Prevalence of HPV infection and anal and cervical cytological abnormalities in transgender people at a referral service in Vitória, Espírito Santo state, Brazil, between 2018 and 2021

Epidemiol Serv Saude. 2024 Dec 16;33(spe1):e2024279. doi: 10.1590/S2237-96222024v33e2024279.especial.en. eCollection 2024.
[Article in English, Portuguese]

Abstract

Objectives: The aim of this study was to determine the prevalence of HPV and cytological alterations in the transgender population and contribute to the development of public policies.

Methods: A descriptive study was conducted in a transgender outpatient clinic in Vitória, Espírito Santo state, between 2018 and 2021. Data were collected through interviews and information from medical records. Anogenital samples were collected for HPV, trichomoniasis, gonococcus and chlamydia testing, cytology.

Results: Of the 110 participants, 60.9% identified as men and 34.5% as women. The overall prevalence of HPV was 58.3%, being higher in women (48.1%). Among men, cervical HPV was positive in 38%, and anal HPV in 25%, with cytological abnormalities found in 9.5%. Abnormal anal cytology was observed in 23.5% of women. Other sexually transmitted infections: chlamydia (4.1%), trichomoniasis (12.5%) and no cases of gonorrhea.

Conclusion: HPV is a prevalent infection with risks for cytological abnormalities in the transgender population, and further studies on prevalence and impacts on sexual health are needed to support screening and prevention policies.

Main results: Transgender people are susceptible to sexually transmitted infections, with a high prevalence of HPV and, consequently, present cytological abnormalities in the anal and cervical regions, which pose a risk for the development of anogenital neoplasia.

Implications for services: This is an invisible population, often absent from health services due to prejudice and stigma. Data on the health of this population contributes to the formulation of inclusive policies for the prevention, screening and diagnosis of STIs and anogenital neoplasia .

Perspectives: Increased support are for further studies on STIs and anogenital neoplasia in the transgender population is needed, through investments in specialized outpatient clinics and research groups, so that public policies can be discussed and implemented.

Objetivos: El objetivo de este estudio es determinar la prevalencia del VPH y cambios citológicos en la población transgénero, cooperar a la creación de políticas públicas.

Métodos: Se realizó estudio descriptivo en un centro especializado en Vitoria-ES entre 2018-2021. Los datos se obtuvieron vía entrevistas y expedientes médicos. Se recogieron muestras anogenitales para investigación de VPH, tricomoniasis, gonorrea, clamidia, y citología.

Resultados: De 110 participantes, 60,9% y 34,5% se identificaron como hombres y mujeres, respectivamente. Se encontró una prevalencia general de VPH de 58,3%, significativamente mayor en mujeres (48,1%). En hombres, el VPH cervical fue positivo en 38%, el VPH anal en un 25%, con cambios citológicos en 9,5%. Las mujeres con citología anal alterada representaron 23,5%. Otras infecciones de transmision sexual: clamidia (4,1%), tricomoniasis (12,5%), ningún caso de gonorrea.

Conclusión: VPH es una infección prevalente con riesgos de alteraciones citológicas en esta población. Se necesitan más estudios sobre prevalencia e impactos en la salud sexual para fundamentar políticas de detección y prevención.

MeSH terms

  • Adolescent
  • Adult
  • Anal Canal*
  • Anus Diseases / epidemiology
  • Anus Diseases / virology
  • Brazil / epidemiology
  • Cervix Uteri / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Papillomavirus Infections* / epidemiology
  • Prevalence
  • Sexually Transmitted Diseases / epidemiology
  • Transgender Persons* / statistics & numerical data
  • Young Adult

Grants and funding

This article received financial support from the Ministry of Health/Pan American Health Organization, under cooperation agreement 66-111/2017, with a total amount of BRL 210,000.00, as part of the Multidisciplinary Outpatient Clinic for Gender Diversity project.