A cross-sectional analysis of Trichomonas vaginalis infection among heterosexual HIV-1 serodiscordant African couples. (4th April 2017)

• Record Type: Journal Article
• Authors: Bochner, Aaron F; Baeten, Jared M; Rustagi, Alison S; Nakku-Joloba, Edith; Lingappa, Jairam R; Mugo, Nelly R; Bukusi, Elizabeth A; Kapiga, Saidi; Delany-Moretlwe, Sinead; Celum, Connie; Barnabas, Ruanne V
• Other Names: author non-byline.; Celum Connie author non-byline.; Baeten Jared M author non-byline.; Donnell Deborah author non-byline.; Coombs Robert W author non-byline.; Frenkel Lisa author non-byline.; Hendrix Craig W author non-byline.; Lingappa Jairam author non-byline.; McElrath M Juliana author non-byline.; Fife Kenneth author non-byline.; Were Edwin author non-byline.; Tumwesigye Elioda author non-byline.; Ndase Patrick author non-byline.; Katabira Elly author non-byline.; Katabira Elly author non-byline.; Ronald Allan author non-byline.; Bukusi Elizabeth author non-byline.; Cohen Craig author non-byline.; Wangisi Jonathan author non-byline.; Campbell James author non-byline.; Tappero Jordan author non-byline.; Kiarie James author non-byline.; Farquhar Carey author non-byline.; John-Stewart Grace author non-byline.; Mugo Nelly Rwamba author non-byline.; Campbell James author non-byline.; Tappero Jordan author non-byline.; Wangisi Jonathan author non-byline.; Celum Connie author non-byline.; Wald Anna author non-byline.; Lingappa Jairam R author non-byline.; Baeten Jared M author non-byline.; Campbell Mary S author non-byline.; Corey Lawrence author non-byline.; Coombs Robert W author non-byline.; Hughes James P author non-byline.; Magaret Amalia author non-byline.; McElrath M Juliana author non-byline.; Morrow Rhoda author non-byline.; Mullins James I author non-byline.; Coetzee David author non-byline.; Fife Kenneth author non-byline.; Were Edwin author non-byline.; Essex Max author non-byline.; Makhema Joseph author non-byline.; Katabira Elly author non-byline.; Ronald Allan author non-byline.; Bukusi Elizabeth author non-byline.; Cohen Craig author non-byline.; Kapiga Saidi author non-byline.; Manongi Rachel author non-byline.; Farquhar Carey author non-byline.; John-Stewart Grace author non-byline.; Kiarie James author non-byline.; Allen Susan author non-byline.; Kanweka William author non-byline.; Allen Susan author non-byline.; Inambao Mubiana author non-byline.; Delany-Moretlwe Sinead author non-byline.; Rees Helen author non-byline.; Bruyn Guy de author non-byline.; Gray Glenda author non-byline.; McIntyre James author non-byline.;
• Is Part Of: Sexually transmitted infections. Volume 93:issue 7(2017)
• Page Start: 520
• Page End: 529
• Publication Date: 2017-04-04
• Subjects: TRICHOMONAS -- AFRICA -- HORMONAL CONTRACEPTION -- BACTERIAL VAGINOSIS -- CIRCUMCISION; Sexually transmitted diseases -- Periodicals; HIV infections -- Periodicals; 616.951005
• DOI: 10.1136/sextrans-2016-053034
• Languages: English
• ISSNs: 1368-4973

Abstract

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.