STD, Trichomonas, More Common in Older Women

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Sexually transmitted diseases (STDs) are thought to be more prevalent in young people, but a new study found that STDs caused by the parasite Trichomonas vaginalis are more common in older women.

Charlotte Gaydos, M.S., Dr.P.H., Johns Hopkins infectious disease expert, and colleagues will present the results of their study to be today at the annual meeting of the International Society for STD Research, in Quebec City, Canada.

Gaydos and her colleagues study involved 7,593 U.S. women between the ages of 18 and 89 from women in 28 states and is is believed to be the largest and most in-depth analysis of the STD ever performed in the United States, complementing periodic national surveys of adolescents and individual city reports.

The test samples were collected from women in private clinics, emergency departments, hospitals, jails and community health STD clinics between July 1 and Dec. 30, 2010. Researchers used the latest genetic assay, a test that is almost 100 percent foolproof in detecting trichomonas, instead of traditional testing methods, which are only accurate about half the time.

Test samples showed women 50 and older had the highest trichomonas infection rate (13%), while women in their 40s were next (11%). The infection rate was 8.5% in women ages 18 and 19, dropping slightly to 8.3% for women in their 20s.

Overall, the survey results showed that 8.7% of all women tested positive for the STD. Infection rates were highest among black women of all ages, at 20%, more than three times the rate in white women (5.7%).

Women in the relatively poorer Southeast United States have the highest regional trichomonas infection rate (14%), whereas women in the more affluent Northeast had the lowest (4.3%).

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Gaydos says this finding mirrors results of other health surveys tying increased STD infection rates – such as chlamydia and gonorrhea, too -- to high levels of poverty, unemployment, and lack of education in different racial and ethnic groups.

Gaydos and colleagues are calling for all sexually active American women age 40 and older to get tested for the parasite Trichomonas vaginalis. Screening is especially important because in many cases there are no symptoms.

"Trichomonas infections are quite treatable with antibiotics," says Gaydos, a professor at the Johns Hopkins University School of Medicine." And these high numbers really warrant older women getting screened by their family physicians and gynecologists during routine check-ups to make sure they are not infected and are not inadvertently spreading it to others."

Gaydos says testing is needed to prevent transmission of the parasite because some infected women and most infected men show no signs of the disease, such as liquid discharge from the vagina or penis, irritation while urinating and genital itching.

Left untreated, trichomoniasis can lead to severe health problems. Trichomonas infection is closely tied to co-infection with HIV, easing transmission of the virus that causes AIDS. Trichomoniasis can also lead to inflammation of the vagina, urethra and cervix and to pelvic inflammatory disease, and in pregnant women, the infection has been known to cause premature labor and result in more low-birth-weight babies.

The public health threat of trichomonas is compounded, Gaydos adds, by the fact that, unlike other common STDs, such as the bacteria Chlamydia trachomatis and Neisseria gonorrhoeae, confirmed cases of parasitic trichomonas infection do not have to be reported to local public health officials and the U.S. Centers for Disease Control and Prevention.

The U.S. CDC lists Trichomonas vaginalis as the most common sexually transmitted disease in the nation, with an estimated 7.2 million men and women newly infected each year. The World Health Organization estimates the annual rate of new infected people at 173 million.

Samples were collected from across the country, including from Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Michigan, Minnesota, Missouri, Nevada, New Jersey, New Mexico, New York, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Utah, Virginia, and Wisconsin.

The above story is reprinted (with editorial adaptations by Ramona Bates, MD) from materials provided by ISSTDRQuebec2011, via EurekAlert!, a service of AAAS.

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