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Trichomoniasis, caused by Trichomonas vaginalis (TV), is the most common non-viral sexually transmitted infection (STI) worldwide, affecting over 174 million people annually and is frequently associated with reproductive co-morbidities. However, its detection can be time-consuming, subjective, and expensive for large cohort studies. This case–control study, conducted at the Mount Sinai Adolescent Health Center in New York City, involved 36 women with prevalent TV infections and 36 controls. The objective was to examine Internal Transcribed Spacer region-1 (ITS1) amplicon-derived communities for the detection of prevalent TV infections with the same precision as clinical microscopy and the independent amplification of the TV-specific TVK3/7 gene. DNA was isolated from clinician-collected cervicovaginal samples and amplified using ITS1 primers in a research laboratory. Results were compared to microscopic wet-mount TV detection of concurrently collected cervicovaginal samples and confirmed against TV-specific TVK3/7 gene PCR. The area under the receiver operating characteristics curve (AUC) for diagnosing TV using ITS1 communities was 0.92. ITS1 amplicons displayed an intra-class correlation coefficient (ICC) of 0.96 (95% CI: 0.93–0.98) compared to TVK3/7 PCR fragment testing. TV cases showed an increased risk of bacterial vaginosis (BV) compared to the TV-negative controls (OR = 8.67, 95% CI: 2.24–48.54, p-value = 0.0011), with no significant differences regarding genital yeast or chlamydia infections. This study presents a bioinformatics approach to ITS1 amplicon next-generation sequencing that is capable of detecting prevalent TV infections. This approach enables high-throughput testing for TV in stored DNA from large-scale epidemiological studies. [ABSTRACT FROM AUTHOR]

Background Clinical research with adolescents can be challenging due to issues of informed consent, parental involvement, institutional review board requirements, and adolescent psychosocial development. These requirements present a dilemma, particularly in the area of sexual health research, as adolescents are disproportionately affected by sexually transmitted infections such as human papillomavirus (HPV). To successfully conduct adolescent research in the clinical setting, one requires an awareness of state statutes regarding adolescent confidentiality and consent for medical care, and a close partnership with the IRB. Case Study In 2007, the Mount Sinai Adolescent Health Center in collaboration with the Albert Einstein College of Medicine developed a longitudinal research study to examine the natural history of oral, cervical, and anal HPV in an adolescent female population engaged in high-risk sexual behaviors. We use this research project as a case study to explore the ethical, methodological, and clinical issues related to conducting adolescent health research. Summary and Conclusions Several strategies were identified to promote adolescent study participation, including: (1) building a research team that is motivated to work with adolescents; (2) combining research and patient care visits to avoid duplication of services; and (3) establishing a personalized communication network with participants. Using these methods, adolescent sexual health research can successfully be integrated into the clinical setting. While retaining a prospective cohort of adolescents has its challenges, a persistent and multi-disciplinary approach can help improve recruitment, sustain participation, and acquire critical data that will lead to improved healthcare knowledge applicable to understudied populations of adolescents. [ABSTRACT FROM AUTHOR]

Tobacco-cannabis co-use is more common than exclusive cannabis use and is linked to more severe tobacco and cannabis health consequences. We assessed trends and predictors of tobacco-cannabis co-use and their link to future substance use problems and severity among Black and Hispanic adolescent and young adult (AYA) females living in New York City. Secondary data were analyzed from a 7-year (2013–2020) prospective open cohort study conducted at Mount Sinai Adolescent Health Center in New York City (n = 1281). Participants completed questionnaires every 6 months, and self-reported information on use of smoked tobacco, cannabis, and blunts/spliffs; sexual risk behaviors; depressive symptoms; and other substance use. Regression analyses examined initiation and frequency of past 30-day co-use and risk of future substance use severity. Age-adjusted prevalence of past 30-day cannabis use increased from 46.5% in 2013–2014 to 59.0% in 2019–2020, while past 30-day tobacco smoking declined from 22.1 to 6.1%. After accounting for blunt/spliff use, any use of tobacco increased from 31.6% in 2013–2014 to 39.6% in 2019–2020. Co-consumers were more likely to meet criteria for clinical depression (OR = 1.34, 95% CI 1.12–1.61) and have same-sex (OR = 1.35, 95% CI 1.03–1.76) and/or multiple male sex partners (OR = 1.45, 95% CI 1.23–1.71). Those who used blunts/spliffs frequently or rarely had higher risk profiles for problematic substance use. Tobacco-cannabis co-use, particularly blunt use, appears to drive increasing prevalence of cannabis use, sustain overall rates of tobacco use, and predicts substance use problems among inner-city Black and Hispanic AYA females, independent of other factors. [ABSTRACT FROM AUTHOR]