Trichomoniasis (Trich) in South Africa: Symptoms, Testing & Treatment | Epicentre
🔬 Trichomonas vaginalis · Parasitic STI

Trichomoniasis: The Most Common Curable STI You've Probably Never Heard Of

Not a bacterium. Not a virus. Trich is caused by a tiny parasite. It's the most common curable STI in the world, but 85% of women and 77% of men have no idea they're carrying it. Sub-Saharan Africa has the highest rates globally.

✓ Curable with treatment 🔬 Parasite (not bacteria or virus) 🧬 PCR detectable in 3-7 days 🏥 No referral needed
Am I At Risk? → How to Get Tested ↓
85%
of women with trich
have no symptoms
🩺
Medically Reviewed
Dr. Samantha Naidoo
MB ChB, FCP (SA) · Medical Director, Epicentre Laboratories
Published: 2 August 2025 · Last reviewed: 1 March 2026
Key facts

How common is trichomoniasis in South Africa?

7.6%
of SA women infected
NICD Surveillance
1.7%
of SA men infected
10× gender disparity in Africa
85%
of infected women are asymptomatic
Waaij et al., 2017
✓
Curable with treatment from your doctor
Both partners must be treated
⚠
Increases HIV transmission risk
Increases genital HIV shedding
2,100+
trich cases detected at Epicentre in 2025
Across JHB, CPT & DBN labs
The gender gap

Why does trichomoniasis affect women and men so differently?

Trich is one of the most gender-unequal STIs. In sub-Saharan Africa, infection rates in women are roughly 10 times higher than in men. The parasite behaves differently depending on where it lives.

In people with a vagina
85% asymptomatic
Infection persists for months without treatment
  • Parasite thrives in the vaginal environment
  • Infection can last months to years if untreated
  • When symptoms appear: frothy yellow-green discharge, strong odour, itching, burning, pain during sex
  • Often mistaken for bacterial vaginosis or yeast infection
  • Increases vulnerability to HIV and other STIs
  • During pregnancy: risk of premature birth and low birth weight
In people with a penis
77% asymptomatic
Infection often clears on its own but transmits first
  • Parasite infects the urethra
  • Male infections frequently clear spontaneously
  • Men act as silent carriers, reinfecting partners
  • When symptoms appear: mild discharge, burning after urination or ejaculation
  • Rarely diagnosed because symptoms are mild or absent
  • Both partners must be treated simultaneously
Why both partners must be treated: Because male infections are usually silent, an untreated male partner will reinfect a treated female partner. Epicentre tests both partners in the same visit. Private rooms available for couples.
"
"Trich is the STI that falls through the cracks. Women get treated for what they think is thrush, but the real culprit is Trichomonas. Their partner has no symptoms, so nobody tests him. She finishes treatment, they have sex, and within weeks she's symptomatic again. PCR testing both partners at Epicentre breaks this cycle."
Dr. Samantha Naidoo, MB ChB, FCP (SA), Medical Director, Epicentre
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If untreated

What happens if trichomoniasis goes untreated?

Trich is curable, but ignoring it has real consequences, particularly for women and during pregnancy.

1
Days 3-28: Infection establishes
The parasite colonises the vagina, cervix, or urethra. Most people have no symptoms. You are infectious from the start.
2
Weeks to months: Chronic infection (women)
In women, the parasite persists for months or years without treatment. May cause chronic vaginitis: persistent discharge, odour, itching, and discomfort during sex. About one-third of asymptomatic women develop symptoms within 6 months.
3
HIV risk: significantly increased
Trich causes genital inflammation that increases HIV shedding and susceptibility. An untreated trich infection makes you more likely to contract or transmit HIV if exposed.
4
In pregnancy: premature birth and low birth weight
Trich can cause premature rupture of membranes, leading to early delivery and low birth weight. Testing during pregnancy is important. Trich is curable during pregnancy with treatment from your doctor.
5
Reinfection cycle
Without treating both partners, reinfection is almost guaranteed. The treated partner clears the infection, the untreated partner reinfects them, and the cycle continues. This is the most common pattern Epicentre sees with trich.
Get tested

Where can I test for trichomoniasis in South Africa without a referral?

Trich is detected by PCR testing using a urine sample or self-collected swab. Testing window: 3-7 days after exposure. Trich is included in every Epicentre PCR sexual health package.

Small PCR (4 pathogens)

R1,235🎓 R1,112

Trich + chlamydia + gonorrhoea + herpes (HSV-2). Good starting point for routine screening.

4× R309/mo with Payflex
🎓 10% student👴 10% pensioner
Learn More →Book

Medium PCR (9 pathogens) ⭐

R1,508🎓 R1,357

Trich + chlamydia + gonorrhoea + herpes + mycoplasma + ureaplasma + E. coli. Best value for couples testing together.

4× R377/mo with Payflex
🎓 10% student👴 10% pensioner
Learn More →Book

Large (14-17 pathogens)

R1,925🎓 R1,733

Trich + all Medium targets + HPV, BV markers, Candida. Choose Cervical (17) or Penile (14) at checkout.

4× R482/mo with Payflex
🎓 10% student👴 10% pensioner
Compare →Book

Trichomoniasis is included in every Epicentre PCR sexual health package. View all packages →

FAQ

Trichomoniasis: Your Questions Answered

Can you have trich without symptoms?

Yes. 85% of women and 77% of men with trich have no symptoms at all. About one-third of asymptomatic women develop symptoms within 6 months. Men often clear the infection spontaneously but transmit it to partners before doing so.

Is trich the same as thrush or BV?

No. Trich is a parasitic STI. Thrush (Candida) is a yeast infection. BV (bacterial vaginosis) is an imbalance of vaginal bacteria. All three can cause discharge and odour, but the causes, treatments, and implications are different. PCR testing at Epicentre distinguishes between them.

Can men get trich?

Yes. Most men are asymptomatic carriers. They carry the parasite in the urethra and transmit it to partners without knowing. Both partners must be treated simultaneously to prevent reinfection.

How soon can I test after exposure?

PCR: 3-7 days. Epicentre uses PCR for all sexual health panels. Trich is included in every package from R1,235.

Is trich dangerous during pregnancy?

Yes. Trich can cause premature rupture of membranes, premature labour, and low birth weight. It is curable during pregnancy with treatment from your doctor.

Why do I keep getting trich?

The most common reason is an untreated partner. Male trich is almost always silent, so if your partner was not tested and treated at the same time as you, reinfection is nearly certain. Bring your partner to Epicentre for same-day testing.

How much does trich testing cost?

Small PCR: R1,235. Medium PCR: R1,508. Large: R1,925. Students 10% off. Payflex 4× interest-free. Trich is in every PCR package. View all packages →

STI guide

Other infections in this guide

🦠 Chlamydia 🦠 Gonorrhoea 🧬 Genital Herpes 🧬 HIV / AIDS 🧬 HPV 🦠 Syphilis 🦠 Mycoplasma genitalium 🦠 Mycoplasma hominis 🦠 Ureaplasma 🧬 Viral Hepatitis 🦠 Male Urethritis 🦠 Chancroid
📚 Interactive STI Guide 🔬 All Packages & Pricing 📦 Home Test Kits 🎓 Student Discount

Trich is Curable. But Both Partners Need Testing.

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