The majority of male partners of women with trichomoniasis were infected; however, few factors predicted infection. T. vaginalis causes a highly prevalent STI, necessitating vastly improved partner management, application of sensitive nucleic-acid based testing, and better clinical recognition.

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Trichomoniasis is moderately prevalent among the general U.S. population of young adults and disturbingly high among certain racial/ethnic groups.

Trichomonas vaginalis infection in men is an important cause of nongonococcal urethritis. Effective detection of the parasite in men using culture requires examination of multiple specimens. We compared culture and PCR-enzyme-linked immunosorbent assay in urethral swabs, urine, and semen for T. vaginalis detection in male sexual partners of women with trichomoniasis identified by wet mount and culture. Trichomonads were detected by at least one positive test in 205/280 men (73.2%) who submitted at least one specimen for culture and PCR. Whereas InPouch TV culture detected only 46/205 cases (22.5%), PCR detected 201/205 (98.0%). Urethral swab cultures from men with urethritis were more likely to be positive with shorter incubation than specimens from men without urethritis. T. vaginalis was detected more often in men with wet-mount-positive partners. Even with a sensitive PCR assay, reliable detection of T. vaginalis in male partners required multiple specimens. The majority of male sexual partners in this study were infected, emphasizing the importance of partner evaluation and treatment.Infection with the protozoan parasite Trichomonas vaginalis is the most common nonviral sexually transmitted infection (STI), with prevalence estimates frequently surpassing those for gonorrhea and chlamydia (36). Infection of the female genital tract can result in vaginitis, cervicitis, and urethritis, and trichomoniasis has been associated with adverse pregnancy outcomes (4, 23, 26). Though it was once virtually ignored, T. vaginalis infection in men is now recognized as an important cause of nongonococcal urethritis (9,27,29) and is associated with prostatitis (17, 25, 31) and male factor infertility (6, 21). In addition, trichomoniasis is a risk factor for sexual transmission of human immunodeficiency virus (HIV) (1,3,5,19). T. vaginalis disrupts the urogenital epithelia and enhances HIV replication in vitro (7). Increased vaginal and endocervical inflammation in women and urethral inflammation in men with trichomoniasis likely contribute to enhanced HIV transmission. Because trichomoniasis is so widespread, substantial proportions of HIV infections might be attributable to T. vaginalis infection in populations where both are prevalent (2, 32).Few studies have examined concordant trichomoniasis in sexual partners. In studies conducted in the early 1990s using culture for T. vaginalis detection, infection was identified in 22 to 48% of male partners of women with trichomoniasis (14, 18). Since that time, more-sensitive nucleic acid amplification assays have been developed for detection of the parasite (8,10,11,13,20,22,30). T. vaginalis detection in men is also improved when multiple urogenital specimens are tested (12, 15, 16). The current study was designed to examine the concordance of T. vaginalis infection in the male sexual partners of women with trichomoniasis attending 3 sexually transmitted diseases (STD) clinics in the United States. In this report, we focus on the performance of culture and PCR from urethral swabs,...

Programs to help people living with HIV/AIDS practice safer sex are needed to prevent transmission of HIV and other sexually transmitted infections. We sought to assess the impact of SafeTalk, a multicomponent motivational interviewing-based safer sex program, on HIV-infected patients’ risky sexual behavior. We enrolled sexually active adult HIV-infected patients from one of three clinical sites in North Carolina and randomized them to receive the 4-session SafeTalk intervention versus a hearthealthy attention-control. There was no significant difference in the proportion of people having unprotected sex between the two arms at enrollment. SafeTalk significantly reduced the number of unprotected sex acts with at-risk partners from baseline, while in controls the number of unprotected sex acts increased. Motivational interviewing can provide an effective, flexible prevention intervention for a heterogeneous group of people living with HIV.