Several risk factors for the acquisition of trichomoniasis have been identified, including multiple sexual partners, black race, history of previous STD and coexistent infection with Neisseria gonorrhoeae.1 Approximately 8% to 50% of patients with T. vaginalis have concomitant infections.
After conducting PCR analysis on the vaginal swabs of a nationally representative sample of 3,754 women, Sutton (2007) reported that the following factors are associated with an increased likelihood of T. vaginalis infection:2
- Being of non-Hispanic black ethnicity
- Being born in the United States
- Increased number of sex partners
- Increased age
- Lower education
- Poverty
- Douching
Numerous studies have identified previous infection with an STD as a risk factor for infection with trichomoniasis.1,3 In a study of 1,236 female STD clinic patients, Peterman (2006) reports that 16.5% of women treated for trichomoniasis were reinfected within three months.Interestingly, 14.8% of patients who had gonorrhea at their first visit had trichomoniasis at their three-month follow-up, but only 3.6% had reacquired gonorrhea.4
| 3-Month Follow-Up | ||||
|---|---|---|---|---|
| Initial Infection | CT | NG | TV | Multi |
| Chlamydia trachomatis (CT) | 10.7% | 3.6% | 3.8% | 13.1% |
| Neisseria gonorrhoeae (NG) | 0% | 3.6% | 14.8% | 16.7% |
| Trichomonas vaginalis (TV) | 4.3% | 5.4% | 16.5% | 23.0% |
| Multiple Infections (Multi) | 4.1% | 10.2% | 17.8% | 25.5% |
| Adapted from Peterman (2006) | Table 1 | |||
Trichomoniasis is often concomitant with bacterial vaginosis.5,6 Cu-Uvin (2002) reports that in participants in the HIV Epidemiology Research Study, T. vaginalis was found in 74% of women with bacterial vaginosis vs. 35% of women without.7
T. vaginalis grows over a wide pH range, from 3.5 to 8. A vaginal pH below 4.5 decreases motility, however, so a vaginal pH above 4.5 would be conducive to infection.8
Failure to use barrier contraceptives (condoms) increases an individual's susceptibility to infection.9
- Sobel JD. Vaginitis. N Engl J Med. 1997 Dec 25;337(26):1896-903.
- Sutton M, Sternberg M, Koumans EH, McQuillan G, Berman S, Markowitz L. The prevalence of Trichomonas vaginalis infection among reproductive-age women in the United States, 2001-2004. Clin Infect Dis. 2007 Nov 15;45(10):1319-26. Epub 2007 Oct 15.
- Niccolai LM, Kopicko JJ, Kassie A, Petros H, Clark RA, Kissinger P. Incidence and predictors of reinfection with Trichomonas vaginalis in HIV-infected women. Sex Transm Dis. 2000 May;27(5):284-8.
- Peterman TA, Tian LH, Metcalf CA, Satterwhite CL, Malotte CK, DeAugustine N, Paul SM, Cross H, Rietmeijer CA, Douglas JM Jr; RESPECT-2 Study Group. High incidence of new sexually transmitted infections in the year following a sexually transmitted infection: a case for rescreening. Ann Intern Med. 2006 Oct 17;145(8):564-72.
- Martin HL, Richardson BA, Nyange PM, Lavreys L, Hillier SL, Chohan B, Mandaliya K, Ndinya-Achola JO, Bwayo J, Kreiss J. Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition. J Infect Dis. 1999 Dec;180(6):1863-8.
- Franklin TL, Monif GR. Trichomonas vaginalis and bacterial vaginosis. Coexistence in vaginal wet mount preparations from pregnant women. J Reprod Med. 2000 Feb;45(2):131-4.
- Cu-Uvin S, Ko H, Jamieson DJ, Hogan JW, Schuman P, Anderson J, Klein RS; HIV Epidemiology Research Study (HERS) Group. Prevalence, incidence, and persistence or recurrence of trichomoniasis among human immunodeficiency virus (HIV)-positive women and among HIV-negative women at high risk for HIV infection. Clin Infect Dis. 2002 May 15;34(10):1406-11. Epub 2002 Apr 22.
- Thomason JL, Gelbart SM. Trichomonas vaginalis. Obstet Gynecol. 1989 Sep;74(3 Pt 2):536-41.
- Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines 2006. MMWR 2006;55(RR11):1-94.
