Barriers to Cervical Cancer Screening among transgender men / Barreiras ao exame do Câncer do Colo do Útero entre homens transgêneros

Abstract

Purpose: to evaluate the barriers to cervical cancer screening among transgender men, and also to understand their experiences and preferences for cervical cancer screening. Methods: 19-item online survey structured based on the Health Belief Model, a conceptual formulation for understanding why individuals do or do not engage in health-related actions. It consists of the following dimensions: perceived susceptibility, perceived severity, perceived benefits, perceived barriers and general health motivation. Familiarity with cervical cancer, with Human Papillomavirus (HPV) and with Pap Test, being up-to-date on Pap Tests and preference for HPV self-sampling were additionally assessed. Results: 27 transgender men aged 18-51 years completed the survey. Most of them have a formal job, income up to 1 minimum wage per month, and are health-insured. The majority is single, heterossexual, and completed high school. Despite the fact that most are familiar with HPV and cervical cancer and are aware of the importance of regular Pap Tests, less than 20% are up-to-date. The barriers to cervical cancer screening may be related to discrimination, fear of invasive procedures and also the gaps in preventive health care associated with Covid-19. Only 25.9% of participants preferred HPV self-sampling over provider-collected Pap Test screening. Conclusion: most participants were not up-to-date on Pap Test screening, and refer unpleasant experiences in the past, discrimination and fear of invasive procedures. Healthcare professionals should be aware of the needs of this specific population, in order to provide better care and to affirm the gender identity.