Prevalence and Correlates of Trichomonas vaginalis Infection Among Men and Women in the United States

• Published in: Clinical infectious diseases Vol. 67; no. 2; pp. 211 - 217
• Main Authors: Patel, Eshan U, Gaydos, Charlotte A, Packman, Zoe R, Quinn, Thomas C, Tobian, Aaron A R
• Format: Journal Article
• Language: English
• Published: US Oxford University Press 02.07.2018
• Subjects: Adolescent; Adult; Age Factors; and Commentaries; Bacteria; Black or African American; Chlamydia Infections - epidemiology; Chlamydia Infections - urine; Confidence intervals; Epidemiology; Ethnicity; Female; Females; Gonorrhea - epidemiology; Gonorrhea - urine; Herpes simplex; Human papillomavirus; Humans; Infections; Male; Males; Middle Aged; Nutrition; Nutrition Surveys; Papillomavirus Infections - epidemiology; Papillomavirus Infections - urine; Parasitic diseases; Poisson density functions; Poverty; Prevalence; Race Factors; Races; Sex Factors; Sexual Behavior; Sexual partners; Sexually transmitted diseases; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - parasitology; Statistical analysis; STD; Trichomonas Infections - epidemiology; Trichomonas Infections - urine; Trichomonas vaginalis; Trichomonas vaginalis - isolation & purification; United States - epidemiology; Urine; Viruses; Young Adult; United States; United States > US; racial disparities; NHANES; sexually transmitted infection; trichomoniasis
• ISSN: 1058-4838; 1537-6591; 1537-6591
• DOI: 10.1093/cid/ciy079

In a nationally representative sample of the civilian, noninstitutionalized US population aged 18-59 years, Trichomonas vaginalis infection was detected in 0.5% of males and 1.8% of females, and was highest among black males (4.2%) and black females (8.9%). Abstract Background The epidemiology of Trichomonas vaginalis (TV) infection in the United States is poorly defined. Methods Males and females aged 18-59 years who participated in the 2013-2014 National Health and Nutrition Examination Survey and provided a urine specimen were tested for TV infection (n = 4057). Participants were also examined for Chlamydia trachomatis (CT) infection, genital human papillomavirus (HPV) infection, and herpes simplex virus type 2 serostatus. Weighted adjusted prevalence ratios (aPRs) were estimated by multivariable Poisson regression. Results TV infection prevalence was 0.5% and 1.8% among males and females, respectively. TV infection prevalence was 4.2% among black males, 8.9% among black females, and 0.03% and 0.8%, respectively, among males and females of other races/ethnicities. TV infection prevalence (aPR [95% confidence interval]) was positively associated with female sex (6.1 [3.3-11.3]), black race (vs other races/ethnicities; 7.9 [3.9-16.1]), older age (vs 18-24 years; 3.0 [1.2-7.1] for 25- to 39-year-olds and 3.5 [1.3-9.4] for 40- to 59-year-olds), having less than a high school education (vs completing high school or more; 2.0 [1.0-4.1]), being below the poverty level (vs at or above the poverty level; 4.0 [2.1-7.7]), and having ≥2 sexual partners in the past year (vs 0-1 sexual partners; 3.6 [2.0-6.6]). There were no TV and CT coinfections. Genital HPV detection was not independently associated with TV infection. Among persons aged 18-39 years, there was a significant racial disparity in all sexually transmitted infections examined, and this disparity was greatest for TV infection. Conclusions There is a high and disproportionate burden of urinary TV infection in the adult civilian, noninstitutionalized black population in the United States that warrants intervention.