title: Trichomonas vaginalis Nucleic Acid Amplification Testing at an Urban HIV Clinic.
abstract: Trichomonas vaginalis is the most common nonviral sexually transmitted infection. T. vaginalis nucleic acid amplification testing (NAAT) recently became available at the University of Alabama at Birmingham human immunodeficiency virus (HIV) clinic. The objective of this study was to determine the uptake of T. vaginalis NAAT testing among clinic providers during the first year of test availability in addition to T. vaginalis prevalence and predictors based on NAAT results.
  
  
  
  This was a retrospective review of HIV+ women and men ages ≥16 years at the University of Alabama at Birmingham HIV Clinic, including those receiving a T. vaginalis NAAT on a genitourinary specimen.
  
  
  
  Between August 2014 and August 2015, 3163 HIV+ patients were seen (768 women, 2395 men), of whom 861 (27.3%) received a T. vaginalis NAAT; 402 women (52.3%) and 459 men (19.2%). Among those with T. vaginalis NAAT results, 70 (17.4%) of 402 women and 12 (2.6%) of 459 men (9 men who have sex with women, 1 man who has sex with men, 2 unknown) tested positive. In adjusted analyses for women, age ≤40 years (odds ratio [OR], 2.93; 95% confidence interval [CI], 1.23-6.96), current cocaine use (OR, 4.86; 95% CI, 1.57-15.06), and CD4 < 200 cells/mm (OR, 6.09; 95% CI, 1.68-22.11) were significantly associated with increased odds of a positive T. vaginalis NAAT. For those with a positive T. vaginalis NAAT, treatment was prescribed for 65 (92.9%) of 70 women and 10 (83.3%) of 12 men.
  
  
  
  Initial uptake of T. vaginalis NAAT testing was modest at this HIV clinic yet identified a high prevalence among women tested. Emphasis on the need for testing in HIV+ women is necessary.
authors.affiliation: From the *Division of Infectious Diseases, and †Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL.
authors.forename: Christina A
authors.initials: CA
authors.lastname: Muzny
authors.forename: Greer A
authors.initials: GA
authors.lastname: Burkholder
authors.forename: Karen R
authors.initials: KR
authors.lastname: Fry
authors.forename: Erika L
authors.initials: EL
authors.lastname: Austin
authors.forename: Jane R
authors.initials: JR
authors.lastname: Schwebke
mesh_terms: D000328:Adult; D000407:Alabama / Q000453:epidemiology; D000554:Ambulatory Care Facilities; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D021141:Nucleic Acid Amplification Techniques; D015995:Prevalence; D012189:Retrospective Studies; D012749:Sexually Transmitted Diseases / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D014245:Trichomonas Infections / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D014246:Trichomonas vaginalis / Q000235:genetics / Q000302:isolation & purification*; D019037:Urban Health Services