No feature of Trichomonas vaginitis is specific to confirm a diagnosis. The diagnosis requires the demonstration of the organism. The vaginal pH is generally 4.5 or higher. Routine culture is not widely available. Treatment Women with HIV infection should receive the same treatment regimen as those who are uninfected.
Sexual abstinence is advised until symptoms improve and partners are treated.
The use of metronidazole is contraindicated in the first trimester of pregnancy and treatment should be deferred until after the first 14 weeks of gestation. Local vaginal therapy is not recommended because of its failure to eradicate infection from the urethra and periurethral glands, which may be a source of endogenous infection. Intravaginal clotrimazole therapy may provide symptomatic relief but is not recommended for routine use. It is unclear whether HIV infection increases the risk of acquiring vaginal infections. However, these infections are common in women at risk for other STDs.