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Trichomonas vaginalis infection among homeless and unstably housed adult women living in a resource-rich urban environment.
Sex Transm Infect. 2016 06; 92(4):305-8.ST

Abstract

OBJECTIVE

The social context of poverty is consistently linked to Trichomonas vaginalis infection, yet few studies regarding T. vaginalis have been conducted exclusively among low-income individuals. We identified social determinants of health associated with prevalent T. vaginalis infection among homeless and unstably housed adult women.

METHODS

Between April and October of 2010, we conducted cross-sectional T. vaginalis screening and behavioural interviews in an existing cohort of San Francisco homeless and unstably housed women. Data were analysed using multivariable logistical regression.

RESULTS

Among 245 study participants, the median age was 47 years and 72% were of non-Caucasian race/ethnicity. T. vaginalis prevalence was 12%, compared to 3% in the general population, and 33% of infected individuals reported no gynaecological symptoms. In adjusted analysis, the odds of T. vaginalis infection were lower among persons older than 47 years, the population median (OR=0.14, 95% CI 0.04 to 0.38), and higher among those reporting recent short-term homeless shelter stays (OR=5.36, 95% CI 1.57 to 18.26). Race and income did not reach levels of significance. Sensitivity analyses indicated that testing all women who report recent unprotected sex would identify more infections than testing those who report gynaecological symptoms (20/30 vs 10/30; p=0.01).

CONCLUSIONS

The prevalence of T. vaginalis is high among homeless and unstably housed adult women, over one-third of infected individuals have no gynaecological symptoms, and correlates of infection differ from those reported in the general population. Targeted screening and treatment among impoverished women reporting recent unprotected sex, particularly young impoverished women and all women experiencing short-term homelessness, may reduce complications related to this treatable infection.

Authors+Show Affiliations

Department of Medicine, University of California, San Francisco, California, USA.Department of Medicine, University of California, San Francisco, California, USA.Department of Medicine, University of California, San Francisco, California, USA.Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.Department of Medicine, University of California, San Francisco, California, USA.Department of Medicine, University of California, San Francisco, California, USA.STD Prevention and Control Services, Department of Public Health, San Francisco, California, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

26347544

Citation

Riley, Elise D., et al. "Trichomonas Vaginalis Infection Among Homeless and Unstably Housed Adult Women Living in a Resource-rich Urban Environment." Sexually Transmitted Infections, vol. 92, no. 4, 2016, pp. 305-8.
Riley ED, Cohen J, Dilworth SE, et al. Trichomonas vaginalis infection among homeless and unstably housed adult women living in a resource-rich urban environment. Sex Transm Infect. 2016;92(4):305-8.
Riley, E. D., Cohen, J., Dilworth, S. E., Grimes, B., Marquez, C., Chin-Hong, P., & Philip, S. S. (2016). Trichomonas vaginalis infection among homeless and unstably housed adult women living in a resource-rich urban environment. Sexually Transmitted Infections, 92(4), 305-8. https://doi.org/10.1136/sextrans-2015-052143
Riley ED, et al. Trichomonas Vaginalis Infection Among Homeless and Unstably Housed Adult Women Living in a Resource-rich Urban Environment. Sex Transm Infect. 2016;92(4):305-8. PubMed PMID: 26347544.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trichomonas vaginalis infection among homeless and unstably housed adult women living in a resource-rich urban environment. AU - Riley,Elise D, AU - Cohen,Jennifer, AU - Dilworth,Samantha E, AU - Grimes,Barbara, AU - Marquez,Carina, AU - Chin-Hong,Peter, AU - Philip,Susan S, Y1 - 2015/09/07/ PY - 2015/05/04/received PY - 2015/08/22/accepted PY - 2015/9/9/entrez PY - 2015/9/9/pubmed PY - 2017/7/7/medline KW - TESTING KW - TRICHOMONAS KW - WOMEN SP - 305 EP - 8 JF - Sexually transmitted infections JO - Sex Transm Infect VL - 92 IS - 4 N2 - OBJECTIVE: The social context of poverty is consistently linked to Trichomonas vaginalis infection, yet few studies regarding T. vaginalis have been conducted exclusively among low-income individuals. We identified social determinants of health associated with prevalent T. vaginalis infection among homeless and unstably housed adult women. METHODS: Between April and October of 2010, we conducted cross-sectional T. vaginalis screening and behavioural interviews in an existing cohort of San Francisco homeless and unstably housed women. Data were analysed using multivariable logistical regression. RESULTS: Among 245 study participants, the median age was 47 years and 72% were of non-Caucasian race/ethnicity. T. vaginalis prevalence was 12%, compared to 3% in the general population, and 33% of infected individuals reported no gynaecological symptoms. In adjusted analysis, the odds of T. vaginalis infection were lower among persons older than 47 years, the population median (OR=0.14, 95% CI 0.04 to 0.38), and higher among those reporting recent short-term homeless shelter stays (OR=5.36, 95% CI 1.57 to 18.26). Race and income did not reach levels of significance. Sensitivity analyses indicated that testing all women who report recent unprotected sex would identify more infections than testing those who report gynaecological symptoms (20/30 vs 10/30; p=0.01). CONCLUSIONS: The prevalence of T. vaginalis is high among homeless and unstably housed adult women, over one-third of infected individuals have no gynaecological symptoms, and correlates of infection differ from those reported in the general population. Targeted screening and treatment among impoverished women reporting recent unprotected sex, particularly young impoverished women and all women experiencing short-term homelessness, may reduce complications related to this treatable infection. SN - 1472-3263 UR - https://www.unboundmedicine.com/medline/citation/26347544/Trichomonas_vaginalis_infection_among_homeless_and_unstably_housed_adult_women_living_in_a_resource_rich_urban_environment_ L2 - https://sti.bmj.com/lookup/pmidlookup?view=long&pmid=26347544 DB - PRIME DP - Unbound Medicine ER -