Unusual STI Linked to Social Determinants of Health and Access to Care

June 23, 2022 - Trichomoniasis — caused by Trichomonas vaginalis (TV) — is a common sexually transmitted infection (STI) that is often present without symptoms but can cause serious complications if left untreated. Results from a recent population analysis conducted in Britain found that 3.5% of all women in the country may have the little-researched infection, and Black, Caribbean, and African women had an elevated risk of developing the condition.

The study conducted by Preventx, a remote sexual health testing provider, looked at STI tests for 8,676 women across six geographic areas and established a background positivity rate of 3.5% for all women. Researchers further analyzed the results and found that minority women experienced a positivity rate of 5.2% and an asymptomatic rate nearly twice that of white British women.

The data surprised study runners and definitively demonstrated the high prevalence of Trichomoniasis for the first time. “We’ve always known that TV was a common infection in London, but our new data shows worryingly high positivity rates elsewhere across England, with certain communities more affected than others,” commented John White, MD, the Medical Director at Preventx.

If left untreated, the STI can contribute to complications like pre-term birth, increased risk of cervical cancer, and increased risk of HIV. The high prevalence of Trichomiansis evidenced by the study established the need for better quality testing. Standard STI tests used in British clinics are not precise enough to detect Trichominaisis; for that, clinicians need more sensitive equipment.

The disproportionately higher rate of Trichominaisis in Black communities corresponds to diminished access to care and economic stability. Achieving health equity depends on ameliorating these and other social determinants of health.

For women living in England who are Black, Caribbean, or of African background, there are underlying barriers to reproductive care that influence their rates of STIs. Preventx posits that clinicians should focus on increased testing access, improved access to care facilities, and low-cost community health initiatives to enhance reproductive health in affected communities.

Racial and ethnic disparities are also prevalent in the United States healthcare system. The corresponding social determinants of health, such as poverty and access to care, often result in minority groups living with STIs for longer periods of time, possibly contributing to worse health outcomes.

US health disparities for most major STIs are aligned around race and ethnicity and social determinants of health. Accordingly, Black people in the US are at disproportionate risk for developing HIV, chlamydia, gonorrhea, and syphilis. Black men were also usually at a higher risk than Black women for contracting these STIs.