Acceptability of routine Trichomonas screening for incarcerated women

BACKGROUND: Trichomonas is the most prevalent curable sexually transmitted infection in the United States. It has been associated with preterm delivery, infertility, HIV and cervical neoplasia. Incarcerated women exhibit a higher prevalence of Trichomonas (37%) than reproductive age women in the general U.S. population (3.1%). Rates of testing remain low despite the potential complications. OBJECTIVE: We sought to determine the acceptability of testing for Trichomonas for women entering jail by a self-obtained vaginal swab. METHODS: A random sample of 118 women entering the Rhode Island Department of Corrections was recruited. Women were instructed on how to collect self-obtained vaginal samples and completed a satisfaction survey after getting the samples. RESULTS: When asked their agreement with the statement, “It was easy to collect the vaginal swab”, 55% of participants indicated “very strong agreement” and 18.3% indicated “moderate agreement”. Regarding preferred specimen collection method, 63.5% selected self-obtained vaginal swab, 23.8% designated pelvic exam and 12.7% opted for urine sample. CONCLUSIONS: Incarcerated women, who exhibit a high STD incidence rate overall, find self-obtained vaginal swabs acceptable to test for STDs. Routine screening of the incarcerated population has the potential to improve Trichomonas detection and treatment rates dramatically. This population is especially important to target not only due to a high burden of disease, but also high rates of associated illnesses, including HIV and cervical neoplasia.