title: Correlates of incident Trichomonas vaginalis infections among African American female adolescents.
abstract: BACKGROUND
  Trichomonas vaginalis is the most common curable sexually transmitted infection associated with adverse reproductive health and pregnancy outcomes and may amplify HIV transmission. The objective was to identify correlates of incident T. vaginalis infections among African American adolescent girls.
  
  
  METHODS
  Data were collected via audio computer-assisted self-interviews at baseline and every 6 months for 18 months from 701 African American girls (14-20 years) in an HIV prevention trial. At each assessment, self-collected vaginal swabs were assayed for T. vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae. Generalized estimating equations assessed associations between incident T. vaginalis infection and sociodemographic characteristics, substance use, partner-level factors, sexual risk behaviors, douching, and other sexually transmitted infections.
  
  
  RESULTS
  Of 605 (86.3%) participants who completed at least 1 follow-up assessment, an incident T. vaginalis infection was detected among 20.0% (n = 121). Factors associated with incident infection in adjusted analysis included the following: cigarette smoking (adjusted odds ratio [AOR], 1.66; 95% confidence interval [CI], 1.04-2.64), using alcohol on an increasing number of days in the past 3 months (AOR, 1.02; 95% CI, 1.00-1.04), acquisition of C. trachomatis (AOR, 2.27; 95% CI, 1.40-3.69) or N. gonorrhoeae (AOR, 5.71; 95% CI, 2.97-11.02), and T. vaginalis infection at the previous assessment (AOR, 3.16; 95% CI, 1.96-5.07).
  
  
  CONCLUSIONS
  Incident T. vaginalis infections were common. Strategies to reduce infection rates among this population may include improving partner notification and treatment services. The benefits of rescreening, screening adolescents screened for or infected with C. trachomatis or N. gonorrhoeae, and associations between substance use and T. vaginalis acquisition warrant further investigation.
authors.affiliation: From the *Department of Behavioral Sciences & Health Education, Rollins School of Public Health and †Centers for AIDS Research, and ‡Division of Infectious Diseases, Epidemiology, and Immunology, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Swartzendruber
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Sales
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Brown
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: Diclemente
authors.forename: Eve S
authors.initials: ES
authors.lastname: Rose
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D012307:Risk Factors; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014247:Trichomonas Vaginitis / Q000453:epidemiology* / Q000517:prevention & control; D014246:Trichomonas vaginalis / Q000302:isolation & purification*; D044364:Vaginal Douching / Q000706:statistics & numerical data*