Background: Trichomoniasis, a common sexually transmitted infection caused by the protozoan Trichomonas vaginalis (TV), affects both men and women. Untreated TV infections may lead to easier acquisition of other STIs including HIV, and have been associated with long-term sequelae such as pelvic inflammatory disease and preterm births. Previous studies report widely differing prevalence rates in women, probably due to differences in population as well as the testing methods used. Very few studies have reported TV prevalence in men. Estimating the prevalence of TV in both men and women is important because most patients are asymptomatic and TV is easily transmitted. The objective of this study is to determine TV prevalence in men and women undergoing screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC).
Methods: Endocervical samples and male urine samples were collected from patients attending Family Planning and STD clinics across Alabama and tested with the Aptima Combo 2 assay for CT/GC detection and the Aptima TV assay (Hologic/Gen-Probe, Inc.).
Results: Samples were collected from 77,740 women and 12,604 men; 60.1% of the subjects were African American and most patients (52.9%) were 20-29 years old. TV prevalence was 10.6% overall, 11.3% for women, 6.1% for men, and was highest for African Americans (14.6%). In women, TV prevalence gradually increased with age by 2-3% in each decade until age 40. In men, TV prevalence increased with age in a bimodal fashion (peak at 8.3% for men 30-39; peak at 11.5% for men ≥50 years).
Conclusions: The high prevalence of TV in men and women undergoing GC and CT screening suggests that both males and females at high risk for STIs such as CT and GC should also be screened for TV, even in patients >40 years old.