: AK
authors.lastname: DeLong
authors.forename: David D
authors.initials: DD
authors.lastname: Celentano
authors.forename: Robert S
authors.initials: RS
authors.lastname: Klein
authors.forename: Jack D
authors.initials: JD
authors.lastname: Sobel
authors.forename: Denise J
authors.initials: DJ
authors.lastname: Jamieson
authors.forename: Susan
authors.initials: S
authors.lastname: Cu-Uvin
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D011329:Prisoners / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology; D014245:Trichomonas Infections / Q000453:epidemiology* / Q000469:parasitology; D014246:Trichomonas vaginalis; D014505:Urban Population; D055815:Young Adult
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