Human Papillomavirus Positivity at 3 Anatomical Sites Among Transgender Women in Central Brazil

Brunna Rodrigues de Oliveira, Bruno Vinícius Diniz e Silva, Kamila Cardoso dos Santos, Karlla Antonieta Amorim Caetano, Giana Mota, Vera Aparecida Saddi, Sílvia Helena Rabelo-Santos, Luísa Lina Villa, Krishna Vaddiparti, Robert L. Cook, Sheila Araujo Teles, Megmar Aparecida dos Santos Carneiro

Although transgender women (TGW) are susceptible to acquiring sexually transmitted infections (STIs), such as human papillomavirus (HPV), the exact data for this population are limited. We estimated the prevalence of HPV infection in the anal, genital, and oral sites among TGW. In addition, we identified the related characteristics and behaviors as risk factors for HPV infection among a sample of TGW in Brazil. Furthermore, we characterized the site-specific HPV genotypes among those who were positive for HPV at the three sites. A cross-sectional study of TGW in the city of Goiânia (Central-Midwest region), Brazil, was conducted between April 2018 and August 2019. Respondent Driven Sampling (RDS) was used for recruitment. Next, self-collected anal, genital, and oral samples were examined for HPV DNA using polymerase chain reaction (PCR) (SPF-10 primer). HPV genotypes were identified in 12 TGW. Among the 268 participants in this study, the prevalence of anal, genital, and oral HPV was 81.9% (95% confidence interval (CI): 76.5-86.5), 40.1% (95% CI: 33.4-47.1), and 10.4% (95% CI: 7.0-14.7), respectively. Additionally, most of the 12 participants tested for HPV had multiple genotypes. Furthermore, HPV-52 was the most prevalent genotype identified in the anal (66.6%) and genital (40.0%) sites, whereas HPV-62 and HPV-66 were most common in the oral site (25.0%). A high prevalence of HPV was observed among TGW. Therefore, additional epidemiological studies on HPV genotypes should generate health intervention information, which includes preventing, diagnosing, and treating STIs.