Cervical Cancer Screening Preferences Among Trans-Masculine Individuals: Patient-Collected Human Papillomavirus Vaginal Swabs Versus Provider-Administered Pap Tests
Cervical Cancer Screening Preferences Among Trans-Masculine Individuals: Patient-Collected Human Papillomavirus Vaginal Swabs Versus Provider-Administered Pap Tests
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DOI：
10.1089/lgbt.2016.0187
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发表时间：
2017-08-01
期刊：
影响因子：
4.8
通讯作者：
Potter, Jennifer
中科院分区：
文献类型：
--
作者：
McDowell, Michal;Pardee, Dana J.;Potter, Jennifer
目的：跨男性（TM，即，具有男性谱系性别身份但出生时被指定为女性的人）与顺性别妇女相比，在宫颈癌筛查率方面存在差异。在这一人群中进行筛查的一些独特障碍是巴氏试验所特有的。引入自收集正面（即，阴道）拭子进行人乳头瘤病毒（HPV）检测作为一种筛查策略可能会消除这些障碍。本研究阐明了宫颈癌筛查的喜好TM individual.Methods之间：TM个人参加了深入访谈（n=31）和在线调查（n=32），探讨有关宫颈癌筛查的看法和经验，包括接受自我收集的正面HPV拭子宫颈癌筛查相比，提供者管理的巴氏试验。提供者收集的正面HPV拭子的可接受性也explored.Results：大多数TM个人（94%的人和91%的在线参与者）喜欢自我或提供者收集的正面HPV拭子的巴氏试验。与巴氏试验相比，参与者认为自我和提供者收集的正面HPV拭子侵入性较小，引起的性别不一致较少，并促进了更大的代理感。然而，一些参与者对HPV拭子的准确性表示担忧，并且对于自我采集的拭子，他们可能不想承认需要接触生殖器感到不适。个人谁报告积极的供应商关系发现巴氏试验和供应商收集的正面拭子更可以接受的比那些谁没有。结论：正面HPV拭子有可能促进定期宫颈癌筛查TM个人之间，缩小筛选差距。目前正在开展工作，以确定拭子的准确性，并开发共同的决策工具。
Purpose: Trans-masculine (TM, i.e., persons who have a masculine spectrum gender identity, but were assigned female sex at birth) individuals face disparities in cervical cancer screening rates compared to cisgender women. Some unique barriers to screening in this population are specific to Pap tests. Introduction of self-collected frontal (i.e., vaginal) swabs for human papillomavirus (HPV) testing as a screening strategy may obviate these barriers. This study elucidates cervical cancer screening preferences among TM individuals.Methods: TM individuals participated in in-depth interviews (n=31) and online surveys (n=32) to explore perceptions and experiences regarding cervical cancer screening, including the acceptability of self-collected frontal HPV swabs for cervical cancer screening compared to provider-administered Pap tests. Provider-collected frontal HPV swab acceptability was also explored.Results: Most TM individuals (94% in-person and 91% online participants) preferred either the self- or provider-collected frontal HPV swab to the Pap test. Participants perceived self- and provider-collected frontal HPV swabs to be less invasive, provoke less gender discordance, and promote a greater sense of agency compared to Pap tests. However, some participants expressed concern about HPV swab accuracy and, regarding the self-collected swab, discomfort about the need to engage with genitals they may not want to acknowledge. Individuals who reported positive provider relationships found Pap tests and provider-collected frontal swabs more acceptable than those who did not.Conclusion: Frontal HPV swabs have the potential to promote regular cervical cancer screening among TM individuals and to narrow screening disparities. Work is ongoing to establish swab accuracy and develop shared decision-making tools.