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在出生时被指定为女性的跨性别和性别多样化人群中进行子宫颈阴道和肛门HPV检测的自我采样:舒适度、难度及使用意愿

Cervicovaginal and anal self-sampling for HPV testing in a transgender and gender diverse population assigned female at birth: comfort, difficulty, and willingness to use.

作者信息

Welsh Erin F, Andrus Emily C, Sandler Claire B, Moravek Molly B, Stroumsa Daphna, Kattari Shanna K, Walline Heather M, Goudsmit Christine M, Brouwer Andrew F

机构信息

Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States.

Reproductive Endocrinology Clinic, Center for Reproductive Medicine, University of Michigan, Ann Arbor, MI, United States.

出版信息

medRxiv. 2023 Aug 16:2023.08.15.23294132. doi: 10.1101/2023.08.15.23294132.

Abstract

BACKGROUND

Transgender and gender diverse (TGD) people assigned female at birth (AFAB) face numerous barriers to preventive care, including for HPV and cervical cancer screening. Self-sampling options may expand access to HPV testing for TGD people AFAB.

METHODS

We recruited TGD individuals AFAB to collect cervicovaginal and anal specimens at-home using self-sampling for HPV testing, and individuals reported their perceptions of self-sampling. Associations between demographic and health characteristics and each of comfort of use, ease of use, and willingness to use self-sampling were estimated using robust Poisson regression.

RESULTS

The majority of the 101 participants who completed the study reported that the cervicovaginal self-swab was not uncomfortable (68.3%) and not difficult to use (86.1%), and nearly all (96.0%) were willing to use the swab in the future. Fewer participants found the anal swab to not be uncomfortable (47.5%), but most participants still found the anal swab to not be difficult to use (70.2%) and were willing to use the swab in the future (89.1%). Participants were more willing to use either swab if they had not seen a medical professional in the past year. About 70% of participants who reported negative experiences with either self-swab were still willing to use that swab in the future.

CONCLUSIONS

TGD AFAB individuals were willing to use and preferred self-sampling methods for cervicovaginal and anal HPV testing. Developing clinically approved self-sampling options for cancer screening could expand access to HPV screening for TGD AFAB populations.

摘要

背景

出生时被指定为女性的跨性别者和性别多样化(TGD)人群在获得预防性保健方面面临诸多障碍,包括人乳头瘤病毒(HPV)和宫颈癌筛查。自我采样选项可能会扩大TGD出生时被指定为女性的人群获得HPV检测的机会。

方法

我们招募了出生时被指定为女性的TGD个体,让他们在家中使用自我采样收集宫颈阴道和肛门标本进行HPV检测,并且个体报告了他们对自我采样的看法。使用稳健泊松回归估计人口统计学和健康特征与使用舒适度、易用性以及使用自我采样的意愿之间的关联。

结果

完成研究的101名参与者中的大多数报告称,宫颈阴道自我采样拭子使用起来并不不舒服(68.3%)且不难用(86.1%),几乎所有参与者(96.0%)都愿意在未来使用该拭子。较少的参与者认为肛门采样拭子使用起来不舒服(47.5%),但大多数参与者仍然觉得肛门采样拭子不难用(70.2%),并且愿意在未来使用该拭子(89.1%)。如果参与者在过去一年中没有看过医疗专业人员,他们更愿意使用这两种拭子中的任何一种。报告在任何一种自我采样拭子上有负面体验的参与者中,约70%仍愿意在未来使用该拭子。

结论

出生时被指定为女性的TGD个体愿意使用并更喜欢自我采样方法进行宫颈阴道和肛门HPV检测。开发经临床批准的癌症筛查自我采样选项可以扩大出生时被指定为女性的TGD人群获得HPV筛查的机会。

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