Trichomonas vaginalis among HIV-Infected women: are immune status or protease inhibitor use associated with subsequent T. vaginalis positivity?

BACKGROUND AND OBJECTIVES: Trichomonas vaginalis (Tv) is a common sexually transmitted disease (STD) among HIV-infected populations. The relationship between Tv and immune status and HIV viral load as affected by protease inhibitor (PI) use has not been well examined.

GOAL: The goals were to evaluate the association between Tv and both immune status and PI use among HIV-infected women, and to characterize factors associated with Tv among HIV-infected women.

STUDY DESIGN: We used a retrospective cohort study conducted between 1990 and 2000.

RESULTS: Of 1578 women, the majority was under 35 years, black (AA), and infected heterosexually or with unidentified risk. Thirty percent (30.2%) had Tv at least once, and 36.9% had at least one subsequent positive test; Tv was more common than chlamydia, gonorrhea, genital warts, or syphilis. After adjusting for follow-up time, young age, AA race, substance use, and other sexually transmitted diseases (STDs) were associated with initial Tv infection, but pregnancy, immune status, and PI use were not associated. After adjusting for follow-up time, having other STDs was associated with and pregnancy was protective of subsequent Tv positivity, but immune status and PI use were not associated; neither were age, race, or substance use.

CONCLUSION: Tv is a common STD among HIV-infected women and does not appear to be associated with immune status or PI use. Aggressive screening might represent a means of reducing the incidence and prevalence of Tv.