[Question #6710] Trich Test Results

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66 months ago
I am a female in my 30s. I had a brief sexual encounter 7 months ago. Naked frottage/apposition. This was vigorous rubbing together penis on vagina but no penetration into the vagina or anus. The penis head may have poked the vaginal opening and anal opening but I would not say that it penetrated. I have tested negative for HIV, Syphilis, Gonorhea, Chalmydia, Hep B & C, HSV, and had a Pap with normal results.  I did give fellatio unprotected and was tested for Gonorrhea and Chlamydia of the throat which also came back negative. 

I was also tested for Trich and BV and am almost certain this test was done under a microscope bc it was done in office with a vaginal swab. I was told I did not have Trichomonas or BV at that same visit, maybe 10 minutes or so after the swab was taken. Are these results reliable? I have read that wet mount microscopy is not a very reliable way to diagnose for Trich and some infections are missed.  Is there any way I could have contracted Trich from the encounter I described above and if so, is the likelihood high they missed the infection?

Fast forward to now, slight symptoms of UTI (the need to urinate frequently) have begun. I went to doc and had a urinalysis dipstick test done, which showed I had leukocyte in urine, but no nitrates, a ph of 6.0 and protein in urine. I’m awaiting culture results and have been given an antibiotic. I guess I am just fearful that I in fact have Trichomonas and the initial vaginal swab may have missed it. 

The sexual encounter I describe was not with my regular partner and I have resumed unprotected sex with regular partner. Any reason I should be worried about Trich? 
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Edward W. Hook M.D.
66 months ago

Welcome to the Forum and thanks for your question, as well as your detailed description of events and test results.  Trichomoniasis is a poorly understood STI.  The tests you had were the standard of care until the past few years when more sensitive PCR-type tests for trichomonas became available.  With the more sensitive tests we have become aware that microscopy for diagnosis of trichomonas detected only about 60% of infections so indeed an infection might have been unlikely.  The encounter you describe however is rather low risk for infection.  As for much with this infection, understanding is still evolving however we do know that most men do not have trich, that most exposure do not lead to infection and that non-penetrative exposures are far less likely to result in infection than penetrative sex.  Thus, while it is possible that trich could be the cause of your current symptoms, it is really not very likely.  Given your level of concern, it may be worthwhile to find a health care provider who can perform a PCR-type test on a vaginal swab for trich.  I suspect the test will be negative but the peace of mind may be worth it. 

I hope that this information is helpful.  EWH

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66 months ago
Thanks so much for the quick reply. I would like to ask though. I’ve read through several threads, and have noticed many of the responses from Dr. Handsfield and yourself have stated that no penetration means no risk for STIs, Trich included. And sexual events like the ones I’ve described are no risk. Is there a reason in particular, that my particular encounter has changed your usual assessment  and that I indeed could have acquired trich from the events I’ve described?

Also, if my results from my urine culture come back and are indeed from a regular bacterial infection, would you say that I could put this event behind me? 
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66 months ago
I’d like to add, I just had a urine trich test done, and they treated me with medication just in case that covers the infection. They gave me the medication and I immediately gave them a urine sample after medication administration.  They said this will not effect the results, do you agree with this? 
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Edward W. Hook M.D.
66 months ago

The reason for my more cautious reply to your question regarding trichomoniasis is that while gonorrhea and chlamydia are pathogens which must reach the cervix of the uterus to cause infection, trichomonas can infect the vaginal and, as a result, has a slightly higher chance of being transmitted through non-penetrative exposure with frottage (genital rubbing and apposition). 

If your urine test is positive for bacteria. then it is more likely than not that you have a UTI and do not have trich. 

The fact that you had just taken the medication for trichomoniasis will not effect the results of your trich test taken immediately after. 

Hope this is helpful. EWH 

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