Prevention

Partner Management

Communication is an important part of treatment and partner management. Patients should be encouraged to inform their sex partners of the diagnosis of trichomoniasis and to refer them for treatment. Patients should be instructed to avoid sex until they and their sex partners are cured. In the absence of a microbiologic test of cure, which is not recommended, "cure" is defined as when therapy has been completed and patient and partner(s) are asymptomatic.

Patient Counseling and Education

Patient counseling and education should cover the nature of the disease, transmission issues, and risk reduction.

Nature of the disease

• Trichomoniasis may be symptomatic or asymptomatic.
• Douching may worsen vaginal discharge.
• Untreated trichomoniasis is associated with adverse pregnancy outcomes such as premature rupture of the membranes, preterm delivery, and low birthweight infants.
• Alcohol consumption is contraindicated with metronidazole.

Transmission issues

• Trichomoniasis is almost always sexually transmitted. Fomite transmission is rare.
• T. vaginalis may persist for months to years in epithelial crypts and periglandular areas.
• Trichomoniasis is associated with increased susceptibility to HIV acquisition.

Risk reduction

The clinician should:

• Assess the patient’s potential for behavior change.
• Discuss individualized risk-reduction plans with the patient.
• Discuss prevention strategies such as abstinence, mutual monogamy with an uninfected partner, use of condoms, and limiting the number of sex partners.
• Latex condoms, when used consistently and correctly, can reduce the risk of transmission of T. vaginalis.

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