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Correlates of Incident Trichomonas vaginalis Infections Among African American Female Adolescents

Swartzendruber, Andrea MPH, PhD*†; Sales, Jessica M. PhD*†; Brown, Jennifer L. PhD*†; DiClemente, Ralph J. PhD*†‡; Rose, Eve S. MSPH*

Sexually Transmitted Diseases: April 2014 - Volume 41 - Issue 4 - p 240–245
doi: 10.1097/OLQ.0000000000000094
Original Study

Background Trichomonas vaginalis is the most common curable sexually transmitted infection associated with adverse reproductive health and pregnancy outcomes and may amplify HIV transmission. The objective was to identify correlates of incident T. vaginalis infections among African American adolescent girls.

Methods Data were collected via audio computer-assisted self-interviews at baseline and every 6 months for 18 months from 701 African American girls (14–20 years) in an HIV prevention trial. At each assessment, self-collected vaginal swabs were assayed for T. vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae. Generalized estimating equations assessed associations between incident T. vaginalis infection and sociodemographic characteristics, substance use, partner-level factors, sexual risk behaviors, douching, and other sexually transmitted infections.

Results Of 605 (86.3%) participants who completed at least 1 follow-up assessment, an incident T. vaginalis infection was detected among 20.0% (n = 121). Factors associated with incident infection in adjusted analysis included the following: cigarette smoking (adjusted odds ratio [AOR], 1.66; 95% confidence interval [CI], 1.04–2.64), using alcohol on an increasing number of days in the past 3 months (AOR, 1.02; 95% CI, 1.00–1.04), acquisition of C. trachomatis (AOR, 2.27; 95% CI, 1.40–3.69) or N. gonorrhoeae (AOR, 5.71; 95% CI, 2.97–11.02), and T. vaginalis infection at the previous assessment (AOR, 3.16; 95% CI, 1.96–5.07).

Conclusions Incident T. vaginalis infections were common. Strategies to reduce infection rates among this population may include improving partner notification and treatment services. The benefits of rescreening, screening adolescents screened for or infected with C. trachomatis or N. gonorrhoeae, and associations between substance use and T. vaginalis acquisition warrant further investigation.

Correlates of incident Trichomonas vaginalis infections during the 18 months of follow-up among African American adolescent girls included Chlamydia trachomatis or Neisseria gonorrhoeae acquisition, previous T. vaginalis infection, and substance use.

From the *Department of Behavioral Sciences & Health Education, Rollins School of Public Health and †Centers for AIDS Research, and ‡Division of Infectious Diseases, Epidemiology, and Immunology, Department of Pediatrics, School of Medicine, Emory University, Atlanta, GA.

Conflicts of interest and financial disclosures: None reported.

Funding statement: This work was supported by the National Institute of Mental Health Grant No. 5R01 MH070537-08 to the fourth author. Additional support was provided by the Emory Center for AIDS Research (P30 AI050409), the Atlanta Clinical & Translational Science Institute (UL1TR000454), and the Center for Contextual Genetics & Prevention (P03 DA027827). Andrea Swartzendruber was supported by National Institute on Alcohol Abuse and Alcoholism Grant No. F32AA022058. Jennifer L. Brown was supported by National Institute of General Medical Sciences Grant No. K12 GM000680. Jessica M. Sales was supported by the National Institute of Mental Health Grant No. K01 MH085506.

Correspondence: Andrea Swartzendruber, MPH, PhD, Rollins School of Public Health, 1518 Clifton Rd, Atlanta, GA 30322. E-mail:

Received for publication August 19, 2013, and accepted December 18, 2013.

© Copyright 2014 American Sexually Transmitted Diseases Association