title: Trichomonas vaginalis prevalence increases with remoteness in rural and remote New South Wales, Australia.
abstract: BACKGROUND
  Trichomonas has been reported to be rare in Australia's major cities while remaining very common in some extremely remote Aboriginal communities. This study examined the Trichomonas prevalence and relationship to remoteness among patients attending sexual health clinics in rural and remote areas of New South Wales, Australia.
  
  
  METHODS
  During the period 2009 to June 2010, all women attending sexual health clinics in the Western and Far Western Local Health Districts of New South Wales who agreed to sexually transmitted infection testing were offered Trichomonas testing using an in-house polymerase chain reaction test. Overall prevalence was calculated, and logistic regression was used to determine association with remoteness of residency.
  
  
  RESULTS
  Of the 506 women attending during the study period, 356 (70%) were tested. Thirty women (8.4%) tested positive to Trichomonas. Trichomonas infection was independently associated with increasing age, being symptomatic, never having had a previous Papanicolaou smear, and remote residency.
  
  
  CONCLUSIONS
  The prevalence of Trichomonas was relatively high among women attending sexual health clinics in rural and remote western New South Wales. Trichomonas was more common among women living more remotely, which may reflect population-level health service use. Testing for Trichomonas should be considered for all women requesting testing for sexually transmitted infections in rural and remote Australia.
authors.affiliation: Sexual Health and Blood Borne Virus Unit, Department of Health, Northern Territory, University of New South Wales, Randwick, New South Wales, Australia. nathan.ryder@nt.gov.au
authors.forename: Nathan
authors.initials: N
authors.lastname: Ryder
authors.forename: Helen
authors.initials: H
authors.lastname: Woods
authors.forename: Kate
authors.initials: K
authors.lastname: McKay
authors.forename: Nicolla
authors.initials: N
authors.lastname: Giddings
authors.forename: Jo-Ann
authors.initials: JA
authors.lastname: Lenton
authors.forename: Christine
authors.initials: C
authors.lastname: Little
authors.forename: Neisha
authors.initials: N
authors.lastname: Jeoffreys
authors.forename: Anna M
authors.initials: AM
authors.lastname: McNulty
mesh_terms: D000328:Adult; D017677:Age Distribution; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D003153:Community Health Services; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D009517:New South Wales / Q000453:epidemiology; D065006:Papanicolaou Test; D011237:Predictive Value of Tests; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D014245:Trichomonas Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D016387:Women's Health