Burden of trichomoniasis among older adults in the United States: a systematic review
Alyssa R. Lindrose
A * , Kyaw Zin Htet B , Samantha O’Connell C , James Marsh B and Patricia J. Kissinger A *
+ Author Affiliations
- Author Affiliations
A Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
B Tulane University School of Medicine, New Orleans, LA, USA.
C Office of Academic Affairs & Provost, Tulane University, New Orleans, LA, USA.
Sexual Health 19(3) 151-156 https://doi.org/10.1071/SH22009
Submitted: 13 January 2022 Accepted: 28 April 2022 Published: 7 June 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Despite being one of the most common sexually transmitted infections (STIs) in the United States, the epidemiology of trichomoniasis remains understudied. One population that has been historically overlooked regarding STIs is that of older adults, despite many individuals remaining sexually active well into their older years. We investigated the reported prevalence and incidence of trichomoniasis in adults aged ≥45 years in the United States using a systematic literature review. Twelve articles were included in the review, all assessing prevalence of trichomoniasis in this age group. Notably, no included articles assessed trichomoniasis incidence. Data collected encompassed several decades, from 1993 to 2016. Estimates of infection prevalence varied widely and ranged from 0.2% to 21.4% in included populations, with the highest prevalence typically seen among individuals seeking diagnostic testing for STIs. Several studies found increased risk for trichomoniasis in older patients compared to younger age groups. This is the first review to examine the risk of trichomoniasis in older adults, and the surprisingly high prevalence suggests that older adults may merit increased screening for trichomoniasis and sexual health education.
Keywords: aging, epidemiology, infection, neglected infectious disease, protozoal infections, sexual health, STIs, trichomonas, trichomoniasis.
References
[1] Lewis FMT, Spicknall IH, Flagg EW, Papp JR, Kreisel KM. Incidence and prevalence of Trichomonas vaginalis infection among persons aged 15 to 59 years: United States, 2018. Sex Transm Dis 2021; 48 232–7.| Incidence and prevalence of Trichomonas vaginalis infection among persons aged 15 to 59 years: United States, 2018.Crossref | GoogleScholarGoogle Scholar | 33492095PubMed |
[2] Kissinger P. Trichomonas vaginalis: a review of epidemiologic, clinical and treatment issues. BMC Infect Dis 2015; 15 307
| Trichomonas vaginalis: a review of epidemiologic, clinical and treatment issues.Crossref | GoogleScholarGoogle Scholar | 26242185PubMed |
[3] Yang S, Zhao W, Wang H, Wang Y, Li J, Wu X. Trichomonas vaginalis infection-associated risk of cervical cancer: a meta-analysis. Eur J Obstet Gynecol Reprod Biol 2018; 228 166–73.
| Trichomonas vaginalis infection-associated risk of cervical cancer: a meta-analysis.Crossref | GoogleScholarGoogle Scholar | 29980111PubMed |
[4] Najafi A, Chaechi Nosrati MR, Ghasemi E, Navi Z, Yousefi A, Majidiani H, et al. Is there association between Trichomonas vaginalis infection and prostate cancer risk?: a systematic review and meta-analysis. Microb Pathog 2019; 137 103752
| Is there association between Trichomonas vaginalis infection and prostate cancer risk?: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 31539586PubMed |
[5] Sutcliffe S, Giovannucci E, Alderete JF, Chang TH, Gaydos CA, Zenilman JM, et al. Plasma antibodies against Trichomonas vaginalis and subsequent risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 2006; 15 939–45.
| Plasma antibodies against Trichomonas vaginalis and subsequent risk of prostate cancer.Crossref | GoogleScholarGoogle Scholar | 16702374PubMed |
[6] Saleh NE, Alhusseiny SM, El-Zayady WM, Aboelnaga EM, El-beshbishi WN, Saleh YM, et al. Trichomonas vaginalis serostatus and prostate cancer risk in Egypt: a case-control study. Parasitol Res 2021; 120 1379–88.
| Trichomonas vaginalis serostatus and prostate cancer risk in Egypt: a case-control study.Crossref | GoogleScholarGoogle Scholar | 33159459PubMed |
[7] Kissinger P, Adamski A. Trichomoniasis and HIV interactions: a review. Sex Transm Infect 2013; 89 426–33.
