Trichomonas vaginalisinfection in men who submit self-collected penile swabs after internet recruitment

Abstract

Background Submission of self-collected penile samples collected at home could remove barriers that men face in getting tested for sexually transmitted infections (STIs). Methods From December 2006 to July 2012, sexually active men aged ≥14 years were recruited by an educational internet program (http://www.iwantthekit.org) which offered free testing for Trichomonas vaginalis infection. Kits were ordered online and swabs were sent via US mail to the laboratory and tested by nucleic acid amplification tests. Demographics and sexual risk factors were accessed by questionnaires. Men called or were contacted to receive their results. Risk factors for trichomonas infection were determined by multivariate logistic regression Results Of 4398 men requesting kits, 1699 (38.6%) returned swabs by mail (55.4% returned in 2012). Forty-one percent of men were aged <25 years, 43% were black subjects and 45% were white. The overall prevalence for trichomonas in the 1699 men was 3.7%; the highest prevalence by age group was for men aged 40–49 years (5.2%) and, by year, 216 men screened in 2008 had the highest prevalence (12.5%). Risk factors for 919 men whose risk information was collected by questionnaire (prevalence 6.0%) indicated that 9.6% had a concurrent chlamydia infection. Significantly associated risks factors included: black race (adjusted OR 2.67), residence in Illinois (OR 12.02), age 30–39 years (OR 6.63) and age >40 years (OR 5.31). Conclusions A fairly high prevalence of trichomonas and sexual risk factors were demonstrated from internet recruitment of men. This method of engaging men to get screened for trichomonas may augment screening in STI clinics.

Trichomonas vaginalis Infections are Rare Among Young Patients Attending an STI Clinic in Sweden

“…T. vaginalis infections have previously been highly associated with higher age of females (peaking at between 40 and 50 years of age) as well as with ethnicity, i.e. black race (2,6,(10)(11)(12)(13)(14). In particular, this difference in age distribution is relevant to informing STI control programmes and appropriate targeting of screening efforts.…”

“…the FDA-approved APTIMA T. vaginalis assay (Hologic; 2,5,[8][9][10][11]. Although T. vaginalis infections are common in many settings internationally (1,2,6,(10)(11)(12)(13)(14), they appear to be rare among young patients attending an STI clinic in Sweden. T. vaginalis infections have previously been highly associated with higher age of females (peaking at between 40 and 50 years of age) as well as with ethnicity, i.e.…”

“…This NAAT has superior sensitivity compared with traditional diagnostic methods (2,(8)(9)(10)(11) and the clinical sensitivity and specificity have been stated to be >95% and 98%, respectively (12). Using this NAAT, studies from the USA have shown prevalences of T. vaginalis in STI populations of 10-12% and in the general population of 3% (6,(10)(11)(12)(13)(14). In Sweden, mainly wet-mount microscopy solely is used for detection of T. vaginalis and the prevalence of trichomoniasis has never been evaluated with a highly sensitive and specific NAAT.…”

Protocolos y manejo práctico de pacientes con secreción uretral o vaginal patológica

“…Es una fuente de controversia el posible beneficio que supondría un despistaje en poblaciones con elevada prevalencia de uretritis, como en adolescentes y jó venes sexualmente activos y hombres que tienen sexo con hombres 2 . Se dispone ya de kits diagnó sticos, para los gé rmenes má s frecuentes, utilizables en el á mbito domé stico o en atenció n primaria, que permitirían evaluar a una mayor cantidad de població n. En los ú ltimos añ os se han ensayado campañ as de informació n en redes sociales, ofreciendo la posibilidad a los usuarios de remitir muestras de forma sencilla para diagnó stico de infecciones por Neisseria gonorrhoeae (N. gonorrhoeae) o Chlamydia trachomatis (C. trachomatis), teniendo mucha aceptació n, y permitiendo llegar a grupos de població n de alto riesgo y que por diversos motivos socioeconó micos no acudirían a una clínica tradicional [3][4][5][6] . En el resto de los casos, sintomá ticos, el paciente consultará generalmente por la presencia de un exudado uretral que puede ser seroso, purulento, mucopurulento o incluso hemorrá gico en casos muy inflamatorios.…”

Response to “Implications of Trichomonas vaginalis Nucleic Acid Amplification Testing on Medical Training and Practice”

“…trachomatis was impressive, and these important prevalence data merit reporting to health care providers. More research will be needed to ascertain prevalence in symptomatic and asymptomatic women, as well as men (2).…”