Use of urine polymerase chain reaction to define the prevalence and clinical presentation of Trichomonas vaginalis in men attending an STD clinic

Objective: To determine the prevalence and clinical features of Trichomonas vaginalis (TV) infection in men. Methods: Men attending a public STD clinic in Baltimore, Maryland, were evaluated between March and July 2000. Clinicians recorded a standardised history and clinical examination. Urethral swab specimens were collected for Gram stain and Neisseria gonorrhoeae culture. First fraction urine samples were evaluated with TV culture and chlamydia and TV polymerase chain reaction (PCR). True positive TV was defined as a positive TV culture or a positive TV PCR confirmed with a second primer set. Results: 355 men were evaluated in 363 visits. The prevalence of gonorrhoea, TV, and chlamydia were 19%, 13%, and 11%, respectively. In men over 28 years, the prevalence of TV was significantly higher than chlamydia. Age and urethritis by Gram stain were associated with a positive result on TV culture (p=0.03 and p=0.02, respectively) but not associated with TV infection as defined by a positive TV culture or a confirmed TV PCR. Discharge or dysuria was reported in 47% and 22% of men with TV, respectively. Conclusions: TV prevalence in an urban STD clinic setting was high. Older age and urethritis were not significantly associated with TV infection as defined by a positive TV culture or a confirmed TV PCR.