Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
Sex Transm Infect. 2013 Sep;89(6):514-8. doi: 10.1136/sextrans-2012-050889. Epub 2013 Feb 28.
Trichomoniasis vaginalis is a risk factor for the acquisition and transmission of HIV. The objective of this study was to determine the prevalence of T vaginalis (using culture) among HIV-infected women receiving gynaecological care at an university HIV clinic in Alabama in addition to predictors of infection.
Electronic medical record review of women presenting to the clinic for gynaecological care during 2006-2012 was performed. Demographic and sexual history data was abstracted in addition to absolute CD4 cell count, HIV-1 viral load and sexually transmitted infection (STI) (including T vaginalis) testing results. Analysis was conducted using Stata V.12.
T vaginalis was prevalent in 17.4% (83/478) of HIV-infected women; other STIs were less prevalent. Among these women, 384 presented for routine STI screening, of which 12% (46/384) were T vaginalis-infected. Younger age, African-American race, lifetime history of tobacco and drug abuse, lack of HIV therapy, HIV-1 viral load >400 copies/ml, and report of seeking gynaecological care for reasons other than routine STI screening (ie, having symptoms) were significant predictors of T vaginalis in univariate analysis. Age, African American race, and report of seeking gynaecological care for reasons other than routine STI screening remained associated with T vaginalis in multivariable analysis.
T vaginalis remains highly prevalent among HIV-infected women, a proportion of which may be asymptomatic. If left undiagnosed and untreated, these women may be more likely to transmit HIV. Increased emphasis on screening for high risk sexual behaviours, testing for T vaginalis, and risk reduction counselling is necessary for all HIV-infected women.
阴道毛滴虫病是感染艾滋病毒的一个危险因素。本研究的目的是确定在阿拉巴马州一所大学艾滋病毒诊所接受妇科护理的艾滋病毒感染妇女中，阴道毛滴虫（通过培养）的流行率，以及感染的预测因素。
对 2006 年至 2012 年期间到诊所就诊的接受妇科护理的妇女进行电子病历回顾。除了绝对 CD4 细胞计数、HIV-1 病毒载量和性传播感染（包括阴道毛滴虫）检测结果外，还提取了人口统计学和性行为史数据。使用 Stata V.12 进行分析。
阴道毛滴虫在 17.4%（478 例中的 83 例）HIV 感染妇女中流行；其他性传播感染的流行率较低。在这些妇女中，384 例为常规性传播感染筛查，其中 12%（46/384）感染了阴道毛滴虫。在单变量分析中，年龄较小、非裔美国人、终生有吸烟和吸毒史、缺乏 HIV 治疗、HIV-1 病毒载量>400 拷贝/ml 以及因非常规性传播感染筛查（即有症状）而寻求妇科护理是阴道毛滴虫的显著预测因素。年龄、非裔美国人种族以及因非常规性传播感染筛查而寻求妇科护理的原因仍然与阴道毛滴虫在多变量分析中相关。
阴道毛滴虫病在 HIV 感染妇女中仍然高度流行，其中一部分可能无症状。如果未被诊断和治疗，这些妇女更有可能传播 HIV。所有 HIV 感染妇女都需要更加重视筛查高危性行为、阴道毛滴虫检测和减少风险咨询。
