Prevalence of Trichomonas vaginalisand Coinfection with Chlamydia trachomatisand Neisseria gonorrhoeaein the United States as Determined by the Aptima Trichomonas vaginalisNucleic Acid Amplification Assay

ABSTRACTOur aim was to determine Trichomonas vaginalisprevalence using the Aptima Trichomonas vaginalisassay (ATV; Gen-Probe) and the prevalence of Chlamydia trachomatisand Neisseria gonorrhoeaecoinfections in U.S. women undergoing screening for C. trachomatis/N. gonorrhoeae. Discarded urogenital samples from 7,593 women (18 to 89 years old) undergoing C. trachomatis/N. gonorrhoeaescreening using the Aptima Combo 2 assay (Gen-Probe) in various clinical settings were tested with ATV. Overall, T. vaginalis, C. trachomatis, and N. gonorrhoeaeprevalences were 8.7%, 6.7%, and 1.7%, respectively. T. vaginaliswas more prevalent than C. trachomatisor N. gonorrhoeaein all age groups except the 18- to 19-year-old group. The highest T. vaginalisprevalence was in women =40 years old (>11%), while the highest C. trachomatisprevalence (9.2%) and N. gonorrhoeaeprevalence (2.2%) were in women <30 years old. Coinfection prevalences were 1.3% for C. trachomatis/T. vaginalis, 0.61% for C. trachomatis/N. gonorrhoeaeand N. gonorrhoeae/T. vaginalis, and 0.24% for C. trachomatis/N. gonorrhoeae/T. vaginalisand highest in women <30 years old. T. vaginalisprevalence differed by race/ethnicity, with the highest prevalence in black women (20.2%). T. vaginalisprevalence ranged from 5.4% in family planning clinics to 22.3% in jails. Multivariate analysis determined that ages of =40 years, black race, and patient locations were significantly associated with T. vaginalisinfection. T. vaginalisis the most common sexually transmitted infection (STI) in women of >40 years, while C. trachomatisand N. gonorrhoeaeprevalence is lowest in that age group. Higher T. vaginalisprevalence in women of >40 years is probably attributed to the reason for testing, i.e., symptomatic status versus routine screening in younger women. Coinfections were relatively low. High T. vaginalisprevalence in all age groups suggests that women screened for C. trachomatis/N. gonorrhoeae, whether asymptomatic or symptomatic, should be screened for T. vaginalis.