Genital human papillomavirus detection in self-samples from transgender men

Transgender men with a cervix may face barriers to routine cervical cancer screening, including discomfort, dysphoria, and avoidance of pelvic examinations. Self-collected human papillomavirus (HPV) testing may offer a more acceptable screening approach.

The aim of this study was to assess the acceptability of self-collected HPV testing and to explore HPV prevalence among transgender men with a cervix.

We conducted a cross-sectional proof-of-concept study at Ghent University Hospital, Belgium, between March 2023 and June 2023. Adult transgender men with a cervix who were not hormone-naïve provided urine and vaginal self-samples for HPV testing and completed a questionnaire on screening history and self-sampling experiences. Analyses were primarily descriptive, and group comparisons used the Mann-Whitney U test or Kruskal-Wallis test, as appropriate.

Nineteen participants were enrolled. Self-collected HPV testing was highly acceptable: 18 of 19 participants (94.7%) considered self-sampling a valuable alternative to routine cervical cancer screening, and 16 of 19 (84.2%) preferred urine-based over vaginal self-sampling. HPV positivity was detected in 2 of 17 urine samples and 3 of 17 vaginal self-samples, with genotypes 53 and 66 identified.

Self-collected HPV testing was well accepted and may reduce barriers to cervical cancer screening in transgender men.