目的:Papanicolaou(Pap)测试过程中细胞收集不令人满意,无法检测到宫颈癌和异型增生。先前的研究发现,跨男性(TM)个体比顺性别女性更有可能进行令人不满意的巴氏试验。这项研究的目的是确定使某些TM个体比其他人面临不满意的Pap测试更大风险的因素。方法:在2015年至2016年之间,150名TM成年人参加了一项横断面调查,评估人口统计学,健康特征,医疗保健经验,外伤史,和不令人满意的巴氏试验历史。2020年进行的双变量和多变量逻辑回归分析检查了年龄之间的关联,睾丸激素的时间长度,吸烟史,必须教育提供者了解变性人接受适当的护理,预期的医疗保健耻辱,创伤后应激障碍(PTSD)症状,和不令人满意的巴氏试验的终生历史。结果:在所有参与者中,20.2%的人在他们的一生中有不令人满意的测试,年龄从21岁到50岁,55.1%使用睾酮1年或更长时间,41.3%有PTSD症状。在多变量模型中,年龄较大(调整后比值比[AOR]=1.15;95%置信区间(CI)=1.04-1.27;p<0.01),1年或更长时间使用睾丸激素(AOR=3.51;95%CI=1.02-12.08;p=0.046),和PTSD症状(AOR=3.48;95%CI=1.10-11.00,p=0.03)与不满意的Pap测试的几率显着相关。结论:年龄较大,睾丸激素的使用,在TM成年人中,PTSD症状与终生不满意的Pap测试有关。临床医生应在Pap测试之前评估TM患者的创伤和睾丸激素使用史,并利用创伤知情的做法,以促进收集足够的Pap样本。
Purpose: Unsatisfactory collection of cells during Papanicolaou (Pap) tests prevents the detection of cervical cancer and dysplasia. Prior research found that trans masculine (TM) individuals are significantly more likely than cisgender women to have an unsatisfactory Pap test. The purpose of this study was to identify factors that place some TM individuals at greater risk for an unsatisfactory Pap test than others. Methods: Between 2015 and 2016, 150 TM adults were enrolled in a cross-sectional survey assessing demographics, health characteristics, health care experiences, trauma history, and unsatisfactory Pap test history. Bivariate and multivariable logistic regression analyses conducted in 2020 examined associations between age, length of time on testosterone, smoking history, having to educate a provider about transgender people to receive appropriate care, anticipated health care stigma, post-traumatic stress disorder (PTSD) symptoms, and lifetime history of unsatisfactory Pap tests. Results: Of all participants, 20.2% had an unsatisfactory test in their lifetime, age ranged from 21 to 50 years, 55.1% used testosterone for 1 year or more, and 41.3% had PTSD symptoms. In the multivariable model, older age (adjusted odds ratio [AOR] = 1.15; 95% confidence interval (CI) = 1.04-1.27; p < 0.01), 1 year or more lifetime testosterone use (AOR = 3.51; 95% CI = 1.02-12.08; p = 0.046), and PTSD symptoms (AOR = 3.48; 95% CI = 1.10-11.00, p = 0.03) were significantly associated with increased odds of having an unsatisfactory Pap test. Conclusions: Older age, testosterone use, and PTSD symptoms are associated with lifetime unsatisfactory Pap tests among TM adults. Clinicians should assess TM patients\' trauma and testosterone use history before Pap tests and utilize trauma-informed practices that facilitate the collection of adequate Pap samples.