Dr. Erika L. Austin (pictured), assistant professor in the department of biostatistics at the University of Alabama at Birmingham, in collaboration with lead author Dr. Christina A. Muzny, assistant professor in UAB’s division of infectious diseases, conducted a study to determine the uptake of T. vaginalis nucleic acid amplification (NAAT) testing among providers at UAB’s 1917 Clinic (which specializes in treating patients living with HIV) during the initial 12 months following test availability, as well as to ascertain the prevalence and predictors of T. vaginalis as indicated by NAAT results. T. vaginalis is the most prevalent non-viral sexually transmitted infection.
[Photo: Dr. Erika L. Austin]
The investigators found that “between August 2014 and August 2015, 3,163 HIV+ patients (768 women, 2,395 men) were seen at the clinic, of whom 861 (27.3 percent) received a T. vaginalis NAAT: 402 women (52.3 percent) and 459 men (19.2 percent).”
Among those participants on whom T. vaginalis NAAT was conducted “70 (17.4 percent) of 402 women and 12 (2.6 percent) of 459 men (nine men who have sex with women; one man who has sex with men; two unknown) tested positive. In adjusted analyses for women, age <=40 years (odds ratio [OR], 2.93; 95 percent confidence interval [CI], 1.23-6.96), current cocaine use (OR, 4.86; 95 percent CI, 1.57-15.06), and CD4 < 200 cells/mm3 (OR, 6.09; 95 percent CI, 1.68-22.11) were significantly associated with increased odds of a positive T. vaginalis NAAT. For those with a positive T. vaginalis NAAT, treatment was prescribed for 65 (92.9 percent) of 70 women and 10 (83.3 percent) of 12 men.”
The researchers concluded that even though there was initially a modest response to T. vaginalis NAAT testing at the clinic, the incidence of positive results in women tested was high. Therefore, they stress the importance of such testing among the HIV-positive female population.
Dr. Muzny states that “studies have shown that T. vaginalis increases the risk of HIV transmission. This, along with the high prevalence of T. vaginalis found among HIV+ women in our study, strongly encourages the use of routine T. vaginalis screening in this population.”
Co-investigators are Drs. Greer A. Burkholder and Jane R. Schwebke in the division of infectious diseases; and nurse practitioner at the UAB 1917 Clinic Ms. Karen R. Fry.
“Trichomonas vaginalis Nucleic Acid Amplification Testing at an Urban HIV Clinic” was published online in June in the journal Sexually Transmitted Diseases.