| Trichomoniasis and HIV interactions: a review.Crossref | GoogleScholarGoogle Scholar | 23605851PubMed |
[8] Muzny CA. Why does Trichomonas vaginalis continue to be a “neglected” sexually transmitted infection? Clin Infect Dis 2018; 67 218–20.
| Why does Trichomonas vaginalis continue to be a “neglected” sexually transmitted infection?Crossref | GoogleScholarGoogle Scholar | 29554227PubMed |
[9] Secor WE, Meites E, Starr MC, Workowski KA. Neglected parasitic infections in the United States: trichomoniasis. Am J Trop Med Hyg 2014; 90 800–804.
| Neglected parasitic infections in the United States: trichomoniasis.Crossref | GoogleScholarGoogle Scholar | 24808247PubMed |
[10] Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2018. Atlanta: U.S. Department of Health and Human Services; 2019.
[11] Patel EU, Gaydos CA, Packman ZR, Quinn TC, Tobian AAR. Prevalence and correlates of Trichomonas vaginalis infection among men and women in the United States. Clin Infect Dis 2018; 67 211–17.
| Prevalence and correlates of Trichomonas vaginalis infection among men and women in the United States.Crossref | GoogleScholarGoogle Scholar | 29554238PubMed |
[12] Agochukwu-Mmonu N, Malani PN, Wittmann D, Kirch M, Kullgren J, Singer D, et al. Interest in sex and conversations about sexual health with health care providers among older U.S. adults. Clin Gerontol 2021; 44 299–306.
| Interest in sex and conversations about sexual health with health care providers among older U.S. adults.Crossref | GoogleScholarGoogle Scholar | 33616005PubMed |
[13] Johnson BK. Sexually transmitted infections and older adults. J Gerontol Nurs 2013; 39 53–60.
| Sexually transmitted infections and older adults.Crossref | GoogleScholarGoogle Scholar | 24066789PubMed |
[14] Smith ML, Bergeron CD, Goltz HH, Coffey T, Boolani A. Sexually transmitted infection knowledge among older adults: psychometrics and test-retest reliability. Int J Environ Res Public Health 2020; 17 2462
| Sexually transmitted infection knowledge among older adults: psychometrics and test-retest reliability.Crossref | GoogleScholarGoogle Scholar |
[15] Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372 n71
| The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.Crossref | GoogleScholarGoogle Scholar | 33782057PubMed |
[16] Ginocchio CC, Chapin K, Smith JS, Aslanzadeh J, Snook J, Hill CS, et al. Prevalence of Trichomonas vaginalis and coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in the United States as determined by the Aptima Trichomonas vaginalis nucleic acid amplification assay. J Clin Microbiol 2012; 50 2601–8.
| Prevalence of Trichomonas vaginalis and coinfection with Chlamydia trachomatis and Neisseria gonorrhoeae in the United States as determined by the Aptima Trichomonas vaginalis nucleic acid amplification assay.Crossref | GoogleScholarGoogle Scholar | 22622447PubMed |
[17] Schwebke J, Merriweather A, Massingale S, Scisney M, Hill C, Getman D. Screening for Trichomonas vaginalis in a large high-risk population: prevalence among men and women determined by nucleic acid amplification testing. Sex Transm Dis 2018; 45 e23–4.
| Screening for Trichomonas vaginalis in a large high-risk population: prevalence among men and women determined by nucleic acid amplification testing.Crossref | GoogleScholarGoogle Scholar |
[18] Sutcliffe S, Kawachi I, Alderete JF, Gaydos CA, Jacobson LP, Jenkins FJ, et al. Correlates of sexually transmitted infection histories in a cohort of American male health professionals. Cancer Causes Control 2009; 20 1623–34.
| Correlates of sexually transmitted infection histories in a cohort of American male health professionals.Crossref | GoogleScholarGoogle Scholar | 19655261PubMed |
[19] Tuddenham SA, Page KR, Chaulk P, Lobe EB, Ghanem KG. Patients fifty years and older attending two sexually transmitted disease clinics in Baltimore, Maryland. Int J STD AIDS 2017; 28 330–44.
| Patients fifty years and older attending two sexually transmitted disease clinics in Baltimore, Maryland.Crossref | GoogleScholarGoogle Scholar | 27101993PubMed |
[20] Daugherty M, Glynn K, Byler T. Prevalence of Trichomonas vaginalis infection among US males, 2013–2016. Clin Infect Dis 2019; 68 460–5.
