title: The incidence of Trichomonas vaginalis infection in women attending nine sexually transmitted diseases clinics in the USA.
abstract: OBJECTIVE
  Trichomoniasis (TV) is associated with an increased risk of acquisition of sexually transmitted diseases (STDs) and HIV. The purpose of this study is to evaluate factors associated with incidence TV among female STD clinic attendees in the USA.
  
  
  METHODS
  Data were collected from women participating in a randomised controlled trial evaluating brief risk reduction counselling at the time of HIV testing to reduce sexually transmitted infections (STIs) incidence in STD clinics. Participants recruited from STD clinics underwent STI testing at baseline and 6-month follow-up. TV testing was performed using Nucleic Acid Amplification Test.
  
  
  RESULTS
  1704 participants completed study assessments. Prevalence of TV was 14.6%, chlamydia 8.6%, gonorrhoea 3.0%, herpes simplex virus 2 44.7% and HIV 0.4%. Cumulative 6-month incidence of TV was 7.5%. Almost 50% of the incident TV cases had TV at baseline and had received treatment. Factors associated with incidence of TV were having chlamydia, TV and HIV at baseline: TV relative risk (RR)=3.37 (95% CI 2.35 to 4.83, p<0.001); chlamydia RR=1.92 (95% CI 1.23 to 2.99, p=0.04); and HIV=1.59 (95% CI 1.01 to 2.50, p=0.047).
  
  
  CONCLUSIONS
  Prevalent and incident TV is common among STD clinic attendees; and baseline TV is the main risk factor for incident TV, suggesting high rates of reinfection or treatment failures. This supports the importance of rescreening women after treatment for TV, evaluating current treatment regimens and programmes to ensure treatment of sexual partners.
  
  
  BACKGROUND
  NCT01154296.
authors.affiliation: Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Alcaide
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Feaster
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Rui
authors.initials: R
authors.lastname: Duan
authors.affiliation: San Francisco Department of Public Health, San Francisco, California, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Cohen
authors.affiliation: University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Chanelle
authors.initials: C
authors.lastname: Diaz
authors.affiliation: Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Jose G
authors.initials: JG
authors.lastname: Castro
authors.affiliation: University of Washington, Seattle, Washington, USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Golden
authors.affiliation: Whitman-Walker Health, Washington DC, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Henn
authors.affiliation: San Francisco Department of Public Health, San Francisco, California, USA.
authors.forename: Grant N
authors.initials: GN
authors.lastname: Colfax
authors.affiliation: Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Metsch
mesh_terms: D000328:Adult; D037001:Directive Counseling / Q000379:methods; D005260:Female; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012747:Sexual Partners; D014247:Trichomonas Vaginitis / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D014246:Trichomonas vaginalis / Q000302:isolation & purification*; D014481:United States / Q000453:epidemiology
keywords: EPIDEMIOLOGY (CLINICAL); TRICHOMONAS; WOMEN