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Prevalence and Correlates of Trichomonas vaginalis Infection Among Female US Federal Prison Inmates

Sutcliffe, Siobhan PHD*; Newman, Sara B. DrPH; Hardick, Andrew BA; Gaydos, Charlotte A. DrPH

doi: 10.1097/OLQ.0b013e3181de4113
Original Study

Background: Previous studies have observed high prevalences of Trichomonas vaginalis infection among women entering US jails and state prisons (22%–47%). We sought to determine the prevalence among women incarcerated in 2 US female-only federal prisons.

Methods: Female inmates were recruited at 2 prisons (n = 624). Participants completed a self-administered questionnaire and provided self-collected first-catch urine and vaginal swab specimens. Specimens were tested for T. vaginalis DNA.

Results: Approximately 8.5% of participants at the first prison, and 8.3% at the second prison had a positive urine result, vaginal swab result or both, for a combined prevalence of 8.5%. Using positivity in either specimen as the reference standard, urine polymerase chain reaction had a sensitivity of 66.7% and vaginal swab polymerase chain reaction had a sensitivity of 84.4%. The only significant positive correlate of T. vaginalis infection was lower household income before arrest. Other variables nonsignificantly positively correlated with T. vaginalis were being employed at the time of arrest, having experienced sexual, physical, or emotional abuse by a family member, having a parent who had not had a drug or alcohol addiction, never exchanging sex for money or drugs, ever being pregnant, having abnormal vaginal bleeding/spotting, and having concurrent chlamydia or gonorrhea.

Conclusions: Although not as high as in other studies of women entering US jails and state prisons, our observed T. vaginalis prevalence of 8.5% was much higher than in the general US population. Therefore, screening for T. vaginalis infection may be warranted at federal prison entry, as well as sexual health education during prison stay.

The prevalence of Trichomonas vaginalis infection at 2 federal, female-only prisons was 8.5%. Positive women were more likely to report a lower income before arrest than negative women.

From the *Department of Surgery and The Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO; †Division of Risk Management, National Park Service, Washington, DC; and ‡Division of Infectious Diseases, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD

The authors thank Ratna Pakpahan for help with literature review, and Catherine G. Sutcliffe for critical review of this manuscript.

Supported by grants from the Centers for Disease Control and Prevention, the Federal Bureau of Prisons, the Uniformed Services University of the Health Sciences, and the HIV Prevention Trials Network (U01 A1068613).

Correspondence: Siobhan Sutcliffe, PhD, Department of Surgery and the Alvin J. Siteman Cancer Center, Washington University School of Medicine, 660 S. Euclid Ave, Box 8100, Room 5026, St. Louis, MO 63110. E-mail:

Received for publication August 18, 2009, and accepted March 17, 2010.

© Copyright 2010 American Sexually Transmitted Diseases Association