| Prevalence of Trichomonas vaginalis infection among US males, 2013–2016.Crossref | GoogleScholarGoogle Scholar | 29893808PubMed |
[21] Flagg EW, Meites E, Phillips C, Papp J, Torrone EA. Prevalence of Trichomonas vaginalis among civilian, noninstitutionalized male and female population aged 14 to 59 years: United States, 2013 to 2016. Sex Transm Dis 2019; 46 e93–6.
| Prevalence of Trichomonas vaginalis among civilian, noninstitutionalized male and female population aged 14 to 59 years: United States, 2013 to 2016.Crossref | GoogleScholarGoogle Scholar | 31517807PubMed |
[22] Gaydos CA, Barnes MR, Quinn N, Jett-Goheen M, Hsieh Y-H. Trichomonas vaginalis infection in men who submit self-collected penile swabs after internet recruitment. Sex Transm Infect 2013; 89 504–8.
| Trichomonas vaginalis infection in men who submit self-collected penile swabs after internet recruitment.Crossref | GoogleScholarGoogle Scholar | 23354525PubMed |
[23] Hearn LE, Whitehead NE, Dunne EM, Latimer WW. Correlates of Trichomonas vaginalis among middle age and older adults who use drugs. Subst Use Misuse 2015; 50 1501–9.
| Correlates of Trichomonas vaginalis among middle age and older adults who use drugs.Crossref | GoogleScholarGoogle Scholar | 26583203PubMed |
[24] Smith KP, Christakis NA. Association between widowhood and risk of diagnosis with a sexually transmitted infection in older adults. Am J Public Health 2009; 99 2055–62.
| Association between widowhood and risk of diagnosis with a sexually transmitted infection in older adults.Crossref | GoogleScholarGoogle Scholar | 19762656PubMed |
[25] Stemmer SM, Adelson ME, Trama JP, Dorak MT, Mordechai E. Detection rates of Trichomonas vaginalis, in different age groups, using real-time polymerase chain reaction. J Low Genit Tract Dis 2012; 16 352–7.
| Detection rates of Trichomonas vaginalis, in different age groups, using real-time polymerase chain reaction.Crossref | GoogleScholarGoogle Scholar | 22968052PubMed |
[26] Tompkins EL, Beltran TA, Gelner EJ, Farmer AR. Prevalence and risk factors for Trichomonas vaginalis infection among adults in the U.S., 2013–2014. PLoS One 2020; 15 e0234704
| Prevalence and risk factors for Trichomonas vaginalis infection among adults in the U.S., 2013–2014.Crossref | GoogleScholarGoogle Scholar | 32544192PubMed |
[27] Hobbs MM, Seña AC. Modern diagnosis of Trichomonas vaginalis infection. Sex Transm Infect 2013; 89 434–8.
| Modern diagnosis of Trichomonas vaginalis infection.Crossref | GoogleScholarGoogle Scholar | 23633669PubMed |
[28] Gatski M, Kissinger P. Observation of probable persistent, undetected Trichomonas vaginalis infection among HIV-positive women. Clin Infect Dis 2010; 51 114–5.
| Observation of probable persistent, undetected Trichomonas vaginalis infection among HIV-positive women.Crossref | GoogleScholarGoogle Scholar | 20518674PubMed |
[29] Peterman TA, Tian LH, Metcalf CA, Malotte CK, Paul SM, Douglas JM. Persistent, undetected Trichomonas vaginalis infections? Clin Infect Dis 2009; 48 259–60.
| Persistent, undetected Trichomonas vaginalis infections?Crossref | GoogleScholarGoogle Scholar | 19113985PubMed |
[30] Howe K, Kissinger PJ. Single-dose compared with multidose metronidazole for the treatment of trichomoniasis in women: a meta-analysis. Sex Transm Dis 2017; 44 29–34.
| Single-dose compared with multidose metronidazole for the treatment of trichomoniasis in women: a meta-analysis.Crossref | GoogleScholarGoogle Scholar | 27898571PubMed |
[31] Kissinger P, Muzny CA, Mena LA, Lillis RA, Schwebke JR, Beauchamps L, et al. Single-dose versus 7-day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial. Lancet Infect Dis 2018; 18 1251–9.
| Single-dose versus 7-day-dose metronidazole for the treatment of trichomoniasis in women: an open-label, randomised controlled trial.Crossref | GoogleScholarGoogle Scholar | 30297322PubMed |
