Trichomonas vaginalis, HIV, and African Americans
Trichomonas vaginalis, HIV, and African Americans
Trichomonas vaginalis may be emerging as one of the most important cofactors in amplifying HIV transmission, particularly in African-American communities of the United States. In a person co-infected with HIV, the pathology induced by T. vaginalis infection can increase HIV shedding. Trichomonas infection may also act to expand the portal of entry for HIV in an HIV-negative person. Studies from Africa have suggested that T. vaginalis infection may increase the rate of HIV transmission by approximately twofold. Available data indicate that T. vaginalis is highly prevalent among African-Americans in major urban centers of the United States and is often the most common sexually transmitted infection in black women. Even if T. vaginalis increases the risk of HIV transmission by a small amount, this could translate into an important amplifying effect since Trichomonas is so common. Substantial HIV transmission may be attributable to T. vaginalis in African-American communities of the United States.
Trichomonas vaginalis is a protozoan parasite transmitted principally through vaginal intercourse. Infection with the organism, while frequently asymptomatic, can cause vaginitis in women and urethritis in men. Despite a relative paucity of studies on the prevalence and incidence of trichomoniasis, recent publications suggest that T. vaginalis is one of the most common sexually transmitted infections (STIs) in the United States, with an estimated 5 million new cases occurring annually. Although the organism appears to be highly prevalent and has a widespread geographic distribution, Trichomonas has not been the focus of intensive study nor of active control programs. This neglect is likely a function of the relatively mild nature of the disease, the lack of effect on fertility, and the historic absence of association with adverse birth outcomes (although recent data suggest a possible causal role in low birth weight and prematurity). However, Trichomonas may play a critical and underrecognized role in amplifying HIV transmission. We present the rationale to support the hypothesis that T. vaginalis may be an important cofactor in promoting the spread of HIV and, in some circumstances, may have a major impact on the epidemic dynamics of HIV in African-American communities.
Trichomonas vaginalis may be emerging as one of the most important cofactors in amplifying HIV transmission, particularly in African-American communities of the United States. In a person co-infected with HIV, the pathology induced by T. vaginalis infection can increase HIV shedding. Trichomonas infection may also act to expand the portal of entry for HIV in an HIV-negative person. Studies from Africa have suggested that T. vaginalis infection may increase the rate of HIV transmission by approximately twofold. Available data indicate that T. vaginalis is highly prevalent among African-Americans in major urban centers of the United States and is often the most common sexually transmitted infection in black women. Even if T. vaginalis increases the risk of HIV transmission by a small amount, this could translate into an important amplifying effect since Trichomonas is so common. Substantial HIV transmission may be attributable to T. vaginalis in African-American communities of the United States.
Trichomonas vaginalis is a protozoan parasite transmitted principally through vaginal intercourse. Infection with the organism, while frequently asymptomatic, can cause vaginitis in women and urethritis in men. Despite a relative paucity of studies on the prevalence and incidence of trichomoniasis, recent publications suggest that T. vaginalis is one of the most common sexually transmitted infections (STIs) in the United States, with an estimated 5 million new cases occurring annually. Although the organism appears to be highly prevalent and has a widespread geographic distribution, Trichomonas has not been the focus of intensive study nor of active control programs. This neglect is likely a function of the relatively mild nature of the disease, the lack of effect on fertility, and the historic absence of association with adverse birth outcomes (although recent data suggest a possible causal role in low birth weight and prematurity). However, Trichomonas may play a critical and underrecognized role in amplifying HIV transmission. We present the rationale to support the hypothesis that T. vaginalis may be an important cofactor in promoting the spread of HIV and, in some circumstances, may have a major impact on the epidemic dynamics of HIV in African-American communities.
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