Oral Trichomoniasis: Epidemiology, Pathogenesis, and Clinical Significance

Abstract

Trichomonas vaginalis is a globally prevalent, non-viral sexually transmitted infection (STI) that significantly impacts reproductive and sexual health. Despite its wide distribution, trichomoniasis remains underrecognized in public health strategies, with routine screening limited to women living with HIV. Traditional diagnostic techniques often lack sensitivity, but the development of nucleic acid amplification tests (NAATs) has enhanced diagnostic accuracy, with several options now available as point-of-care (POC) tests. This review explores the current understanding of trichomoniasis, including its epidemiology, pathogenesis, diagnosis, and treatment. Epidemiological data indicate higher prevalence in women than men, although spontaneous resolution in men may contribute to this disparity. Socioeconomic factors such as age, education level, and income, as well as race, particularly among Black communities, play a significant role in infection rates. Structural inequities, limited access to care, and lack of awareness have hindered effective control efforts. The review concludes that addressing trichomoniasis requires improved access to sensitive diagnostics, targeted screening in high-risk populations, culturally competent education, and integrated sexual health services. Greater focus on underrepresented groups, such as men and gender-diverse populations, is also necessary to reduce the global burden of this STI.