Implementation of Screening for T. Vaginalis in Incarcerated Adolescents with Vaginas

Trichomonas vaginalis, a parasitic infection causing trichomoniasis, is the most prevalent non-viral sexually transmitted infection globally. Trichomoniasis presents potential reproductive health risks to people with vaginas such as preterm birth, preterm rupture of membranes, heightened susceptibility to HIV, bacterial vaginosis, and herpes simplex virus type 2. Local Problem: The CDC (2022) advocates for trichomoniasis screening for individuals with vaginas aged 35 years and younger in correctional facilities but screening is not currently done in JJYS facilities. Implementing trichomoniasis screening for adolescents with vaginas during initial intake in juvenile detention facilities was recommended. Methods: A quality improvement project occurred over the course of three and a half months to implement trichomoniasis screening in adolescents with vaginas at juvenile detention centers in the state of Utah. A pre-intervention and post-intervention survey was distributed to registered nurses (RNs) and advanced practice registered nurses (APRNs) to assess confidence in sexual health management and trichomoniasis infection in adolescents with vaginas. The data from both surveys was compared to determine feasibility, usability, and satisfaction. A chart review of the electronic health record (EHR) was used to determine if screening was being done during the intervention period. Interventions: Protocol for sexual transmitted infection screening was adapted to included trichomoniasis screening. Education was provided to staff on the implementation of trichomoniasis screening and how to instruct adolescents with vaginas to provide a self-swab sample. Resources on STIs in general and trichomoniasis screening protocol were added into the encrypted electronic application for staff to reference. Results: During the intervention 19 adolescents with vaginas were screened for trichomoniasis. No statistical significance existed between pre- and post-survey confidence responses concerning knowledge of STIs and educating adolescents on STIs and screening methods. The first two questions had a confidence increase from 64% to 83% and 55% to 82% respectively. The remaining confidence questions had a negligible increase in confidence from pre- to post- survey. However clinical significance is evident in the responses regarding feasibility, usability, and satisfaction of the intervention in the post-survey. Conclusion: This QI project addressed a practice gap by implementing trichomoniasis screening for incarcerated adolescents with vaginas. The results of the QI project indicate that staff members were overall satisfied with the new screening protocol for trichomoniasis, and the screening protocol is feasible and usable in the long-term. Keyw