Abstract：
OBJECTIVE: Currently, available data on preventive measures for Human Papillomavirus (HPV) infection and cervical cancer in the transgender assigned female at birth (AFAB) community are extremely limited. Our aim was to analyze adherence to primary and secondary cervical cancer prevention screening programs among transgender AFAB people attending our gender clinic.
METHODS: Transgender AFAB people attending our center were recruited. Anamnestic data were collected for each person through completion of a medical history form and medical records. Variables recorded included previous HPV vaccination, adherence to regional screening programs (Pap smear or HPV DNA test), subject age, duration of current or prior gender-affirming hormone therapy (GAHT) and whether gender affirmation surgery (GAS) with hysterectomy had been performed. Open questions regarding reasons for not undergoing screening tests were also included.
RESULTS: In this cross-sectional study, 263 AFAB transgender people were included, with a mean age of 30.6 ± 10.5 years. GAS with hysterectomy had been performed on 37.6 % of these people. Of our participants, 71.7 % who were born after 1998 (the first cohort to receive HPV vaccination invitations in Italy) had been vaccinated for HPV. Seventy-four-point-nine percent of participants who were still eligible for cervical screening had never undergone Pap smear or HPV DNA testing, whereas those who had undergone at least one cervical screening had done so on average 4.2 ± 4.5 years ago.
CONCLUSIONS: HPV vaccination prevalence in the AFAB transgender population born after 1998 is in line with the Italian AFAB general population. However, adherence to cervical cancer screening programs in the transgender AFAB population appears to be lower in comparison to the cisgender population. Further efforts are required from the medical community to enhance AFAB transgender people\'s adherence to HPV vaccination and to cervical screening.
METHODS: Transgender AFAB people attending our center were recruited. Anamnestic data were collected for each person through completion of a medical history form and medical records. Variables recorded included previous HPV vaccination, adherence to regional screening programs (Pap smear or HPV DNA test), subject age, duration of current or prior gender-affirming hormone therapy (GAHT) and whether gender affirmation surgery (GAS) with hysterectomy had been performed. Open questions regarding reasons for not undergoing screening tests were also included.
RESULTS: In this cross-sectional study, 263 AFAB transgender people were included, with a mean age of 30.6 ± 10.5 years. GAS with hysterectomy had been performed on 37.6 % of these people. Of our participants, 71.7 % who were born after 1998 (the first cohort to receive HPV vaccination invitations in Italy) had been vaccinated for HPV. Seventy-four-point-nine percent of participants who were still eligible for cervical screening had never undergone Pap smear or HPV DNA testing, whereas those who had undergone at least one cervical screening had done so on average 4.2 ± 4.5 years ago.
CONCLUSIONS: HPV vaccination prevalence in the AFAB transgender population born after 1998 is in line with the Italian AFAB general population. However, adherence to cervical cancer screening programs in the transgender AFAB population appears to be lower in comparison to the cisgender population. Further efforts are required from the medical community to enhance AFAB transgender people\'s adherence to HPV vaccination and to cervical screening.
摘要：
目标：目前，在出生时变性人(AFAB)的女性群体中,关于人类乳头瘤病毒(HPV)感染和宫颈癌预防措施的现有数据极为有限.我们的目的是分析参加我们性别诊所的跨性别AFAB患者对原发性和继发性宫颈癌预防筛查计划的依从性。
方法：招募参加我们中心的变性人AFAB。通过完成病史表和医疗记录收集每个人的记忆数据。记录的变量包括以前的HPV疫苗接种，坚持区域筛查计划（巴氏涂片或HPVDNA检测），受试者年龄,目前或之前的性别确认激素治疗(GAHT)的持续时间以及是否进行了性别确认手术(GAS)和子宫切除术.还包括有关未进行筛查测试的原因的开放性问题。
结果：在这项横断面研究中，包括263名AFAB变性人，平均年龄30.6±10.5岁。对这些人中的37.6％进行了GAS子宫切除术。在我们的参与者中，1998年以后出生的71.7％（意大利第一个接受HPV疫苗接种邀请的队列）已经接种了HPV疫苗。仍有资格进行子宫颈筛查的参与者中，有74％的人从未接受过子宫颈抹片检查或HPVDNA检测，而那些至少接受过一次宫颈筛查的患者在平均4.2±4.5年前就接受了宫颈筛查.
结论：1998年以后出生的AFAB跨性别人群的HPV疫苗接种率与意大利AFAB普通人群一致。然而,与顺式人群相比,跨性别AFAB人群对宫颈癌筛查计划的依从性似乎较低.医学界需要进一步努力，以提高AFAB变性人对HPV疫苗接种和子宫颈筛查的依从性。
方法：招募参加我们中心的变性人AFAB。通过完成病史表和医疗记录收集每个人的记忆数据。记录的变量包括以前的HPV疫苗接种，坚持区域筛查计划（巴氏涂片或HPVDNA检测），受试者年龄,目前或之前的性别确认激素治疗(GAHT)的持续时间以及是否进行了性别确认手术(GAS)和子宫切除术.还包括有关未进行筛查测试的原因的开放性问题。
结果：在这项横断面研究中，包括263名AFAB变性人，平均年龄30.6±10.5岁。对这些人中的37.6％进行了GAS子宫切除术。在我们的参与者中，1998年以后出生的71.7％（意大利第一个接受HPV疫苗接种邀请的队列）已经接种了HPV疫苗。仍有资格进行子宫颈筛查的参与者中，有74％的人从未接受过子宫颈抹片检查或HPVDNA检测，而那些至少接受过一次宫颈筛查的患者在平均4.2±4.5年前就接受了宫颈筛查.
结论：1998年以后出生的AFAB跨性别人群的HPV疫苗接种率与意大利AFAB普通人群一致。然而,与顺式人群相比,跨性别AFAB人群对宫颈癌筛查计划的依从性似乎较低.医学界需要进一步努力，以提高AFAB变性人对HPV疫苗接种和子宫颈筛查的依从性。
