Aaron F Bochner1,2, Jared M Baeten1,2,3, Alison S Rustagi4, Edith Nakku-Joloba5, Jairam R Lingappa2,3,6, Nelly R Mugo2,7, Elizabeth A Bukusi2,8, Saidi Kapiga9, Sinead Delany-Moretlwe10, Connie Celum1,2,3, Ruanne V Barnabas1,2,3. 1. Department of Epidemiology, University of Washington, Seattle, Washington, USA. 2. Department of Global Health, University of Washington, Seattle, Washington, USA. 3. School of Medicine, University of Washington, Seattle, Washington, USA. 4. Department of Medicine, University of California, San Francisco, California, USA. 5. School of Public Health, Makerere University, Kampala, Uganda. 6. Department of Pediatrics, University of Washington, Seattle, Washington, USA. 7. Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya. 8. Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya. 9. Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK. 10. Wits Reproductive Health and HIV Institute, University of Witwatersrand, Johannesburg, South Africa.
Abstract
OBJECTIVES: Trichomonas vaginalis is the most prevalent curable STI worldwide and has been associated with adverse health outcomes and increased HIV-1 transmission risk. We conducted a cross-sectional analysis among couples to assess how characteristics of both individuals in sexual partnerships are associated with the prevalence of male and female T. vaginalis infection. METHODS: African HIV-1 serodiscordant heterosexual couples were concurrently tested for trichomoniasis at enrolment into two clinical trials. T. vaginalis testing was by nucleic acid amplification or culture methods. Using Poisson regression with robust standard errors, we identified characteristics associated with trichomoniasis. RESULTS: Among 7531 couples tested for trichomoniasis, 981 (13%) couples contained at least one infected partner. The prevalence was 11% (n=857) among women and 4% (n=319) among men, and most infected individuals did not experience signs or symptoms of T. vaginalis. Exploring concordance of T. vaginalis status within sexual partnerships, we observed that 61% (195/319) of T. vaginalis-positive men and 23% (195/857) of T. vaginalis-positive women had a concurrently infected partner. In multivariable analysis, having a T. vaginalis-positive partner was the strongest predictor of infection for women (relative risk (RR) 4.70, 95% CI 4.10 to 5.38) and men (RR 10.09, 95% CI 7.92 to 12.85). For women, having outside sex partners, gonorrhoea, and intermediate or high Nugent scores for bacterial vaginosis were associated with increased risk of trichomoniasis, whereas age 45 years and above, being married, having children and injectable contraceptive use were associated with reduced trichomoniasis risk. Additionally, women whose male partners were circumcised, had more education or earned income had lower risk of trichomoniasis. CONCLUSIONS: We found that within African HIV-1 serodiscordant heterosexual couples, the prevalence of trichomoniasis was high among partners of T. vaginalis-infected individuals, suggesting that partner services could play an important role identifying additional cases and preventing reinfection. Our results also suggest that male circumcision may reduce the risk of male-to-female T. vaginalis transmission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
OBJECTIVES: Trichomonas vaginalis is the most prevalent curable STI worldwide and has been associated with adverse health outcomes and increased HIV-1 transmission risk. We conducted a cross-sectional analysis among couples to assess how characteristics of both individuals in sexual partnerships are associated with the prevalence of male and female T. vaginalis infection. METHODS: African HIV-1 serodiscordant heterosexual couples were concurrently tested for trichomoniasis at enrolment into two clinical trials. T. vaginalis testing was by nucleic acid amplification or culture methods. Using Poisson regression with robust standard errors, we identified characteristics associated with trichomoniasis. RESULTS: Among 7531 couples tested for trichomoniasis, 981 (13%) couples contained at least one infected partner. The prevalence was 11% (n=857) among women and 4% (n=319) among men, and most infected individuals did not experience signs or symptoms of T. vaginalis. Exploring concordance of T. vaginalis status within sexual partnerships, we observed that 61% (195/319) of T. vaginalis-positive men and 23% (195/857) of T. vaginalis-positive women had a concurrently infected partner. In multivariable analysis, having a T. vaginalis-positive partner was the strongest predictor of infection for women (relative risk (RR) 4.70, 95% CI 4.10 to 5.38) and men (RR 10.09, 95% CI 7.92 to 12.85). For women, having outside sex partners, gonorrhoea, and intermediate or high Nugent scores for bacterial vaginosis were associated with increased risk of trichomoniasis, whereas age 45 years and above, being married, having children and injectable contraceptive use were associated with reduced trichomoniasis risk. Additionally, women whose male partners were circumcised, had more education or earned income had lower risk of trichomoniasis. CONCLUSIONS: We found that within African HIV-1 serodiscordant heterosexual couples, the prevalence of trichomoniasis was high among partners of T. vaginalis-infected individuals, suggesting that partner services could play an important role identifying additional cases and preventing reinfection. Our results also suggest that male circumcision may reduce the risk of male-to-female T. vaginalis transmission. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Olamide D Jarrett; Sujatha Srinivasan; Barbra A Richardson; Tina Fiedler; Jacqueline M Wallis; John Kinuthia; Walter Jaoko; Kishor Mandaliya; David N Fredricks; R Scott McClelland Journal: J Infect Dis Date: 2019-09-26 Impact factor: 5.226
Authors: Jonathan M Grund; Tyler S Bryant; Inimfon Jackson; Kelly Curran; Naomi Bock; Carlos Toledo; Joanna Taliano; Sheng Zhou; Jorge Martin Del Campo; Ling Yang; Apollo Kivumbi; Peizi Li; Sherri Pals; Stephanie M Davis Journal: Lancet Glob Health Date: 2017-11 Impact factor: 26.763