Cervical Cancer Screening with Human Papillomavirus Self-Sampling Among Transgender Men in El Salvador

LGBT Health. 2020 May/Jun;7(4):174-181. doi: 10.1089/lgbt.2019.0202. Epub 2020 May 14.

Abstract

Purpose: Sexual and gender minority persons in low-income countries have very limited access to routine health services. This study evaluated the feasibility of using a self-sampled human papillomavirus (HPV) test to increase access to screening for cervical cancer among transgender men in El Salvador. Methods: We partnered with a local advocacy organization for recruitment. A total of 24 transgender men (men assigned female at birth) ages 19-55 were enrolled and provided consent. Questionnaires assessed sociodemographics, health and sexual histories, and knowledge about HPV and cervical cancer. Screening was performed with a self-sampled HPV test. Participants with a positive test were offered colposcopy and cryotherapy treatment, if appropriate. Those with a negative test were advised to return in 5 years for rescreening. Results: Out of 24 consenting participants, 23 (95.83%) agreed to conduct HPV self-sampling, and 22/23 (95.65%) expressed willingness to self-sample in the future. Among self-sampled individuals, 3/23 (13%) tested positive and accepted colposcopy and biopsy. Analyses of biopsied tissue revealed one case of cervical intraepithelial neoplasia grade 1. Conclusion: HPV self-sampling and subsequent procedures were accepted by the majority of participants. This screening method may be a viable alternative to cytology among transgender men in El Salvador.

Keywords: El Salvador; HPV self-sampling; LMICs; cervical cancer; sexual and gender minorities; transgender men.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alphapapillomavirus
  • Colposcopy
  • Early Detection of Cancer*
  • El Salvador
  • Female
  • Gender Identity
  • Humans
  • Incidence
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Papillomavirus Infections / complications
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / epidemiology
  • Papillomavirus Infections / virology
  • Patient Acceptance of Health Care* / statistics & numerical data
  • Prevalence
  • Self Care
  • Specimen Handling
  • Transgender Persons*
  • Transsexualism*
  • Uterine Cervical Neoplasms / complications
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / virology
  • Vaginal Smears / methods
  • Young Adult