fOur aim was to determine Trichomonas vaginalis prevalence using the Aptima Trichomonas vaginalis assay (ATV; Gen-Probe) and the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae coinfections 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. gonorrhoeae screening using the Aptima Combo 2 assay (Gen-Probe) in various clinical settings were tested with ATV. Overall, T. vaginalis, C. trachomatis, and N. gonorrhoeae prevalences were 8.7%, 6.7%, and 1.7%, respectively. T. vaginalis was more prevalent than C. trachomatis or N. gonorrhoeae in all age groups except the 18-to 19-year-old group. The highest T. vaginalis prevalence was in women >40 years old (>11%), while the highest C. trachomatis prevalence (9.2%) and N. gonorrhoeae prevalence (2.2%) were in women <30 years old. Coinfection prevalences were 1.3% for C. trachomatis/T. vaginalis, 0.61% for C. trachomatis/N. gonorrhoeae and N. gonorrhoeae/T. vaginalis, and 0.24% for C. trachomatis/N. gonorrhoeae/T. vaginalis and highest in women <30 years old. T. vaginalis prevalence differed by race/ethnicity, with the highest prevalence in black women (20.2%). T. vaginalis prevalence 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. vaginalis infection. T. vaginalis is the most common sexually transmitted infection (STI) in women of >40 years, while C. trachomatis and N. gonorrhoeae prevalence is lowest in that age group. Higher T. vaginalis prevalence 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. vaginalis prevalence in all age groups suggests that women screened for C. trachomatis/N. gonorrhoeae, whether asymptomatic or symptomatic, should be screened for T. vaginalis.

Low-level HIV replication in blood and high-level seminal CMV shedding, but not presence of asymptomatic STIs, is associated with seminal shedding of HIV in men receiving ART, conferring a potential risk for HIV transmission.

Background Recent data suggest sexual transmission of hepatitis C virus (HCV). However, data on the association between HCV and sexually transmitted disease (STD) prevalence are limited. Methods This was a retrospective cohort study of treatment-naïve HIV-infected adults ≥ 18 years first engaging at Washington University HIV Clinic from 2001 to 2009, who had routine STD and HCV antibody testing done. Gonorrhea, chlamydia, syphilis, and HCV cases were defined by positive urine nucleic acid amplification test for Neisseria gonorrhoeae, Chlamydia trachomatis, reactive serum rapid plasma reagin, and positive HCV antibody, respectively. Associations with HCV and STD using χ2, Student's t, and Wilcoxon tests were determined. Discussion Of 926 subjects (median age 32 years, 70% African American, 44% heterosexual, 42% men-who-have-sex-with-men [MSM], 4% injection drug users [IDU]), 8% had HCV (range 5-11%/year). Baseline STD was prevalent in 27% (18-34%/year). The prevalence of gonorrhoea, chlamydia and syphilis were 12% (7-21%/year), 12% (6-17%/year) and 10% (5-16%/year), respectively. Subjects with HCV were older (42 years, interquartile range versus 31 years, ) (p < 0.001) and more likely to report past IDU (30% versus 2%) (p < 0.001) than those without. Male subjects with HCV were less likely to be MSM (28% vs 66%) (p < 0.001) and 36% of subjects with HCV were heterosexuals without past IDU. Subjects with HCV were less likely to have STD (17% vs 28%, p = 0.06), although this finding did not reach statistical significance. Furthermore, the number and type of STDs at presentation were not associated with prevalent HCV. Conclusion Hepatitis C was prevalent in approximately 1 in 10 persons engaging in HIV outpatient care over nine years. A high prevalence of HCV among heterosexuals without past IDU suggests a possible role for sexual transmission of HCV not reflected by STD prevalence. Continued universal HCV screening among HIVinfected adults is imperative. Results In 2011, 346911 cases of chlamydia (rate: 175 per 100000 population) were reported compared to 39179 cases of gonorrhoea (12.6/100000) and 19798 cases of syphilis (4.9/100000). Chlamydia was more frequently reported among women (male-to-female ratio: 0.7) in contrast to gonorrhoea and syphilis (male-to-female ratios: 2.7 and 3.9 respectively). The highest age and gender-specific rates were observed among 15-19 year old females for chlamydia (1748); 20-24 year-old males for gonorrhoea (71) and 25-24 year-old males for syphilis (16.1). Young adults (15-24 years) accounted for 73% of chlamydia, 42% of gonorrhoea and 16% of syphilis cases. Transmission among MSM was more frequently reported for syphilis (42%) and gonorrhoea (33%) cases than for chlamydia (5%). HIV co-infection was reported among 11% of gonorrhoea and 28% of syphilis Background We investigated spatial clustering of primary and secondary syphilis rates in North Carolina (2003-2010) using multiple scales and geographical boundaries. We examined the influence of changes in scale and boundary on ide...