The following is a summary of “Disparities in adherence to retesting guidelines in women with Trichomonas vaginalis infection,” published in the SEPTEMBER 2023 issue of Obstetrics and Gynecology by Getaneh, et al.
Trichomoniasis is the most common nonviral sexually transmitted infection in the United States, with notably higher prevalence rates observed among non-Hispanic Black women. Due to the elevated risk of reinfection, the Centers for Disease Control and Prevention (CDC) recommends retesting women treated for trichomoniasis. However, there’s limited research on adherence to these retesting guidelines, which can significantly impact racial disparities in healthcare. For a study, researchers sought to assess Trichomonas vaginalis infection rates, evaluate adherence to retesting guidelines, and analyze the characteristics of women who were not retested according to the guidelines in an urban, diverse, hospital-based obstetrics and gynecology clinic population.
A retrospective cohort study was conducted using data from a single hospital-based obstetrics and gynecology clinic where patients were tested for Trichomonas vaginalis between January 1, 2015, and December 31, 2019. Descriptive statistics were used to examine adherence to guideline-recommended retesting for reinfection among patients with trichomoniasis. Multivariable logistic regression was employed to identify factors associated with testing positive and appropriate retesting. Subgroup analyses were performed for pregnant patients who tested positive for Trichomonas vaginalis.
Among the 8,809 patients tested for Trichomonas vaginalis, 799 (9.1%) tested positive at least once during the study period. Factors associated with trichomoniasis included identifying as non-Hispanic Black (adjusted odds ratio, 3.13; 95% CI, 2.52–3.89), current or former tobacco smoking (adjusted odds ratio, 2.27; 95% CI, 1.94–2.65), and single marital status (adjusted odds ratio, 1.96; 95% CI, 1.51–2.56). Similar associated factors were found in the pregnant subgroup analysis. However, guideline-concordant retesting rates were generally low across the entire population, with only 27% (214/799) of patients retested within the recommended time frame. Non-Hispanic Black women had significantly lower odds of undergoing guideline-recommended retesting than non-Hispanic White women (adjusted odds ratio, 0.54; 95% CI, 0.31–0.92). Among patients tested according to guideline recommendations, a high rate of Trichomonas vaginalis positivity was observed at retesting: 24% in the entire cohort (51/214) and 33% in the pregnant subgroup (27/82).
Trichomonas vaginalis infection was prevalent in a diverse, urban hospital-based obstetrics and gynecology clinic population. There are opportunities to enhance equitable and guideline-concordant retesting of patients with trichomoniasis.