(132) Prevalence and Risk Factors of Human Papillomavirus Infection Among Transmasculine People

Introduction Transgender medicine is an evolving field that encompasses a broad spectrum of essential health concerns, including hormone therapy, surgical interventions, psychological support, and overall quality of life. While these areas are commonly recognized, sexually transmitted infections (STIs) remain an often-overlooked concern, particularly for transmasculine individuals (TM). Due to sexual preferences and behaviors, TM are at heightened risk for STIs, including human papillomavirus (HPV). HPV is one of the most prevalent STIs among cisgender women, with high-risk strains found even in women who have sex with women (WSW) without receptive vaginal intercourse. This highlights the need for HPV screening across all individuals with a cervix, including TM. In the U.S., approximately 14% of TM have undergone hysterectomy, leaving the majority still at risk for HPV-related diseases. Despite these risks, specific guidelines for cervical cancer screening in TM are absent. Barriers to screening include provider unfamiliarity with the unique needs of TM patients, particularly those on testosterone therapy who experience masculinization effects and vaginal atrophy. Additionally, many TM individuals experience discomfort and stigma surrounding cervical exams. Self-collected HPV tests may provide a viable, patient-centered solution to increase screening adherence in this population. Objective This study aims to evaluate the prevalence of HPV infection among transmasculine individuals (TM ) using both self-collected and provider-collected methods. Moreover, cervical cytology results and potential risk factors associated with HPV infection in this specific population were assessed. Methods All eligible participants were provided both self-collected and provider-collected methods for 28 HPV strains. Additionally, cervical cytology samples were obtained by provider-collected method. Results A total of 227 TM were enrolled with a mean age of 31.6 ± 6.2 years. Among them, 197 (86.8%) reported having female sexual partners, 6 (2.6%) had male partners, 5 (2.2%) had both male and female partners, and 19 (8.4%) reported having no partner. The prevalence of HPV was 22.5% (51/227) in self-collected method and 14.5% (33/227) in provider-collected method, with a kappa agreement of 0.653. The most common HPV types detected by both methods were HPV 39 and 52. HPV 16/18 were detected in 5.4% (12/227) of participants. Majority of participants, 96.9% (220/227) were unvaccinated for HPV. Moreover, TM who reported having male partners had a highest risk of HPV infection (adjusted OR 11.832, 95% CI: 1.254–111.684, p = 0.031), as did those who reported vaginal sex as their primary sexual activity (adjusted OR 10.965, 95% CI: 2.941–40.882, p < 0.001). Lastly, 59.9% (136/227) of participants preferred self-collected over provider-collected method. Conclusions HPV infection is common among TM, underscoring the urgent need for more accessible screening options. Self-collected method yielded promising results and were preferred by most participants, making self-collection a practical, TM-friendly option. These results highlighted the need for accessible, inclusive sexual healthcare, and increased provider awareness of transgender health needs. Disclosure No